Advancing health at the intersection of alcohol use and HIV care.
ARCH REACH is a national research center dedicated to understanding and addressing unhealthy alcohol use among people living with HIV. We work to make effective treatment more accessible and help people stay engaged in HIV care, through rigorous research, real-world clinical programs, and close partnership with the communities most affected.
Study protocol published for our stepped-care trial
Details how we're testing hands-on support for HIV clinics adopting stepped alcohol care, published in Addiction Science & Clinical Practice.
About ARCH REACH
ARCH REACH is a national research center that brings together scientists, clinicians, and community members to improve the health and well-being of people living with HIV. Our focus is on understanding and addressing unhealthy alcohol use among people with HIV, in a way that is grounded in and shaped by the experiences of the people most affected.
Alcohol use can make it harder for people with HIV to stay engaged in care, take medication consistently, and manage the other health conditions that can come with aging. It rarely happens in isolation — it's often connected to mental health, stigma, and the broader social and economic conditions in someone's life. ARCH REACH studies these connections and develops, tests, and shares practical ways to help.
Funded by the National Institutes of Health (NIH), ARCH REACH builds on more than a decade of research through the Alcohol Research Consortium in HIV (ARCH) and draws on data and infrastructure from CNICS, a network of HIV clinics across the United States that follows nearly 50,000 people with HIV over time. The center's work is organized around three research projects — ARCH ERA, T-BAI, and ARCH-STAR — supported by three Cores, and guided throughout by a community partner board made up of people with lived experience.
Our Team
Leadership, investigators, staff, and trainees across ARCH REACH's Cores and projects.
The Cores
Three Cores provide the infrastructure, scientific rigor, and community connection that make ARCH REACH's research possible.
Administrative Core
University of Washington
Keeps ARCH REACH running smoothly — coordinating communication across Cores and projects, overseeing timelines, budgets, and regulatory compliance, and supporting the training of students and early-career researchers. Also convenes the Steering Committee and Program Advisory Committee.
Methods Core
University of Washington
Provides the scientific and statistical expertise behind ARCH REACH's research — designing rigorous studies, developing advanced statistical approaches for how alcohol use, HIV, and social factors intersect, and helping translate findings into real-world practice.
Dissemination Core
Tulane University
Connects ARCH REACH's research with the people it's meant to help — leading the Transdisciplinary Community Partner Board, training researchers in community-engaged methods, and sharing findings with the public, providers, and policymakers.
ARCH ERA — Epidemiological Research Arm
University of Washington
Uses data from nearly 50,000 people with HIV to understand how alcohol use affects HIV care, medication adherence, and age-related health conditions over time.
How alcohol use — and treatment for it — relates to staying in HIV care, medication adherence, and age-related conditions like sleep, bone, and kidney problems.
Analysis of CNICS, a network of HIV clinics across the U.S. following nearly 50,000 people with HIV over time.
Identifies which newer treatments and social factors — like housing and discrimination — matter most, so care can be better targeted.
T-BAI — Telephone-Based Brief Alcohol Intervention
University of Washington
Adapts an effective in-person and computer-based counseling program for delivery over the phone, then pilot-tests it with patients at Seattle-area HIV clinics.
Whether an effective in-person/computer counseling program for unhealthy alcohol use works just as well delivered over the phone.
Patients and clinicians at UW/Harborview HIV clinics help redesign the program; a small pilot study then tests it with patients.
Makes counseling accessible to people without reliable internet, a computer, or transportation to an in-person visit.
ARCH-STAR — Syndemic Conditions Treatment Arm
UC San Diego & University of Miami
Offers layered, "stepped" support for people with HIV whose unhealthy alcohol use occurs alongside depression or anxiety — starting light, and stepping up to combined therapy when needed.
A "stepped" model of care for people with HIV whose unhealthy alcohol use occurs alongside depression or anxiety.
Patients at HIV clinics in San Diego and Miami, starting with lighter-touch online support before stepping up as needed.
Tests whether combined therapy for alcohol use and mental health can be delivered at scale in everyday clinic settings.
Publications
Peer-reviewed work from the ARCH REACH team, in plain language.
Healthcare Provider Perceptions on Screening and Treatment for Unhealthy Alcohol Use in HIV Primary Care Settings
Kennedy AJ, et al. AIDS and Behavior
Summary: Interviews with 19 healthcare providers across three HIV clinics found that mixed confidence in screening tools, discomfort with alcohol medications, and competing priorities make it harder to address unhealthy alcohol use in HIV care — while embedding alcohol treatment directly in HIV clinics, having a clinical champion, and offering telemedicine made it easier.
Practice facilitation to implement stepped care for unhealthy alcohol use in HIV clinics: study protocol for a type III hybrid effectiveness-implementation study
Chander G, et al. Addiction Science & Clinical Practice
Summary: This paper lays out the design of the ARCH REACH clinical study: testing whether hands-on support for clinic staff, called practice facilitation, helps HIV clinics successfully adopt a "stepped" model of alcohol care that starts with brief counseling and steps up to more intensive treatment for patients who need it.
Brief report: Are changes in cannabis use frequency associated with changes in alcohol use and smoking among people with HIV (PWH) — a substitution question
Whitney BM, et al. Drug and Alcohol Dependence
Summary: Some have hypothesized that using more cannabis might lead people to cut back on alcohol or cigarettes. In a large group of people with HIV followed over more than a decade, the opposite was true: increasing cannabis use was linked to more drinking days and higher odds of hazardous drinking, while cutting back on cannabis was linked to less alcohol and cigarette use.
Alcohol use disorder, but not current alcohol use, is associated with falls among people with HIV in care
Dai M, et al. AIDS
Summary: Looking at nearly 5,700 people with HIV in care, researchers found that having an alcohol use disorder diagnosis — but not alcohol use itself — was linked to a higher risk of falling in the past year, suggesting something other than being drunk in the moment may explain the connection.
Association of Alcohol Use with COVID-19 Infection and Hospitalization Among People Living with HIV in the United States, 2020
Xia C, et al. AIDS and Behavior
Summary: Using health records from over 5,000 people with HIV in care during 2020, this study found that rates of COVID-19 diagnosis and hospitalization were somewhat higher among people who drank more, though the differences were not statistically significant — suggesting alcohol use had, at most, a modest effect on COVID-19 risk in this group.
Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study
Ruderman SA, et al. Journal of the Association of Nurses in AIDS Care
Summary: "Sick quitting" describes people cutting back on alcohol because their health is declining, which can make alcohol look protective against frailty in research when it isn't. This study followed over 5,600 people with HIV and found that those who became frail were more likely to later quit or cut back on drinking, supporting sick quitting as an explanation researchers need to account for.
Alcohol use and the longitudinal HIV care continuum for people with HIV who enrolled in care between 2011 and 2019
Lesko CR, et al. Annals of Epidemiology
Summary: Following nearly 1,800 people with HIV for several years after they entered care, this study found that those who reported unhealthy or moderate alcohol use at the start spent more time out of HIV care than those who didn't drink, though alcohol use wasn't linked to differences in time spent virally suppressed.
The temporal relationship of alcohol use and subsequent self-reported health status among people with HIV
Pytell JD, et al. The American Journal of Medicine Open
Summary: In a study of over 5,000 people with HIV, heavy alcohol use was linked to worse self-reported health at later visits among women, but not among men — a pattern not explained by depression symptoms, suggesting the health effects of drinking may differ by gender.
News & Updates
What's happening across ARCH REACH's Cores, projects, and community partnerships.
ARCH REACH launches
ARCH REACH officially begins its first project year, building on more than a decade of ARCH research within CNICS.
Contact Us
For any questions, comments, or other inquiries, please contact the ARCH REACH lead research coordinator at sselsky@uw.edu.