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Inconsistent condom use among HIV-infected patients with alcohol problems
Vera Ehrenstein1, Nicholas J Horton, Jeffrey H Samet
1Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Epidemiology, Boston Medical Center, Boston University Schools of Medicine and Public Health, Boston, MA 02118, USA.
Drug and Alcohol Dependence
|January 17, 2004
Summary
Excessive alcohol use is linked to unsafe sex practices in HIV-infected individuals who inject drugs. This association was not found in those who do not inject drugs.
Area of Science:
- Public Health
- Infectious Diseases
- Addiction Medicine
Background:
- Unsafe sexual behavior is prevalent, particularly among individuals with unknown HIV status.
- Alcohol consumption can exacerbate risky sexual practices in certain populations.
- This study focuses on HIV-infected individuals with a history of alcohol problems.
Purpose of the Study:
- To investigate the relationship between alcohol consumption levels and inconsistent condom use.
- To analyze this association within a cohort of HIV-infected individuals with prior alcohol issues.
Main Methods:
- Utilized generalized estimating equations (GEE) for repeated measurements analysis in 345 participants over 36 months.
- Employed multivariate logistic regression, adjusting for confounding factors and exploring interactions.
- Collected data through structured interviews assessing alcohol consumption and condom use.
Main Results:
- At baseline, 38% of participants reported inconsistent condom use.
- A significant interaction (P=0.0002) was found between alcohol consumption and injection drug use (IDU).
- Among active IDUs, at-risk drinking correlated with inconsistent condom use (OR 4.3; 95% CI: 1.5, 12.2), but not among non-IDUs (OR 0.7; 95% CI: 0.4, 1.3).
- Inconsistent condom use was higher among women, those finding condoms inconvenient, and individuals cohabiting.
Conclusions:
- Excessive alcohol use is significantly associated with unsafe sexual practices in HIV-infected individuals who also inject drugs.
- The link between at-risk drinking and unsafe sex was specific to the IDU subgroup.
- Findings highlight the need for targeted interventions addressing both substance use and sexual health in this population.