HIV and Alcohol: Consumption, Tolerance, Safety, and More

Medically Reviewed by Jonathan E. Kaplan, MD on April 03, 2022
4 min read

If you’re living with HIV, you may be curious if alcohol is safe for you. In general, too much alcohol can weaken a person’s immune system, which could lead to health problems.

But it also may be possible for you to enjoy alcohol in moderation. Experts define moderate drinking as one alcoholic drink a day for women and two for men. A 12-ounce bottle of beer, 5-ounce glass of wine, or a single shot of liquor all count as one drink.

Some research suggests that when drinking, blood alcohol levels may be higher per drink in people living with HIV. This is especially something to watch for if you have a detectable viral load.

The effects of alcohol abuse on how HIV disease progresses is still under study. But there is some evidence that people with HIV who drink regularly may have a rise in viral load while lowering their CD4 count. They also have higher odds than HIV-negative people of death and health problems. This even applies to drinking moderate amounts of alcohol.

Alcohol also negatively affects your liver. If you live with HIV and hepatitis B or C, this is especially serious. If you are currently taking HIV medication, alcohol can still have a negative impact. That’s because alcohol can still seriously weaken your immune system, especially if you drink more than a moderate amount. This is a serious concern because HIV already attacks your immune system, and alcohol use could amplify the negative side effects of a weakened immune system.

Alcohol abuse is common among people living with HIV. It’s a substance people typically turn to during a challenging diagnosis period or if they’re sad, stressed, and more. People living with HIV also commonly have depression. In fact, a 2019 study found that 39% of people with HIV also live with depression.

Occasional social drinking with friends may actually help with your mental health. But habitual drinking or drinking too much can have the opposite effect. If you’re having trouble controlling your drinking, depression, or anxiety, talk with a mental health specialist.

Currently, there are no meaningful interactions between common HIV medications and alcohol. But, there are multiple negative impacts of drinking while taking your HIV treatment. Overall, drinking alcohol can seriously impact how well your HIV medication works.

The first thing to think about with alcohol and HIV medication is how easy it is to forget to follow your treatment plan. When you’re tipsy or drunk, it’s easier to forget to take your medication, which could become a more serious problem if this happens often.

Mixing alcohol and HIV medicine can also affect you physically. Alcohol is hard on your liver and could even cause liver damage. The health of your liver is critical when you're on medication. That’s because your liver works to get rid of waste from your medicine. If it’s not working at its highest level because of too much alcohol, this could become a problem. Taking HIV medication can also raise your cholesterol levels. Pairing these drugs with alcohol is even more concerning because drinking also contributes to higher cholesterol, so be sure to watch your levels.

Too much alcohol can lead to more dangerous sexual interactions. You could forget to use protection, such as condoms, or lower your inhibitions. That means, overall, overdrinking is more likely to lead to unprotected sex. Alcohol use may decrease adherence to HIV medication, or other mechanisms, so the chance of spreading HIV to your partner through unprotected sex is far more likely.

Unprotected sex negatively impacts your partner’s health as well as your own. Forgetting to use protection always comes with the chance of sexually transmitted infections. If you’re living with HIV, these infections may be more serious, and it could take your immune system longer to heal.

Drinking could also affect your memory and whether you’ve informed a sexual partner about your HIV status. So, if you’re going to drink alcohol, keep a few things in mind:

  • Inform your partner that you’re living with HIV before you begin drinking.
  • Remember to take your medication with you or set a reminder to take it, depending on your treatment schedule.
  • It’s also helpful to keep protection, such as condoms, in easy-to-see places in your home.
  • Keep protection with you at all times if you’re drinking outside of your home.
  • If you choose to drink, it’s best to limit the amount before having sex.

If you’re having trouble cutting back on alcohol, talk to your doctor or mental health specialist.