By Jill Pease • Published: October 26th, 2011
University of Florida researchers have received a $2.7 million grant from the National Institute on Alcohol Abuse and Alcoholism to evaluate whether a common medication can help women with HIV reduce their alcohol consumption and improve their overall health.
“Alcohol consumption can be harmful in persons with HIV infection if it affects the ability to take medications on schedule, causes people to make poor decisions, or has direct harmful effects on the immune system or other parts of the body,” said the study’s lead investigator Robert Cook, M.D., M.P.H., an associate professor of epidemiology and medicine at the UF College of Public Health and Health Professions and the College of Medicine. “It is the same with any chronic disease, such as diabetes. Our goals are to identify simple and acceptable treatment options that can help reduce these harmful effects.”
More than 290,000 women in the United States are living with HIV/AIDS, according to the Kaiser Family Foundation. Florida ranks second among U.S. states for the number of women with the disease. Miami and Jacksonville are among the nation’s urban areas most affected by HIV/AIDS, along with Baton Rouge, La., New York City and Washington, D.C.
“Florida is unique in terms of its racial and ethnic diversity, which will allow us to better understand ongoing health disparities related to HIV,” said Cook, who is also affiliated with the UF division of general internal medicine and the UF Emerging Pathogens Institute.
In an earlier long-term study of alcohol consumption in women with HIV, Cook and colleagues found that 14 percent to 24 percent of the women reported hazardous drinking in the past year. Hazardous alcohol consumption is defined as having four or more drinks daily or seven or more drinks in a week. Previous studies have shown elevated risk for adverse health effects in people with HIV who consume hazardous amounts of alcohol, including higher levels of HIV virus, lower medication adherence, increased risky sexual behavior and more rapid disease progression.
UF researchers, with colleagues from Florida International University and the University of Miami, will study whether the prescription medication naltrexone can reduce hazardous drinking in women with HIV and improve their health outcomes. Naltrexone has been found to decrease alcohol use in previous studies of men with severe drinking problems, but has not been tested exclusively in women or in people with HIV infection, Cook said. Researchers also will assess important clinical measures, such as adherence to HIV medications, white blood cell counts, levels of HIV virus present in the body and risky sexual behavior.
The study is one of three involving Florida universities to examine alcohol consumption in women with HIV. Cook serves as director of this Florida consortium, which brings together a team of investigators from UF, Florida International University and the University of Miami, as well as Rush University in Chicago. Together, the three studies total $5 million in funding from the National Institute on Alcohol Abuse and Alcoholism.
“Florida is a key state for the National AIDS Strategy,” said Kendall J. Bryant, Ph.D., director of alcohol and HIV/AIDS research at the National Institute on Alcohol Abuse and Alcoholism. “We must understand the dynamics of the many cultures that live there to effectively address the role of alcohol use and the prevention and treatment of HIV/AIDS. Translating what we already know about alcohol misuse and about HIV prevention and treatment will take a talented team of scientists and practitioners working together in Florida.”
Maria Jose Miguez, M.D., Ph.D., a professor in the School of Integrated Science and Humanity at Florida International University, will serve as the South Florida site principal investigator and will lead a study of possible connections between alcohol consumption, cholesterol and serious long-term outcomes in women with HIV infection. In the third study, Seema Desai, Ph.D., an assistant professor of microbiology and immunology at Rush University, will focus on the direct effects of alcohol consumption on the immune system over time. Participants in the new studies will be recruited primarily from the Miami and Fort Lauderdale areas.
“This research partnership shows the power of Florida universities when they work together and represents an important public health collaboration to benefit our state and local communities,” said Linda B. Cottler, Ph.D., chair of the UF department of epidemiology. “This work will also provide valuable opportunities for our students to learn research design and methods.”
Other UF team members on the study include Babette Brumback, Ph.D., an associate professor in the department of biostatistics, and Jeffrey Harman, Ph.D., an associate professor in the department of health services research, management and policy. Co-investigators from the University of Miami include Luis Espinoza, M.D., an associate professor of clinical medicine, and John Lewis, Ph.D., a research assistant professor of psychiatry and behavioral sciences.