The Relationship of Alcohol to ART Adherence Among Black MSM in the U.S.: Is it Any Different Among Black MSM in the South?

Shantrel S Canidate,Robert L Cook,Christina Parisi,Nioud Mulugeta Gebru,Stephen Maisto,Robert F Leeman,Eric W Schrimshaw,Noelani Powers,Nancy Schaefer,Sheldon Fields

doi:10.1007/s10461-021-03479-3

Abstract

Alcohol-using Black MSM (Men who have sex with men) are disproportionately impacted by HIV in the U.S.—particularly in the southern U.S.—despite the availability of antiretroviral therapy (ART). The purpose of this study was to summarize the current evidence on alcohol use and ART adherence among Black MSM in the U.S. and in the South and to identify future research needs. A systematic review was conducted using eight databases to identify relevant peer-reviewed articles published between January 2010 and April 2021. The authors also snowballed remaining studies and hand-searched for additional studies. Including both quantitative and qualitative studies, five published studies examined alcohol and ART adherence among Black MSM in the U.S. The search identified 240 articles, the study team reviewed 114 in full-text and determined that only five met the inclusion criteria. Three of the five included studies identified alcohol use as a barrier to ART adherence. In conclusions, the general lack of literature on HIV disparities among alcohol-using Black MSM in the U.S. (specifically in the South) indicates a critical need for research on this population’s unique risks and needs to inform the development of tailored interventions.

Highlights

Black/African American men who have sex with men (MSM) in the United States (U.S.) experience HIV-related disparities that may directly or indirectly be exacerbated by alcohol use
Despite the effectiveness of treatment as prevention approaches (TasP) such as antiretroviral therapy (ART) in reducing the transmission of HIV, substantial evidence suggests that Black MSM in the U.S are less likely to adhere optimally to ART compared to other MSM [1,2,3]
We found no systematic review of the literature examining the association between alcohol use and ART adherence among Black MSM in the U.S overall nor in the South

Summary

Introduction

Black/African American (referred hereafter as Black) men who have sex with men (MSM) in the United States (U.S.) experience HIV-related disparities that may directly or indirectly be exacerbated by alcohol use. This is the case in the southern US. Despite the effectiveness of treatment as prevention approaches (TasP) such as antiretroviral therapy (ART) in reducing the transmission of HIV, substantial evidence suggests that Black MSM in the U.S are less likely to adhere optimally to ART compared to other MSM [1,2,3]. The goals of the paper were to summarize the current evidence on alcohol use and ART adherence among Black MSM in the South and to identify future research needs.

Objectives

Methods

Results

Discussion

Conclusion