title: Decreased injecting is associated with increased alcohol consumption among injecting drug users in northern Vietnam.
abstract: BACKGROUND
  Reducing injecting frequency may reduce the risk of HIV infection and improve health outcomes among injection drug users (IDUs). However, the reduction of one risk behavior may be associated with an increase in other risk behaviors, including the use of other risk-associated substances. Our objective was to determine if an association exists between a reduction in injecting and level of alcohol use among IDU.
  
  
  METHODS
  We conducted a longitudinal analysis of data collected for a randomized controlled trial examining the efficacy of a peer education intervention in reducing HIV risk among IDU and their network members in Thai Nguyen, Vietnam. Our analysis included active male injectors (n = 629) who were study participants and attended both baseline and 3-month visits. Frequency of alcohol consumption was assessed as the number of alcoholic drinks in the past 30 days. Change in risk and outcome behaviors was calculated as the difference in frequencies of behaviors between baseline and 3-month follow-up visits. The outcome of interest was concurrent decreased drug injection and increased alcohol consumption.
  
  
  RESULTS
  The mean difference between baseline and 3-month follow-up of alcohol consumption and injection frequency in the past 30 days was 19.03 drinks (93.68 SD) and 20.22 injections (35.66 SD), respectively. Participants who reported reduced injection frequency were almost three times as likely to report increased alcohol consumption (OR 2.8; 95% CI, 2.0, 4.0). The proportion that both decreased injecting and increased alcohol by any amount in the past 30 days was 35.6%. In multivariate analysis higher education was significantly associated with an increase in alcohol and decrease in injecting of any amount.
  
  
  CONCLUSIONS
  Male IDU may be at risk for increasing alcohol consumption when they reduce injection frequency. Interventions with male IDU that encourage reduction of injection may need to review specific strategies to limit alcohol consumption.
authors: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD 21205, USA. vgo@jhsph.edu
authors: Vivian F
authors: VF
authors: Go
authors: Nguyen Le
authors: NL
authors: Minh
authors: Constantine
authors: C
authors: Frangakis
authors: Tran Viet
authors: TV
authors: Ha
authors: Carl A
authors: CA
authors: Latkin
authors: Teerada
authors: T
authors: Sripaipan
authors: Wendy
authors: W
authors: Davis
authors: Carla
authors: C
authors: Zelaya
authors: Nguyen Phuong
authors: NP
authors: Ngoc
authors: Vu Minh
authors: VM
authors: Quan
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D004522:Educational Status; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D010379:Peer Group; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D014744:Vietnam / Q000453:epidemiology
keywords: Alcohol use; Injecting drug use; Vietnam