title: HIV, Hepatitis C, and Abstinence from Alcohol Among Injection and Non-injection Drug Users.
abstract: Individuals using illicit drugs are at risk for heavy drinking and infection with human immunodeficiency virus (HIV) and/or hepatitis C virus (HCV). Despite medical consequences of drinking with HIV and/or HCV, whether drug users with these infections are less likely to drink is unclear. Using samples of drug users in treatment with lifetime injection use (n = 1309) and non-injection use (n = 1996) participating in a large, serial, cross-sectional study, we investigated the associations between HIV and HCV with abstinence from alcohol. About half of injection drug users (52.8 %) and 26.6 % of non-injection drug users abstained from alcohol. Among non-injection drug users, those with HIV were less likely to abstain [odds ratio (OR) 0.55; adjusted odds ratio (AOR) 0.58] while those with HCV were more likely to abstain (OR 1.46; AOR 1.34). In contrast, among injection drug users, neither HIV nor HCV was associated with drinking. However, exploratory analyses suggested that younger injection drug users with HIV or HCV were more likely to drink, whereas older injection drug users with HIV or HCV were more likely to abstain. In summary, individuals using drugs, especially non-injection users and those with HIV, are likely to drink. Age may modify the risk of drinking among injection drug users with HIV and HCV, a finding requiring replication. Alcohol intervention for HIV and HCV infected drug users is needed to prevent further harm.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Elliott
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. dsh2@columbia.edu.|Department of Psychiatry, Columbia University Medical Center, New York, NY, USA. dsh2@columbia.edu.|Division of Clinical Phenomenology, New York State Psychiatric Institute, New York, NY, USA. dsh2@columbia.edu.|Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Box 123, New York, NY, 10032, USA. dsh2@columbia.edu.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
authors.affiliation: Division of Clinical Phenomenology, New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Malka
authors.initials: M
authors.lastname: Stohl
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY, USA.
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D040261:Harm Reduction; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D055815:Young Adult
keywords: Alcohol; Drug use; HIV; Hepatitis C