244120 Long-term alcohol consumption trajectories in adult women with and without HIV infection

Wednesday, November 2, 2011: 1:10 PM

Robert L. Cook, MD, MPH , Department of Epidemiology, University of Florida, Gainesville, FL
Fang Zhu, PhD , Biostatistics Facilities, Fox Chase Cancer Center, Philadelphia, PA
Bea Belnap, Dr Biol Hum , Department of Medicine, Universtiy of Pittsburgh, Pittsburgh, PA
Kathleen Weber , CORE Center, John H. Stroger Hospital of Cook County, Chicago, IL
Stephen Cole, PhD , Department of Epidemiology, University of North Carolina, Chapel Hill, NC
David Vlahov, PhD , Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY
Judith A. Cook, PhD , Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
Nancy Hessol, MSPH , Department of Clinical Pharmacy & Medicine, Univ of California, San Francisco, San Francisco, CA
Tracey E. Wilson, PhD , Department of Community Health Sciences, SUNY Downstate Medical Center, Brooklyn, NY
Michael W. Plankey, PhD , Department of Medicine / Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC
Andrea Howard, MD, MS , Department of Epidemiology, Columbia University, New York, NY
Gerald Sharp, DrPH , Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD
Jean Richardson, PhD , Institute For Prevention Research, University of Southern California, Los Angeles, CA
Mardge H. Cohen, MD , Women's Equity in Access to Care and Treatment, Boston, MA
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

Learning Areas:
Chronic disease management and prevention
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
List several distinct drinking trajectories in HIV-infected women and identify the proportion of women who follow specific trajectories. Identify risk factors associated with long-term heavy drinking in HIV-infected women.

Keywords: Alcohol Use, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I do research and clincial work related to alcohol and HIV infection
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Substance Use & HIV/AIDS
See more of: HIV/AIDS