Prevalence and Correlates of Non-Alcoholic Beverage Consumption Among People Living with HIV: A Potential Alcohol Reduction Strategy.

Abstract

Unhealthy alcohol use is prevalent among people living with HIV (PLH) and is associated with worse HIV care outcomes. Non-alcoholic beverages (NABs; beer, wine, or spirits containing 0.0% to 0.5% alcohol by volume) may represent a novel alcohol reduction strategy; however, the prevalence and correlates of NAB use among PLH remain unexamined. This study utilized baseline data from the Florida Cohort Study (N = 589; June 2024-October 2025). Self-report measures assessed past 12-month NAB consumption and likelihood of future NAB use. Multivariable logistic regression models examined sociodemographic and health-related correlates of past-year NAB consumption and future use. Overall, 26.83% of participants consumed NABs in the past 12 months; 18.34% were likely or extremely likely to use NABs in the future. In multivariable analyses, higher odds of past-year NAB consumption were associated with identifying as Non-Hispanic Black (AOR = 3.10, 95% CI: 1.77-5.42 vs. Non-Hispanic White) or Latine (AOR = 2.57, 95% CI: 1.36-4.86 vs. Non-Hispanic White), lesbian, gay, bisexual, or queer (AOR = 1.74, 95% CI: 1.14-2.64 vs. straight/heterosexual), and moderate/high risk of alcohol use disorder (AUD) (AOR = 2.43, 95% CI: 1.39-4.23 vs. no/low risk). Similar patterns were observed for future likelihood to use NABs. Approximately one-quarter of PLH reported past 12-month NAB consumption, although relatively fewer expressed interest in future use. NABs may represent a promising, yet underutilized, alcohol reduction strategy for PLH; however, additional research is needed to understand motivations, contexts of use, and impacts on alcohol-related and HIV outcomes.