ArticleAlcohol, clinical & experimental research2025
Harmonization of alcohol use data and mortality across a multi-national HIV cohort collaboration.
Article in Alcohol, clinical & experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Alcohol consumption and oral human papillomavirus infection among men living with HIV: a cross-sectional study from the ULACNet 201 trial.Scientific reports · 2026Trial
- Syndemic Classes of Unhealthy Alcohol Use Reveal Inequities in Alcohol-Related Consequences and HIV Care Outcomes.Alcohol, clinical & experimental research · 2026Article
- Maladaptive Coping Strategies Mediate the Relationship Between Depression and Anxiety and Moderate-to-Heavy Alcohol Use in Young South Africans with HIV.AIDS and behavior · 2026Article
- Harmonization of alcohol use data and mortality across a multi-national HIV cohort collaboration.Alcohol, clinical & experimental research · 2025Article
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Authors and funding
22 authors.
Funding
Abstract
backgroundAlcohol use is measured in diverse ways across settings. Harmonization of measures is necessary to assess effects of alcohol use in multi-cohort collaborations, such as studies of people with HIV (PWH).
methodsData were combined from 14 HIV cohort studies (nine European, five North American) participating in the Antiretroviral Therapy Cohort Collaboration. We analyzed data on adult PWH with measured alcohol use at any time from 6 months before starting antiretroviral therapy. Five cohorts measured alcohol use with AUDIT-C and others used cohort-specific measures. We harmonized alcohol use as grams/day, calculated using country-level definitions of a standard drink. For Alcohol Use Disorders Identification Test (AUDIT-C), we used Items 1 (frequency) and 2 (number of drinks on a typical day). Where alcohol was measured in categories, we used the mid-point to calculate grams/day. We used multivariable Cox models to estimate associations of alcohol use with mortality.
resultsAlcohol use data were available for 83,424 PWH, 22,447 (27%) had AUDIT-C measures and 60,977 (73%) recorded the number of drinks/units per week/day. Of the sample, 19,150 (23%) were female, 54,006 (65%) had White ethnicity, and median age was 42 years. Median alcohol use was 0.3 g/day (interquartile range [IQR] 0-4.8) and 0 g/day (IQR 0-20) for those with and without AUDIT-C. There was a J-shaped relationship between grams/day and mortality, with higher mortality for PWH reporting no alcohol use (adjusted hazard ratio [aHR] 1.46; 95% CI: 1.23-1.72) and heavier (>61.0 g/day) alcohol use (aHR 1.92; 1.41-2.59) compared with 0.1-5.5 g/day among those with AUDIT-C measures. Associations were similar among those with non-AUDIT-C measures.
conclusionsGrams/day is a useful metric to harmonize diverse measures of alcohol use. Magnitudes of associations of alcohol use with mortality may differ by setting and measurement method. Higher mortality among those with heavier alcohol use strengthens the case for interventions to reduce drinking.
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