title: The role of drinking severity on sex risk behavior and HIV exposure among illicit drug users.
abstract: OBJECTIVE
  The current study examined how drinking severity among injection and non-injection drug users is associated with sex risk behaviors and risk of HIV exposure.
  
  
  METHODS
  The study is a secondary analysis of an investigation of risk factors among drug users in Baltimore known as the NEURO-HIV epidemiologic study. Participants (N = 557) completed an interview, self-reported 30-day alcohol use, lifetime injection and non-injection drug use, and provided blood samples to screen for HIV. Participants were grouped into one of three drinking severity conditions: abstinent (no reported alcohol use in prior 30 days), moderate alcohol use (≤30 drinks for females, or ≤60 drinks for males), or problematic alcohol use (>30 drinks for females, or >60 drinks for males). Drinking severity groups were significantly different on lifetime injection drug use, heroin injection, snorting/sniffing cocaine, and smoking crack.
  
  
  RESULTS
  Logistic regression analyses found problematic alcohol users to be more likely than alcohol abstainers to inject drugs before or during sex (AOR = 5.78; 95% CI = 2.07-16.10), and more likely than moderate alcohol users to use alcohol before/during sex (AOR = 4.96; 95% CI = 2.09-11.81), inject drugs before/during sex (AOR = 2.96; 95% CI = 1.29-6.80), and to be HIV+ among Black participants (AOR = 2.72; 95% CI = 1.14-6.49).
  
  
  CONCLUSIONS
  These results outline the necessity for research and clinical intervention among this population to reduce sex risk behaviors and potential HIV exposure, while highlighting the need to examine drinking severity as a predictor of sex risk behaviors.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. mscherer@jhsph.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Scherer
authors.forename: Rebecca
authors.initials: R
authors.lastname: Trenz
authors.forename: Paul
authors.initials: P
authors.lastname: Harrell
authors.forename: Pia
authors.initials: P
authors.lastname: Mauro
authors.forename: William
authors.initials: W
authors.lastname: Latimer
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000704:Analysis of Variance; D015142:Baltimore / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015528:HIV Seroprevalence; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012309:Risk-Taking; D012725:Sexual Behavior / Q000187:drug effects*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*