TY - JOUR
T1 - Drinking trajectories among HIV-infected men who have sex with men
T2 - A cohort study of United States veterans
AU - Marshall, Brandon D.L.
AU - Operario, Don
AU - Bryant, Kendall J.
AU - Cook, Robert L.
AU - Edelman, E. Jennifer
AU - Gaither, Julie R.
AU - Gordon, Adam J.
AU - Kahler, Christopher W.
AU - Maisto, Stephen A.
AU - McGinnis, Kathleen A.
AU - van den Berg, Jacob J.
AU - Zaller, Nickolas D.
AU - Justice, Amy C.
AU - Fiellin, David A.
N1 - Funding Information:
This work was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA: U24-AA022000 , U10-AA013566 , U01-AA020795 , U01-AA020790 , U24-AA020794 , U10-AA013566 , and P01-AA019072 ), the National Institute of Allergy and Infectious Diseases ( P30-AI042853 ), and in kind by the U.S. Department of Veterans Affairs . Dr. Robert Cook is supported by the NIAAA (U24-AA022002). Ms. Julie Gaither is supported by the National Institute on Drug Abuse ( F31-DA035567 ). Dr. Stephen Maisto is supported by the NIAAA (K05-AA16928). Dr. E. Jennifer Edelman is a Yale-Drug Abuse, Addiction, and HIV Research Scholar ( K12-DA033312 ). The sponsors had no role in the study design; the collection, analysis and interpretation of data; the writing of the report; and in the decision to submit the article for publication.
Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Although high rates of alcohol consumption and related problems have been observed among HIV-infected men who have sex with men (MSM), little is known about the long-term patterns of and factors associated with hazardous alcohol use in this population. We sought to identify alcohol use trajectories and correlates of hazardous alcohol use among HIV-infected MSM. Methods: Sexually active, HIV-infected MSM participating in the Veterans Aging Cohort Study were eligible for inclusion. Participants were recruited from VA infectious disease clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh, and Washington, DC. Data from annual self-reported assessments and group-based trajectory models were used to identify distinct alcohol use trajectories over an eight-year study period (2002-2010). We then used generalized estimate equations (GEE) to examine longitudinal correlates of hazardous alcohol use (defined as an AUDIT-C score ≥4). Results: Among 1065 participants, the mean age was 45.5 (SD = 9.2) and 606 (58.2%) were African American. Baseline hazardous alcohol use was reported by 309 (29.3%). Group-based trajectory modeling revealed a distinct group (12.5% of the sample) with consistently hazardous alcohol use, characterized by a mean AUDIT-C score of >5 at every time point. In a GEE-based multivariable model, hazardous alcohol use was associated with earning <$6000 annually, having an alcohol-related diagnosis, using cannabis, and using cocaine. Conclusions: More than 1 in 10 HIV-infected MSM US veterans reported consistent, long-term hazardous alcohol use. Financial insecurity and concurrent substance use were predictors of consistently hazardous alcohol use, and may be modifiable targets for intervention.
AB - Although high rates of alcohol consumption and related problems have been observed among HIV-infected men who have sex with men (MSM), little is known about the long-term patterns of and factors associated with hazardous alcohol use in this population. We sought to identify alcohol use trajectories and correlates of hazardous alcohol use among HIV-infected MSM. Methods: Sexually active, HIV-infected MSM participating in the Veterans Aging Cohort Study were eligible for inclusion. Participants were recruited from VA infectious disease clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh, and Washington, DC. Data from annual self-reported assessments and group-based trajectory models were used to identify distinct alcohol use trajectories over an eight-year study period (2002-2010). We then used generalized estimate equations (GEE) to examine longitudinal correlates of hazardous alcohol use (defined as an AUDIT-C score ≥4). Results: Among 1065 participants, the mean age was 45.5 (SD = 9.2) and 606 (58.2%) were African American. Baseline hazardous alcohol use was reported by 309 (29.3%). Group-based trajectory modeling revealed a distinct group (12.5% of the sample) with consistently hazardous alcohol use, characterized by a mean AUDIT-C score of >5 at every time point. In a GEE-based multivariable model, hazardous alcohol use was associated with earning <$6000 annually, having an alcohol-related diagnosis, using cannabis, and using cocaine. Conclusions: More than 1 in 10 HIV-infected MSM US veterans reported consistent, long-term hazardous alcohol use. Financial insecurity and concurrent substance use were predictors of consistently hazardous alcohol use, and may be modifiable targets for intervention.
KW - Alcohol
KW - HIV infection
KW - Men who have sex with men
KW - Trajectories
KW - Trends
KW - Veterans
UR - http://www.scopus.com/inward/record.url?scp=84923107082&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923107082&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2014.12.023
DO - 10.1016/j.drugalcdep.2014.12.023
M3 - Article
C2 - 25596785
AN - SCOPUS:84923107082
SN - 0376-8716
VL - 148
SP - 69
EP - 76
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
ER -