This study explores using **off-label medication** (medication used for purposes not officially approved) to help people with **Alcohol Use Disorder (AUD)**, who also have **HIV**, reduce their alcohol use. Over 12 weeks, participants will receive medication, medical management (MM), and counseling by a **clinical pharmacist**. Counseling will include feedback, advice, and motivation to change alcohol use habits and manage taking many medications (five or more) safely. Participants will be offered a medication called varenicline in the first part of the study. The goal is to see how well this plan works and how patients feel about it. Participants will have interviews, bring their medication bottles to visits, and complete tests about their readiness to change and alcohol use. They will also be screened for mild, moderate, or severe AUD.

• Study lasts 12 weeks with regular visits and assessments.
• Participants must have HIV, be 18 or older, and meet alcohol use criteria.
• Cannot participate if currently pregnant, receiving formal alcohol treatment, or have specific health conditions.