HIV risk behavior among alcoholic inpatients before and after treatment

In order to evaluate the natural history of HIV risk behavior among alcoholics during pretreatment active alcoholism, posttreatment sobriety, and posttreatment postrelapse periods, self-report data were collected from alcoholic inpatients at two times. During treatment, patients reported pretreatment behaviors. At 90 day follow-up, patients reported behavior during posttreatment sobriety, and if appropriate, during posttreatment postrelapse periods. A total of 68 patients participated, with 28 (41.2%) completing follow-up questionnaires. There were no differences on pretreatment HIV risk behaviors between completers and those lost to follow-up, although there were several differences on age of onset of alcoholism. Among the 28 completers, 9 relapsed before follow-up. Data were analyzed comparing pretreatment and posttreatment sobriety behaviors on all 28 patients, and pretreatment, posttreatment sobriety, and posttreatment postrelapse behaviors on the 9 relapsers. Findings indicated that survivors (those who had not relapsed) significantly decreased HIV risk behavior during posttreatment sobriety. There was a relapse by time interaction such that relapsers reported more sex partners per day during posttreatment sobriety than did survivors. There was no significant change upon relapse, although this may have reflected the low power of this pilot study. The author concludes that HIV risk behaviors among alcoholics are associated with the context of active alcoholism. Relapsers appeared to continue in that context, with its concomitant HIV risk behavior, even during posttreatment sobriety.