Trends in Alcohol Use Before and During the COVID-19 Pandemic Among Women Living With and Without HIV in the United States (2017-2022).

Data on alcohol use trends in women living with HIV (WLWH) are lacking. We examine data collected before and across the COVID-19 pandemic (2014-2022) in WLWH and socio-demographically similar women living without HIV (WLWOH)(n = 1564; 67% WLWH) who self-reported alcohol use to establish and compare trends. Women were categorized into baseline groups based on use pattern from 10/2014 to 09/2017: abstinence (no alcohol at any visit), non-heavy drinking (0 heavy drinking visits), some heavy drinking (1-4 visits), and persistent heavy drinking (5-6 visits) with heavy drinking defined as > 7 drinks/week or > 3 drinks/day. A linear mixed model (LMM) was used to assess for changes in average number of drinks/week (ADW) by time segment: pre-pandemic (10/2017-09/2019), early pandemic (08/2020-05/2021), and late pandemic (06/2021-09/2022). Time, baseline group, and HIV status were included as interactions. In the LMM, WLWH with persistent heavy drinking histories had lower ADW compared to WLWOH. There were no significant differences in ADW in the other groups by HIV status and no significant interactions between HIV status and the time segments. The largest change in ADW occurred among the persistent heavy drinking group, with decreases at pandemic onset followed by increases into 2021. Overall, WLWH reported less alcohol use than WLWOH, but changes in alcohol use trends from 10/2017 to 09/2022 were similar regardless of HIV status. This suggests that the pandemic did not uniquely impact alcohol use among WLWH, rather socio-economically disadvantaged women generally. These findings support the need for greater research in the role of socioeconomic disruption on alcohol use among women.