Alcohol and HIV
Alcohol use can have negative effects on both the body and behavior of an individual living with HIV. Regular consumption of alcohol can weaken the immune system and damage the liver, as well as lead to risky behaviors that increase the chance of getting HIV or passing it on to others.
The Relationship Between Alcohol and HIV
Many people that are diagnosed with HIV continue to drink alcohol despite their medical condition for a variety of reasons, including recreational purposes and self-medication. Alcohol relaxes the brain and body, which can help relieve stress, encourage relaxation, and act as an appetite stimulant. Individuals living with HIV may be dealing with a significant amount of emotional distress and alcohol can seemingly provide temporary relief. However, the combination of alcohol and HIV can also alter mood and lead to numerous physical, psychological, and social problems.
The effects of alcohol have been proven to be more pronounced for HIV+ individuals. According to a study performed by Yale University, people living with the illness report feeling more “drunk” with less alcohol than those who don’t have HIV, and are more likely to forget to take their medications when drinking than people without HIV. This suggests that HIV infection makes the brain particularly vulnerable to alcohol’s effects and the substance can cause a great deal of damage if used consistently. The areas most affected by alcohol use are those responsible for short-term memory, fast mental processes and movements, and decision making. Researchers noted that HIV patients who have even just one or two drinks a day are at greater risk for death and other alcohol-related health issues than non-infected individuals.
What Is HIV?
HIV (Human Immunodeficiency Virus) is a virus spread through certain bodily fluids that attacks the body’s immune system, specifically CD4 cells, which help the immune system fight off infections. Untreated, HIV quickly reduces the number of CD4 cells in the body, making the person more likely to get other infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease.
Without treatment, HIV advances in stages, overwhelming the immune system and getting worse over time. The three stages of HIV infection are: (1) acute HIV infection, (2) clinical latency, and (3) AIDS (Acquired Immunodeficiency Syndrome). AIDS is the most severe phase of HIV infection. People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses and cancers, called opportunistic infections.
There is currently no effective cure for HIV, but the disease can be controlled with proper medical care. The medicine used to treat HIV is called antiretroviral therapy (ART). If taken every day as prescribed, the viral load of HIV in the blood can become undetectable. ART can dramatically prolong the lives of people infected with HIV, improve health, and greatly lower their chance of infecting others. Before the introduction of ART as a viable treatment in the mid-1990s, people with HIV could progress to AIDS in as little as a year. Today, someone diagnosed with HIV and treated before the disease advances can live just as long as someone who does not have HIV.
In order for HIV to be transmitted, the virus must be present and must enter the body via bodily fluids.
Bodily fluids that can contain HIV:
- Blood (including menstrual blood)
- Semen and pre-seminal fluid
- Vaginal secretions
- Breast milk
HIV is most commonly transmitted through vaginal, oral, or anal sex, but can also be contracted by the sharing of needles when shooting drugs, accidental needle sticks, blood transfusions, childbirth, and organ transplantation. Most people with HIV don’t look sick, and a good number of people that are infected have no idea they have the disease because they have not been tested for it. To avoid getting HIV, it’s important to always have protected sex and be aware of your partner’s medical history. Additionally, always use a clean needle if injecting drugs and seek immediate medical care if pregnant.
How Does Alcohol Use Affect a Person with HIV?
Alcohol use can have negative effects on both the body and behavior of an individual living with HIV. Regular consumption of alcohol can weaken the immune system and damage the liver, as well as lead to risky behaviors that increase the chance of getting HIV or passing it on to others. Research has shown that people with HIV who regularly drink alcohol tend to have a higher viral load and lower overall CD4 count.
Weakened Immune System
Drinking too much alcohol actively weakens the immune system, and when an individual has HIV, their immune system is already damaged. A weaker immune system will have a harder time fighting off common infections (such as a cold), as well as HIV-related infections. A weaker immune system also increases the chance that those with the disease will experience more side effects from their HIV medications. Additionally, alcohol has a major effect on the liver. For HIV+ people that also have Hepatitis B or C, even small amounts of alcohol can speed up liver damage. It can also increase one’s cholesterol levels, which is already at a high-risk of increasing while on HIV meds.
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Impaired Decision Making
Drinking alcohol can make it hard to think clearly and affect someone’s ability to make smart and responsible decisions. For example, an HIV+ individual that has been drinking might not use a condom or tell their partner that they are infected with the virus. In the United States, HIV is most commonly spread by having anal or vaginal sex with someone who has HIV without using a condom. Unprotected sex can also lead to sexually transmitted diseases, which can divert the immune system’s resources away from fighting HIV and increase the chances of getting sick. Infections like herpes and gonorrhea tend to be more severe in people with HIV.
In addition to engaging in unprotected sex, drinking too much can make it hard for individuals to take their medications correctly. Research has shown that people with HIV who drink alcohol are more likely to miss doses of their treatment than those who don’t. In one study of alcohol use and HIV medication adherence, it was found that on days in which participants drank, they were 9 times more likely to miss a dose, and that each drink they had increased the odds of their missing a dose by 20%.
If heavy alcohol use prevents people from taking their antiretroviral regimens effectively, there can be potential consequences for both their own health and that of their sex partners. Current research indicates that HIV treatment doubles as HIV prevention by reducing viral load – less virus in the body means lower likelihood of passing it onto others through unprotected sex.
Negative Psychological Effects
Alcohol use can also have negative mental health consequences for someone living with HIV. Alcohol is a depressant and can exacerbate certain conditions such as anxiety and depression. A recent study found that depression is the most commonly observed mental health disorder among those diagnosed with HIV, affecting 22% of the population. Common emotions after being diagnosed with HIV are sadness and grief, and alcohol may initially provide temporary relief from these emotions; however, it actually makes depression worse. Many people with HIV may also feel isolated from the rest of society due to their condition, and alcohol can intensify these feelings and even lead to suicidal thoughts. Depression can cause HIV-infected individuals to stop taking their medications, going to medical appointments, and to actively stop engaging in personal care.
Get Help for Alcohol Abuse and HIV
Alcohol can negatively impact the progression of HIV, both on the body and through behavior. There are no established “safe” levels of alcohol use for HIV+ individuals and alcohol consumption should be as limited as possible. If you’re someone that’s living with HIV and struggles with alcohol consumption, contact a dedicated treatment professional today. They are here to help and answer any questions that you may have.
- Medical Reviewer — Last Reviewed: July 9, 2019
Artavia, David. (2017). Mixing Alcohol With Your HIV Meds: What You Need to Know. Retrieved on 3rd May 2019 from https://www.hivplusmag.com/medications/2017/5/02/mixing-alcohol-your-hiv-meds-what-you-need-know
Brown University Alcohol Research Center on HIV. (2019). Information For Those Living With HIV. Retrieved on 3rd May 2019 from https://www.brown.edu/academics/medical/alcohol-research-center-on-hiv/information-those-living-hiv-4
HIV.gov. (2019). About HIV & AIDS: What Are HIV and AIDS? Retrieved on 6th May 2019 from https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids
San Francisco AIDS Foundation. (2012). Alcohol & HIV: What You Need to Know. Retrieved on 3rd May 2019 from http://www.sfaf.org/hiv-info/hot-topics/from-the-experts/hiv-alcohol-what-you-need-to-know.html
University of California, San Francisco. (2019). How Do You Get (and Avoid Getting) HIV? Retrieved on 7th May 2019 from http://hivinsite.ucsf.edu/hiv?page=basics-00-05
U.S. Department of Health and Human Services. (2019). HIV and Drug and Alcohol Users. Retrieved on 3rd May 2019 from https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/25/84/hiv-and-drug-and-alcohol-users
U.S. Department of Veteran Affairs. (2019). Drugs, Alcohol and HIV. Retrieved on 3rd May 2019 from https://www.hiv.va.gov/patient/daily/alcohol-drugs/index.asp
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