Substance use patterns and factors associated with changes over time in a cohort of heterosexual women at risk for HIV acquisition in the United States.
BACKGROUND
Substance use is associated with HIV sexual risk behaviors, yet few studies have examined substance use patterns longitudinally. We evaluated the types and frequency of substances used over a six-month period among U.S. women at risk for HIV acquisition.


METHODS
Women reporting unprotected sex with a man in the previous six months and at least one other personal or partner HIV risk characteristic enrolled in a multisite cohort study and completed interviews about substance use at study visits. Prevalence and frequency of substance use at the baseline and six-month visits were compared and correlates of decreased substance use at the six-month visit were assessed.


RESULTS
Of 2099 women enrolled, 1882 had substance use data at baseline and six-months. Of these, 76.1% reported using at least one drug or binge drinking in the previous six months; 37.5% were frequent and 38.6% non-frequent substance users. Binge drinking was most frequently reported (63.3%), followed by cocaine (25.0%) and opioids (16.5%). Fifty-five percent of opiate users and 30% of cocaine users reported daily/almost daily use. At the six-month visit, 40.5% reported a decrease in frequency of use. Adjusting for income and type of drug used, poly-substance users were less likely to decrease frequency of use compared to those who only used one substance.


CONCLUSIONS
A substantial decrease in frequency of substance use over time was observed in this cohort. Poly-substance users were less likely to reduce frequency of use over time, suggesting that specific substance use interventions targeting these users are warranted.
George Washington University, School of Public Health and Health Services, Washington, DC, USA. Electronic address: ikuo@gwu.edu.
Irene
I
Kuo
University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, NC, USA.
Carol E
CE
Golin
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Jing
J
Wang
FHI 360, Durham, NC, USA; Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, USA.
Danielle F
DF
Haley
Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA.
James
J
Hughes
Harlem Hospital Center, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA.
Sharon
S
Mannheimer
Mailman School of Public Health, Columbia University, New York, NY, USA.
Jessica
J
Justman
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Anne
A
Rompalo
Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, USA; Emory University, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, USA.
Paula M
PM
Frew
University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, NC, USA.
Adaora A
AA
Adimora
National Institutes of Health, National Institute on Allergy and Infectious Diseases, Bethesda, MD, USA.
Lydia
L
Soto-Torres
Rutgers, New Jersey Medical School, Newark, NJ, USA.
Sally
S
Hodder
D000293:Adolescent; D000328:Adult; D063425:Binge Drinking / Q000453:epidemiology / Q000523:psychology; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000209:etiology*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
Binge drinking; Cocaine use; HIV; Opiate use; Substance use; Women