Factors associated with missed antiretroviral therapy doses due to alcohol use among individuals with alcohol use disorder (AUD) living with HIV in San Francisco Bay Area, California.

Alcohol use is associated with antiretroviral therapy (ART) non-adherence among individuals living with HIV. We examined prevalence and factors associated with missed ART doses due to alcohol use among 111 sexually active individuals and 46 sexual minority men (SMM) with alcohol use disorder (AUD) living with HIV in San Francisco Bay Area (SFBA). Separate modified Poisson regression models with robust standard errors were fitted while controlling for demographics. The analytic sample comprised cisgender males (77%), cisgender females (21%), transgender participants (2%), and 41% sexual minority men (SMM). Prevalence of missed ART doses due to alcohol use was 51% overall. Factors associated with missed ART due to alcohol use overall include: engaging in vaginal intercourse (1.73 [1.19, 2.52], p = 0.004), condomless vaginal intercourse (1.88 [1.26, 2.80], p = 0.002), while under the influence of alcohol and recent diagnosis with Syphilis (2.31 [1.38, 3.88], p = 0.001). Among SMM, 57% reported missing ART due to alcohol use. Engaging in condomless vaginal intercourse (1.79 [1.11, 2.90], p = 0.02), while under the influence of alcohol, and being diagnosed with Syphilis (2.33 [1.28, 4.23], p = 0.01) were associated with missed ART doses due to alcohol among SMM. These findings highlight the need for integrating alcohol use interventions into HIV care for these populations.