The current study examined how drinking severity among
injection and non-injection drug users is associated with sex risk behaviors
and risk of HIV exposure.
The study is a secondary analysis of an investigation of
risk factors among drug users in Baltimore known as the NEURO-HIV Epidemiologic
Study. Participants (N = 557) completed an interview, self-reported 30-day
alcohol use, lifetime injection and non-injection drug use, and provided blood
samples to screen for HIV. Participants were grouped into one of three drinking
severity conditions: Abstinent (no reported alcohol use in prior 30-days),
Moderate Alcohol Use (≤30 drinks for females, or ≤ 60 drinks for males), or
Problematic Alcohol Use (>30 drinks for females, or >60 drinks for males).
Drinking severity groups were significantly different on lifetime injection
drug use, heroin injection, snorting/sniffing cocaine, and smoking crack.
Logistic regression analyses found problematic alcohol users
to be more likely than alcohol abstainers to inject drugs before or during sex, and more likely than moderate alcohol users
to use alcohol before/during sex, inject
drugs before/during sex and to be HIV+ among
Black participants.
These results outline the necessity for research and
clinical intervention among this population to reduce sex risk behaviors and
potential HIV exposure, while highlighting the need to examine drinking
severity as a predictor of sex risk behaviors.
Table 2
Multivariate Analyses of Substance Use and Sex Risk Behavior History
| Abstinent (n = 220) | Moderate Alcohol Users (n = 220) | Problematic Alcohol Users (n = 116) | |||||
|---|---|---|---|---|---|---|---|
| M | SD | M | SD | M | SD | F | |
| Age first drink | 13.99 | 4.11 | 14.23 | 4.07 | 13.93 | 4.02 | 2.25 |
| Age first IDU | 21.83 | 6.27 | 24.18 | 6.43 | 22.52 | 6.85 | 4.84** |
| Age first NIDU | 14.63 | 3.75 | 14.63 | 4.03 | 14.42 | 3.51 | 0.07 |
| Number of lifetime partners | 28.26 | 80.54 | 48.30 | 271.22 | 26.83 | 33.38 | 0.57 |
| Frequency of condom use | 46.57 | 49.32 | 46.89 | 51.17 | 48.62 | 28.45 | 0.05 |
| Alcohol use during or before sex | -- | -- | 28.15 | 24.73 | 47.53 | 26.69 | 15.08*** |
| IDU during or before sex | 21.71 | 46.89 | 11.55 | 20.20 | 13.77 | 22.66 | 3.53* |
| Non-IDU during or before sex | 28.21 | 43.65 | 29.32 | 27.03 | 35.18 | 34.00 | 1.20 |
| n | % | n | % | n | % | χ 2 | |
|---|---|---|---|---|---|---|---|
| Illicit Substance Usea | |||||||
| Injection Drug Users | 158 | 71.8 | 142 | 64.5 | 64 | 55.2 | 9.97** |
| Heroin Injection | 157 | 71.4 | 136 | 61.8 | 60 | 51.7 | 13.82** |
| Heroin Snort/Sniff | 181 | 82.3 | 188 | 85.4 | 93 | 80.2 | 0.23 |
| Cocaine Injection | 113 | 51.4 | 109 | 49.5 | 45 | 38.8 | 4.78 |
| Cocaine Snort/Sniff | 139 | 63.2 | 159 | 72.3 | 91 | 78.5 | 8.19* |
| Crack Injection | 9 | 4.1 | 11 | 5.0 | 5 | 4.3 | 0.14 |
| Crack Smoke | 134 | 60.9 | 166 | 75.5 | 89 | 76.7 | 11.07** |
| Meth Injection | 10 | 4.5 | 9 | 4.1 | 9 | 7.8 | 2.53 |
| Meth Smoke | 7 | 3.2 | 4 | 1.8 | 4 | 3.5 | 1.25 |
| Sex Risk Behaviorsb | |||||||
| Sex with IDU partner | 90 | 40.9 | 66 | 30.0 | 26 | 22.4 | 2.61 |
| Sex with possible AIDS/HIV+ partner | 189 | 85.9 | 209 | 95.0 | 100 | 86.2 | 3.64 |
| Sex with possible HBV/STD partner | 170 | 77.3 | 178 | 80.9 | 80 | 68.9 | 4.74 |
aIndicates lifetime
bIndicates prior 6-months
*p<.05
**p<.01
***p<.001
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2School of Social and Behavioral Sciences, Mercy College, Dobbs Ferry, New York
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