Hazardous Alcohol Use, Impulsivity, and HIV-Risk Behavior Among HIV-Positive Russian Patients With a History of Injection Drug Use.

Kathryn Chavez, Tibor P Palfai, Debbie M Cheng, Elena Blokhina, Natalia Gnatienko, Emily K Quinn, Evgeny Krupitsky, Jeffrey H Samet
Author Information
  1. Kathryn Chavez: Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts. ORCID
  2. Tibor P Palfai: Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts.
  3. Debbie M Cheng: Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
  4. Elena Blokhina: First St. Petersburg Pavlov State Medical University, St. Petersburg, Russian Federation.
  5. Natalia Gnatienko: Clinical Addiction Research and Education (CARE) Unit, Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts.
  6. Emily K Quinn: Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA.
  7. Evgeny Krupitsky: First St. Petersburg Pavlov State Medical University, St. Petersburg, Russian Federation.
  8. Jeffrey H Samet: Clinical Addiction Research and Education (CARE) Unit, Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts.

Abstract

BACKGROUND AND OBJECTIVES: Previous findings on the association between hazardous drinking and HIV-risk behavior have been equivocal, varying by population and individual difference factors. This study examined associations between hazardous drinking, impulsivity, and HIV-risk behaviors among HIV-positive Russian patients with a history of injection drug use (IDU), not on antiretroviral therapy.
METHODS: Negative binomial regression analyses of data from a randomized controlled trial were performed (N = 241). Main independent variables were the Alcohol Use Disorders Identification Test and the Barratt Impulsiveness Scale. Outcomes were number of condomless sexual episodes (CSE; primary), number of sexual partners, and needle-sharing frequency (secondary).
RESULTS: Hazardous drinking was positively associated with the frequency of CSE (adjusted incidence rate ratio [aIRR] = 2.16, 95% confidence interval [CI], 1.98-2.36). Moderate (aIRR = 0.51, 95% CI, 0.46-0.56) and high (aIRR = 0.66, 95% CI, 0.60-0.73) impulsivity were associated with fewer CSE compared with low impulsivity. Hazardous drinking (aIRR = 0.64, 95% CI, 0.52-0.79) and impulsivity (aIRR = 0.95, 95% CI, 0.94-0.96) were both associated with fewer sexual partners. Hazardous drinking and impulsivity were each associated with increased needle sharing. The association between hazardous drinking and number of needle-shares was strongest at higher impulsivity levels.
CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Hazardous drinking may be a risk factor for CSE among HIV-positive Russian patients and may influence needle sharing. Findings contribute to our understanding of the interactive associations between hazardous drinking and impulsivity with sexual risk behaviors and needle sharing among HIV-positive Russian patients with a history of IDU. (Am J Addict 2020;00:00-00).

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Grants

  1. P30 AI042853/NIAID NIH HHS
  2. R01 DA032082/NIDA NIH HHS
  3. P30AI042853/Providence/Boston Center for AIDS Research

MeSH Term

Adult
Alcoholism
Female
HIV Infections
Humans
Impulsive Behavior
Male
Middle Aged
Needle Sharing
Risk Factors
Risk-Taking
Russia
Sexual Behavior
Substance Abuse, Intravenous

Word Cloud

Created with Highcharts 10.0.0drinkingimpulsivityHazardous95%hazardousRussiansexualCSEassociatedaIRR = 0CI0amongHIV-positivepatientsUsenumberneedlesharingANDassociationHIV-riskassociationsbehaviorshistoryIDUAlcoholpartnersfrequencyfewermayriskBACKGROUNDOBJECTIVES:PreviousfindingsbehaviorequivocalvaryingpopulationindividualdifferencefactorsstudyexaminedinjectiondruguseantiretroviraltherapyMETHODS:NegativebinomialregressionanalysesdatarandomizedcontrolledtrialperformedN = 241MainindependentvariablesDisordersIdentificationTestBarrattImpulsivenessScaleOutcomescondomlessepisodesprimaryneedle-sharingsecondaryRESULTS:positivelyadjustedincidencerateratio[aIRR] = 216confidenceinterval[CI]198-236Moderate5146-056high6660-073comparedlow6452-0799594-096increasedneedle-sharesstrongesthigherlevelsCONCLUSIONSCIENTIFICSIGNIFICANCE:factorinfluenceFindingscontributeunderstandinginteractiveJAddict202000:00-00ImpulsivityHIV-RiskBehaviorAmongHIV-PositivePatientsHistoryInjectionDrug

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