Weekending Phenomenon: Alcohol use, HAART non-adherence, and provider communication among people living with HIV

Little is understood about determinants of alcohol use and/or drinking patterns among people living with HIV (PLWH). We conducted a cross-sectional study to examine patterns of alcohol use among our population of PLWH and their effects on highly active antiretrovial therapy (HAART) adherence. In addition, we assessed provider knowledge of alcohol use behaviors. An alcohol use questionnaire was administered to 50 alcohol-using PLWH in Miami, Florida, and medical records were reviewed to assess provider's awareness of alcohol use. Data was analyzed to describe population demographics and explore potential associations between patterns of alcohol use and HIV outcomes. Thirty-eight percent of the sample met the National Institute on Alcohol Abuse and Alcoholism's criteria for hazardous drinking and 20% reported “weekending,” a behavioral phenomenon we described as drinking more on the weekends and intentionally skipping HAART due to planned alcohol use. Seventy-three percent of providers' notes indicated participants abstained from alcohol, yet 100% of our sample used alcohol. We concluded that HIV providers' lack of knowledge regarding alcohol use patterns may contribute to the high prevalence of weekending and other hazardous drinking behaviors linked to HAART non-adherence. Larger studies are warranted to determine if our findings can be generalized to other populations and to better understand the impact of provider communication on alcohol use among PLWH.