Article

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: 6.56). 01/2011; 25(2):221-8. DOI: 10.1097/QAD.0b013e328340fee2
Source: PubMed

ABSTRACT 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.

0 Bookmarks
 · 
120 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: This study aims to determine whether psychiatric co-morbidity is associated with HCV infection in a substance misuse population.Methods: We identified all subjects in the National Drug Treatment Monitoring System (NDTMS) during the period January 2007–December 2010 for whom information was recorded which identified their psychiatric co-morbidity status and their HCV status. Multivariate analysis was used to identify risk factors that could predict HCV infection.Results and conclusions: The HCV prevalence rate was 32%. HCV infected subjects were younger (21.4% versus 23.1%) when they first started to use drugs, they were more likely to be white (85.1% versus 13.1%) and male (74% versus 72.6%), to have urgent housing problems (13.0% versus 9.7%), to inject (42.8% versus 18.8%), and to share injecting paraphernalia (35.4% versus 9.2%). After adjusting for demographics and drug and alcohol use behaviours, the Odds Ratio of psychiatric co-morbidity for HCV infection was 1.33 (95% CI 1.01–1.75). The results suggest that psychiatric co-morbidity is associated of HCV infection.Clinical implications: It is important to take psychiatric co-morbidity into account when treating these patients and designing intervention strategies.
    Journal of Substance Use 06/2014; 19(3). DOI:10.3109/14659891.2013.784370 · 0.48 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Injection drug users (IDUs) are at increased risk of contracting HIV. From a clinical trial assessing an intervention to enhance the linkage of hospitalized patients to opioid treatment after discharge, we conducted multivariate analysis of baseline data from hospitalized IDUs with a history of opioid dependence (n = 104) to identify differences in factors predicting HIV drug and sex risk behaviors. Factors significantly associated with HIV drug risk were being non-Hispanic Caucasian and recent cocaine use. Being female, binge drinking, and poorer mental health were significantly associated with higher sex risk. Because factors predicting HIV sex risk behaviors differ from those predicting HIV drug risk, interventions aimed at specific HIV risks should have different behavioral and substance use targets.
    AIDS and Behavior 07/2014; 19(3). DOI:10.1007/s10461-014-0754-7 · 3.49 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Background: Alcohol use is common among injecting drug users. The coexistence of alcohol consumption and injecting risk behaviour has the potential to increase harms among intravenous drug users (IDUs). Objective: This study aimed to determine whether the level of alcohol use is a risk factor for injecting paraphernalia sharing behaviours. Methods: A total of 637 treatment-seeking IDUs were assessed for injecting paraphernalia sharing behaviours and drinking risk level as defined by the National Institute for Health and Care Excellence (NICE). Multivariate analyses were performed to identify alcohol risk factors associated with injecting paraphernalia sharing behaviours. Results: After adjusting for the effects of ethnicity, employment and drug used, the odds ratio of higher risk drinking for injecting paraphernalia sharing behaviours was 1.92 (95% CI 1.31-2.83). Conclusion: Higher-risk drinking in IDUs is associated with higher rates of injecting paraphernalia sharing behaviours. It is important to take alcohol use into account when evaluating these patients for treatment and designing intervention strategies.
    The American Journal of Drug and Alcohol Abuse 02/2014; 40(2). DOI:10.3109/00952990.2013.861844 · 1.55 Impact Factor

Full-text (2 Sources)

Download
55 Downloads
Available from
May 20, 2014