Post-treatment drinking among HIV patients: Relationship to pre-treatment marijuana and cocaine use.
BACKGROUND
For individuals with HIV, heavy drinking can pose serious threats to health. Some interventions are effective at reducing drinking in this population, but many HIV-infected heavy drinkers also use marijuana or cocaine. Although these drugs have predicted poor alcohol outcomes in other treatment studies, whether this occurs among HIV patients who drink heavily is unknown.


METHODS
Participants were binge-drinking HIV primary care patients (N=254) enrolled in a randomized trial of three brief drinking interventions over 60 days that varied in intensity. We investigated the relationship of baseline past-year drug use (marijuana-only, cocaine-only, both, neither) to end-of-treatment drinking quantity and frequency. We also evaluated whether the relationship between intervention type and end-of-treatment drinking varied by baseline drug use. Final models incorporated control for patients' demographic and HIV characteristics.


RESULTS
In final models, drinking frequency at the end of treatment did not vary by baseline drug use, but drinking quantity did (X(2)[3] = 13.87, p < 0.01), with individuals using cocaine-only drinking significantly more per occasion (B = 0.32, p < 0.01). Baseline drug use also interacted with intervention condition in predicting end-of-treatment drinking quantity (X(2)[6] = 13.98, p < 0.05), but not frequency, with the largest discrepancies in end-of-treatment drinks per drinking day by intervention intensity among cocaine-only patients.


CONCLUSIONS
In general, HIV patients using cocaine evidenced the highest levels of drinking after alcohol intervention. However, these individuals also evidenced the most pronounced differences in end-of-treatment drinking by intervention intensity. These results suggest the importance of more intensive intervention for individuals using alcohol and cocaine.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
Jennifer C
JC
Elliott
Department of Psychiatry, Columbia University Medical Center, 180 Ft. Washington Avenue, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
Efrat
E
Aharonovich
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA; Department of Psychiatry, Columbia University Medical Center, 180 Ft. Washington Avenue, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. Electronic address: deborah.hasin@gmail.com.
Deborah S
DS
Hasin
D000328:Adult; D063425:Binge Drinking / Q000453:epidemiology*; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D008875:Middle Aged; D062405:Motivational Interviewing; D009519:New York City / Q000453:epidemiology
Alcohol; Brief intervention; Cocaine; Drinking; HIV; Marijuana