Long-term alcohol consumption trajectories in adult women with and without HIV infection

Background. HIV-infected women with excessive alcohol consumption have an increased risk of adverse health outcomes, but little is known about their long-term drinking trajectories. Our objectives were to identify long-term drinking trajectories in women with and without HIV infection, and to identify characteristics associated with distinct drinking trajectories. Methods. Data were obtained 2791 HIV-infected and 975 HIV-uninfected participants from the Women's Interagency HIV Study (mean age 35 years, 58% African-American, 24% Hispanic). Participants completed semi-annual assessments from 1996 – 2006, with heavy drinking at each time point defined as >7 drinks/week. A semi-parametric group-based model identified distinct drinking trajectories. Multivariable analyses identified factors associated with distinct trajectories. Results. Five distinct drinking trajectory patterns emerged: continued heavy drinking (4%), reduction from heavy to non-heavy drinking (7%), increase from non-heavy to heavy drinking (9%), continued non-heavy drinking (45%), and continued non-drinking (35%). The trajectory patterns were similar in HIV-infected and HIV-uninfected women. Continued heavy drinking was significantly associated with depressive symptoms, crack/cocaine use, and previous heavy drinking. Increase from non-heavy to heavy drinking was significantly associated with less education, current use of crack/cocaine, marijuana or tobacco, and previous heavy drinking or alcohol treatment. Conclusions. Although most HIV-infected women in this sample had low levels of drinking, important subgroups of women demonstrated continuation and initiation of heavy drinking. Alcohol prevention and treatment interventions could significantly improve the health of women with HIV, and these should target women with previous drinking problems, current depressive symptoms, and who also use tobacco or illicit drugs