Relationships between states' DUI policies and HIV-positive persons' drinking behaviors nationally

Introduction: Alcohol consumption can be harmful, especially among persons with chronic diseases such as HIV. Alcohol policies influence drinking in the general population. However, we are unaware of studies examining this issue among people with HIV.

Methods: Using multi-level modeling, we examined how individuals' drinking correlated with states' driving under the influence (DUI) policies. We examined four drinking behaviors from the national HIV Cost and Services Utilization Study's 1998 follow-up (n=2,263): 1) past month, any drinking; 2) past month, the number of days of drinking; 3) the typical number of drinks on drinking days, and 4) past month heavy binge drinking (5+ drinks per day for 1+ days per week). We studied four DUI policies: 1) having any treatment or education program versus not, and the strictness of: 2) fines, 3) jail time, and 4) revoking drivers' licenses. All DUI policies and several individual-level characteristics were included simultaneously in models.

Results: Residents of states with stricter fines were less likely to drink, drank fewer days, had fewer drinks when drinking, and were less likely to binge. Residents of states with treatment or education programs were more likely to drink, had more drinks, and were more likely to binge. Residents of states with stricter license revocation policies drank on more days.

Conclusions: Although policies and drinking appear related, the direction of influence is unclear. Treatment/education program and stricter revocation policies might be enacted in response to perceived high DUI levels. However, people appear to reduce their drinking in response to fines.