A prospective study of alcohol consumption and HIV acquisition among injection drug users

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559-7435, USA.
AIDS (London, England) (Impact Factor: 5.55). 01/2011; 25(2):221-8. DOI: 10.1097/QAD.0b013e328340fee2
Source: PubMed


to estimate the effect of alcohol consumption on HIV acquisition while appropriately accounting for confounding by time-varying risk factors.
african-American injection drug users in the AIDS Link to Intravenous Experience cohort study. Participants were recruited and followed with semiannual visits in Baltimore, Maryland between 1988 and 2008.
marginal structural models were used to estimate the effect of alcohol consumption on HIV acquisition.
at entry, 28% of 1525 participants were women with a median (quartiles) age of 37 (32-42) years and 10 (10-12) years of formal education. During follow-up, 155 participants acquired HIV and alcohol consumption was 24, 24, 26, 17, and 9% for 0, 1-5, 6-20, 21-50, and 51-140 drinks per week over the prior 2 years, respectively. In analyses accounting for sociodemographic factors, drug use, and sexual activity, hazard ratios for participants reporting 1-5, 6-20, 21-50, and 51-140 drinks per week in the prior 2 years compared to participants who reported 0 drinks per week were 1.09 (0.60-1.98), 1.18 (0.66-2.09), 1.66 (0.94-2.93), and 2.12 (1.15-3.90), respectively. A trend test indicated a dose-response relationship between alcohol consumption and HIV acquisition (P value for trend = 9.7 × 10).
a dose-response relationship between alcohol consumption and subsequent HIV acquisition is indicated, independent of measured known risk factors.

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    • "In this study, almost 10% of patients with severe alcohol use disorders were HIV positive, which is higher than what was reported in a previous study (Lahmek et al., 2009). There have been reports about the causal relationship between alcohol abuse and HIV infection (Howe et al., 2011; Shuper et al., 2010), and a correlation between the intensity of alcohol consumption and the risk of sexual transmission of HIV infection was described recently (Zakhari and Li, 2007). Cross-sectional studies analyzing associations between HIV infection and alcohol have reported that close to 50% of HIV-positive patients drink alcohol, and that up to 20% have alcohol use disorders (Bryant, 2006). "
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