title: Heavy drinking trajectories among men who have sex with men: a longitudinal, group-based analysis.
abstract: BACKGROUND
  Heavy episodic drinking (HED) is associated with sexual risk behavior and HIV seroconversion among men who have sex with men (MSM), yet few studies have examined heavy drinking typologies in this population.
  
  
  METHODS
  We analyzed data from 4,075 HIV-uninfected MSM (aged 16 to 88) participating in EXPLORE, a 48-month behavioral intervention trial, to determine the patterns and predictors of HED trajectories. HED was defined as the number of days in which ≥5 alcohol drinks were consumed in the past 6 months. Longitudinal group-based mixture models were used to identify HED trajectories, and multinomial logistic regression was used to determine correlates of membership in each group.
  
  
  RESULTS
  We identified 5 distinct HED trajectories: nonheavy drinkers (31.9%); infrequent heavy drinkers (i.e., <10 heavy drinking days per 6-month period, 54.3%); regular heavy drinkers (30 to 45 heavy drinking days per 6 months, 8.4%); drinkers who increased HED over time (average 33 days in the past 6 months to 77 days at end of follow-up, 3.6%); and very frequent heavy drinkers (>100 days per 6 months, 1.7%). Intervention arm did not predict drinking trajectory patterns. Younger age, self-identifying as white, lower educational attainment, depressive symptoms, and stimulant use were associated with reporting heavier drinking trajectories. Compared to nonheavy drinkers, participants who increased HED more often experienced a history of childhood sexual abuse (CSA). Over the study period, depressive symptomatology increased significantly among very frequent heavy drinkers.
  
  
  CONCLUSIONS
  Socioeconomic factors, substance use, depression, and CSA were associated with heavier drinking patterns among MSM. Multicomponent interventions to reduce HED should seek to mitigate the adverse impacts of low educational attainment, depression, and early traumatic life events on the initiation, continuation, or escalation of frequent HED among MSM.
authors: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
authors: Brandon D L
authors: BD
authors: Marshall
authors: Jean A
authors: JA
authors: Shoveller
authors: Christopher W
authors: CW
authors: Kahler
authors: Beryl A
authors: BA
authors: Koblin
authors: Kenneth H
authors: KH
authors: Mayer
authors: Matthew J
authors: MJ
authors: Mimiaga
authors: Jacob J
authors: JJ
authors: van den Berg
authors: Nickolas D
authors: ND
authors: Zaller
authors: Don
authors: D
authors: Operario
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D001727:Bisexuality; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D018450:Disease Progression; D004522:Educational Status; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Depression; Educational Attainment; Men Who Have Sex With Men; Substance Use