{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:49:50Z","timestamp":1789649390075,"version":"4.0.0"},"reference-count":48,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Alcohol consumption is associated with poor health outcomes in women living with HIV (WLWH), but whether medication can help to reduce drinking in non\u2013treatment\u2010seeking women or whether reduction in drinking improves HIV outcomes is unclear. We conducted a randomized clinical trial (RCT) of daily oral naltrexone (50\u00a0mg) versus placebo in WLWH who met criteria for current unhealthy alcohol use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>WLWH with current unhealthy alcohol use (&gt;7\u00a0drinks\/wk or &gt;3\u00a0drinks\/occasion) were randomly assigned to daily oral naltrexone 50\u00a0mg (<jats:italic>n<\/jats:italic>\u00a0=\u00a096) or placebo (<jats:italic>n<\/jats:italic>\u00a0=\u00a098) for 4\u00a0months. Drinking outcomes, including the proportion of women who reduced (&lt;unhealthy use criteria) or quit drinking, were assessed at baseline, 2\u00a0months, 4\u00a0months (end of treatment), and 7\u00a0months. In a secondary analysis, HIV viral suppression and changes in CD4 counts were compared in women who did or did not reduce\/quit drinking, regardless of intervention assignment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The participants\u2019 mean age was 48\u00a0years, 86% were African American, and 94% were receiving HIV antiretroviral therapy. Among all participants, 89% and 85% completed the 4\u2010month and 7\u2010month follow\u2010ups, respectively. Participants in both groups substantially reduced drinking over time. At 1 and 3\u00a0months, naltrexone was associated with a greater reduction in drinking (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), but the proportion who reduced\/quit drinking at 4\u00a0months (52% vs. 45%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.36) or 7\u00a0months (64% in both groups) was not different. HIV viral suppression at follow\u2010up was significantly better in participants who reduced\/quit drinking versus those continuing unhealthy alcohol use at 4\u00a0months (72% vs. 53%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02) and 7\u00a0months (74% vs. 54%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Participating in an RCT to reduce drinking was associated with significant drinking reduction regardless of medication assignment, suggesting that nonmedication aspects of research study participation (e.g., repeated assessments and support from research staff) could be important interventions to help reduce drinking outside of research studies. Drinking reduction was associated with improved HIV viral suppression, providing evidence to support recommendations to avoid unhealthy alcohol use among WLWH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14130","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T14:10:19Z","timestamp":1562767819000},"page":"1790-1800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Reduction in Drinking was Associated With Improved Clinical Outcomes in Women With HIV Infection and Unhealthy Alcohol Use: Results From a Randomized Clinical Trial of Oral Naltrexone Versus Placebo"],"prefix":"10.1111","volume":"43","author":[{"given":"Robert L.","family":"Cook","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Florida Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3861-5911","authenticated-orcid":false,"given":"Zhi","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Florida Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jose","family":"Miguez","sequence":"additional","affiliation":[{"name":"School of Integrated Science and Humanity Florida International University Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clery","family":"Quiros","sequence":"additional","affiliation":[{"name":"School of Integrated Science and Humanity Florida International University Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Department of Public Health &amp; Medical Affairs Gilead Sciences Inc. Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Miami School of Medicine Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babette","family":"Brumback","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Florida Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall","family":"Bryant","sequence":"additional","affiliation":[{"name":"Alcohol and HIV\/AIDS Research National Institute on Alcohol Abuse and Alcoholism Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agl027"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq047"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2011.0447"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1580-x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0000000000000138"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj149"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13313"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h4238"},{"key":"e_1_2_9_10_1","unstructured":"Centers for Disease Control and Prevention(2016)HIV Among Women. 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