Risk factors associated with excessive alcohol consumption among HIV-infected men who have sex with men (MSM) at an urban community health center

Introduction: HIV-infected MSM have an increased risk for excessive-alcohol-consumption (EAC), which is associated with other high-risk behavior and HIV-transmission. Understanding the characteristics associated with EAC can have implications for program-development for this population. The aim of this analysis was to determine the demographic, HIV-disease-stage and treatment, and mental health characteristics associated with longitudinal changes in weekly EAC (i.e., 5 or more drinks in a single day). Methods: 201 HIV-infected MSM were recruited from a Boston community-health-center and participated in a secondary HIV-prevention intervention. Participants completed an assessment at baseline, 3, 6, 9, and 12-months. Analyses were conducted using block-stepwise multivariable longitudinal logistic-regression. Results: 23.6% reported weekly EAC within the past 3-months at baseline, and 15.4%, 21.2%, 21.2% and 16.4% at months 3, 6, 9, and 12, respectively (p=0.02). In the final multivariable model, controlling for intervention status, age, and race/ethnicity, completing college (AOR: 0.49; CI: 0.29-0.83) or a graduate degree (AOR: 0.09; CI: 0.03-0.26) decreased the odds of EAC on average longitudinally; whereas men who were not taking antiretroviral-therapy (AOR: 2.08; CI: 1.27-3.41) and who met criteria for depression (AOR: 1.74; CI: 1.06-2.86) had an increased odds of weekly EAC on average longitudinally. Conclusions: HIV-infected MSM in this study had a high frequency of weekly EAC at baseline, which decreased over time. Because of the well-documented association with alcohol use and HIV-transmission risk behavior, future programs that seek to intervene on EAC should focus on men with lower education, who are not taking antiretroviral-therapy, and who meet criteria for depression.