Changes in Alcohol Use are Associated With Changes in Depression Severity Among People With HIV.

OBJECTIVES: High-risk alcohol use is associated with depressive symptoms. It is unclear if changes in alcohol use are correspondingly associated with changes in depression severity among people with HIV (PWH). METHODS: Data were from clinical assessments of patient-reported outcomes (PROs) completed by PWH receiving primary care at 7 sites of the Center for AIDS Research Network of Integrated Clinical Systems. Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) scores, range (lower to higher risk): 0-12, and Patient Health Questionnaire-9 (PHQ-9) scores, range for depressive symptom burden: 0-27 (≥10 indicative of clinically relevant depression), from PROs were identified as observation pairs (PHQ-9 and AUDIT-C on the same day) occurring 1-2 years apart. We used linear regression with clustered standard errors to estimate the association between changes in AUDIT-C and changes in PHQ-9 stratified by baseline alcohol consumption. RESULTS: A total of 7806 PWH contributed 13,302 observation pairs with a baseline mean age of 45.4 (SD: ±11.4); 15% were female and 55% identified with a non-White race/ethnicity. Each 1-point increase in AUDIT-C was associated with a 0.30-point (95% CI: 0.15-0.44), 0.26-point (95% CI: 0.14-0.37), and 0.20-point (95% CI: 0.10-0.30) increase in PHQ-9 for PWH with no alcohol use, low-to-moderate risk alcohol use, and high-risk alcohol use at baseline, respectively. Estimates were essentially stable after adjusting for sex, age, and race/ethnicity. CONCLUSIONS: There is a modest, statistically significant association between change in AUDIT-C and change in PHQ-9. These findings highlight the importance of routinely monitoring alcohol use and depression in HIV primary care settings. Future studies exploring causal directions are warranted.