title: Inconsistent condom use among HIV-infected patients with alcohol problems.
abstract: BACKGROUND
  Unsafe sexual behavior is common among persons with negative or unknown HIV status and it is augmented by alcohol use in some populations. We examined the association between alcohol consumption level (abstinent, moderate, at-risk) and inconsistent condom use in a cohort of HIV-infected individuals with a history of alcohol problems.
  
  
  METHODS
  Subjects (n=345) had up to seven structured interviews over 36 months. Identical questions on alcohol consumption and inconsistent condom use were asked at each interview. We used generalized estimating equations (GEE) multivariate logistic regression for repeated measurements analysis. We adjusted for potential confounding factors and explored possible interactions.
  
  
  RESULTS
  At baseline, 132 (38%) participants reported inconsistent condom use. We detected a significant (P=0.0002) interaction between alcohol consumption and injection drug use (IDU) variables. Among active injection drug users, at-risk drinking was associated with inconsistent condom use, adjusted odds ratio (OR; 95% confidence interval) 4.3 (1.5, 12.2). Among those who did not inject drugs, at-risk drinking and inconsistent condom use were not associated, 0.7 (0.4, 1.3). Inconsistent condom use was more common among women, those believing condoms to be 'a hassle', and persons living with a partner.
  
  
  CONCLUSIONS
  In HIV-infected drug-injecting individuals, excessive use of alcohol is associated with unsafe sexual practices.
authors.affiliation: Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Epidemiology, Boston Medical Center, Boston University Schools of Medicine and Public Health, Boston, MA 02118, USA.
authors.forename: Vera
authors.initials: V
authors.lastname: Ehrenstein
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012725:Sexual Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires