This study is exploring if a medicine called semaglutide, which is not regularly used for alcohol issues, can help people with both HIV and alcohol use disorder (AUD) drink less. AUD is when someone has trouble controlling their drinking. The study will last for 12 weeks and includes counseling sessions with a clinical pharmacist, who will give advice on reducing alcohol and safely managing other medications. Participants will be asked about their alcohol use and readiness to change their drinking habits.

• The study takes place over 12 weeks with regular visits and assessments.
• Participants will receive counseling and may be offered semaglutide to help reduce alcohol use.
• Participants need to be diagnosed with both HIV and AUD, and take at least five medications.

To join, participants must be 18 or older, have a cell phone, and not be in another alcohol treatment. They also can't be pregnant, planning to get pregnant, or have certain medical conditions. This study is being conducted at the Atlanta VA Healthcare System.