injury to the lung. However, studies using animals suggest that this combination does indeed increase the risk for problems. Lung infections remain a major cause of illness and death in those with HIV, and chronic alcohol consumption has been found to increase the rate at which viruses infect lungs and aid in the emergence of opportunistic infections( i. e., rare viruses that infect only people whose immune systems are weakened by a condition like HIV infection).
10, 11
Advances in imaging techniques have revealed another organ at risk for HIV and alcohol injury— the brain. In studies comparing patients with alcoholism, HIV infection, or both, people with alcoholism had more changes in brain structure and abnormalities in brain tissues than those with HIV alone. Patients with HIV infection and alcoholism were especially likely to have difficulty remembering and to experience problems with coordination and attention. Those with alcoholism whose HIV had progressed to AIDS had the greatest changes in brain structure. 12
Preventing the Spread of HIV
In addition to these direct effects, alcohol also works indirectly to raise the risk for HIV and for the problems associated with this virus. For example, alcohol consumption often occurs in bars and clubs where people meet potential sex partners. These establishments create networks of at-risk people through which HIV can spread rapidly. In addition, alcohol abusers’ high-risk sexual behaviors make them more likely to be infected with other sexually transmitted diseases; those, in turn, increase the susceptibility to HIV infection. They also are more likely to abuse illegal substances, which can involve other risky behaviors, such as needle sharing. 6
Currently, the primary HIV prevention efforts seek to change people’ s risky sexual behaviors and to promote the use of barriers, such as topical microbicides and condoms, which kill the virus or reduce the spread of disease during sexual contact. Unfortunately alcohol use can interfere with these efforts, impairing people’ s judgment and making them less likely to use protection during sex.
Although people who abuse alcohol and other drugs can be a difficult population to reach, research shows that individuals in treatment programs are less likely to engage in risky sexual behavior 13 or to inject drugs or share needles 14— behaviors that greatly increase the spread of the infection. Thus, alcohol treatment itself can help prevent risky behaviors.
Also, some research suggests that looking at the places, where alcohol consumption and risky sexual behaviors take place( such as bars and clubs) can help in the development of social policy tools and successful interventions, 15 including targeting such environments with prevention messages16, 17 and providing HIV testing, condoms, and sexual health services at those establishments. 18
Societal Level
Neighborhood Level
Interpersonal Level
Individual Level
The Role of Alcohol in HIV / AIDS Risk
Individual Characteristics
Policy, Formal and Informal
Neighborhood Alcohol Environment
Alcohol Consumption
Social & Sexual Networks, Social Norms
High Risk Sexual Behavior
HIV Infection
Alcohol influences the risk for HIV / AIDS on a variety of levels, from the neighborhood( the number of bars and clubs) to the individual( his or her use of alcohol and other drugs as well as his or her sexual behavior). Policy, both formal and informal, can help to reduce these risks. For example, laws can dictate how many liquor stores can do business in a neighborhood.
SOURCE: Scribner, R.; Theall, K. P.; Simonsen, N.; and Robinson, W. HIV risk and the alcohol environment: advancing an ecological epidemiology for HIV / AIDS. Alcohol Research & Health 33( 3): 179 – 183, 2010.
Treatment— Targeting HIV and Alcohol
As noted previously, HIV-infected individuals who drink, even those who consume only low levels of alcohol, are less likely to comply with a strict ART regimen, which may increase the risk of AIDS. 19 Drinking fewer than five standard drinks per day, one or more times a week, has been found to reduce survival among patients with HIV by more than 1 year. Binge drinking( defined as five or more drinks per day) produces even more pronounced effects. Binge drinking twice a week was found to reduce survival rates by 4 years, and daily binge drinking reduced survival by 6.4 years, a 40-percent decrease in life expectancy. 20
When ART fails, the patient progresses to AIDS. The significance of this problem, along with alcohol’ s other negative effects on the success of ART,
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