OBJECTIVES: Modifiable factors contributable to disease progression and survival among people with HIV infection are of particular importance for HIV research. Hazardous drinking is one such variable associated with delayed linkage in care, increased HIV disease progression, worsened comorbidities (e.g., liver diseases). Curtailing hazardous drinking may have important survival implications. Few studies have explored the relationship among hazardous drinking, alcohol treatment and survival. We developed a computer simulation model predicting the survival influence of hazardous drinking and usage of alcohol treatment among individuals with HIV infection.  METHODS: We simulated cohorts of 50,000 antiretroviral-naïve hazardous drinkers with newly diagnosed chronic HIV infection. The model incorporated the influence of ART and distinguished AIDS-related deaths and non-AIDS-related deaths (CVD, Cancer, Liver, and others). We modeled the impact of hazardous drinking on survival via its influence on viral suppression, and subsequent AIDS-related deaths, and mortality of various non-AIDS-related deaths. The role of alcohol treatment on survival was mediated through changes in hazardous drinking.  The simulation model was a probabilistic, Monte-Carlo model created by Microsoft Excel 2010, and Oracle Crystal Ball 11.  RESULTS: Hazardous drinking substantially reduced mean survival years and increased risk of dying due to liver diseases. For patients aged 35, hazardous drinkers had an average of 2.9 years lower in expected life years compared with those without hazardous drinking (30.4 years vs. 33.3 years). Receipt of alcohol treatment, regardless of behavioral treatment or pharmacotherapy, saved an average of 0.3 to 1.2 years per hazardous drinker when utilization rate varying from 10% to 80%.  CONCLUSIONS: This study quantified deleterious effect of hazardous drinking in survival and provided evidence supporting the survival benefits of using alcohol treatment. Given the high prevalent of hazardous drinking among individuals with HIV infection, interventions to decrease alcohol use may have great public health implications.