Vol.:(0123456789) 1 3
AIDS and Behavior
https://doi.org/10.1007/s10461-019-02709-z
ORIGINAL PAPER
Motivation to Quit Drinking in Individuals Coinfected with HIV
and Hepatitis C
Jumi Hayaki
1
· Bradley J. Anderson
2
· Debra S. Herman
2,3
· Ethan Moitra
3
· Megan M. Pinkston
3,4
· H. Nina Kim
5,6
·
Michael D. Stein
7
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Alcohol consumption is common among individuals coinfected with HIV and hepatitis C (HCV) despite the uniquely harm-
ful efects in this population. Limited research has examined factors that could infuence drinking reduction or cessation
among HIV/HCV coinfected persons; this study investigates motivation to quit. Participants were 110 alcohol-consuming
HIV/HCV coinfected patients recruited from medical clinics. Participants self-reported 90-day drinking frequency and
intensity; alcohol-related problems; reasons to quit drinking; reasons to drink; and motivation to quit drinking. Participants
consumed alcohol on 54.1 (± 26.9) of the past 90 days. In a multivariate model that controlled for demographic variables,
motivation to quit drinking was directly associated with alcohol-related problems (β
y·x
= 0.35, p = .007) and reasons to quit
drinking (β
y·x
= 0.23, p = .021), and inversely associated with drinking for enhancement (β
y·x
= − 0.36, p = .004). This study
identifed several factors associated with motivation to quit drinking in a sample of alcohol-consuming HIV/HCV patients.
Keywords Motivation to quit · Alcohol consumption · HIV/HCV coinfection
Introduction
Hazardous drinking is common among persons living with
HIV (PLWH) [1] and may cause unique harm in this popu-
lation. For instance, even at lower levels of alcohol con-
sumption, PLWH experience increased mortality and phys-
ical injury compared to their uninfected counterparts [2].
Alcohol use is also known to compromise both adherence
to antiretroviral therapy [3, 4] and retention in HIV care [5],
exacerbate HIV pathogenesis [6, 7], and correlate with mul-
tiple medical and psychiatric comorbidities [8, 9]. Problem
drinkers with HIV are less likely to seek treatment for their
drinking than uninfected individuals [10], and many PLWH
appear unaware of the medical risks associated with their
alcohol use [11] or continue drinking despite knowledge of
the risks [12]. In particular, drinking to cope with negative
afect appears to be associated with continued heavy drink-
ing in PLWH [13]. Interventions to reduce drinking among
PLWH have produced mixed results, with some reviews
reporting limited success [10] and others reporting success
[14].
Excessive drinking is frequent among individuals with
hepatitis C (HCV) infection, who also experience uniquely
harmful negative alcohol-related consequences [15]. For
instance, alcohol consumption exacerbates the underlying
liver disease associated with HCV [16, 17]. In a parallel
to the HIV literature, many drinkers with HCV do not
seek alcohol-related care [18] or continue drinking despite
knowledge of its negative efects [19, 20]. Drinking to
cope with negative afect and to socialize [21] is common
in this population, and the former is especially associated
* Jumi Hayaki
jhayaki@holycross.edu
1
Department of Psychology, College of the Holy Cross, P.O.
Box 217A, Worcester, MA 01610, USA
2
Behavioral Medicine and Addictions Research Unit, Butler
Hospital, Providence, RI, USA
3
Department of Psychiatry and Human Behavior, Alpert
Medical School of Brown University, Providence, RI, USA
4
Lifespan Physicians Group, Providence, RI, USA
5
Department of Global Health, University of Washington,
Seattle, WA, USA
6
Department of Medicine, University of Washington, Seattle,
WA, USA
7
Department of Health Law, Policy and Management, Boston
University School of Public Health, Boston, MA, USA