Fairbairn Nadia, Hayashi Kanna, Milloy M-J, Nolan Seonaid, Nguyen Paul, Wood Evan, Kerr Thomas
Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Alcohol Clin Exp Res. 2016 Nov;40(11):2394-2400. doi: 10.1111/acer.13216. Epub 2016 Sep 17.
Alcohol is associated with a multitude of severe health consequences. While risk behaviors related to illicit drug use are commonly studied among people who inject drugs (PWID), the role of alcohol use has received substantially less attention in this population. We explored whether drug and sexual risk behaviors as well as experiences of violence were associated with hazardous alcohol use in a cohort of PWID.
Analyses were conducted using observational data from a prospective cohort of community-recruited HIV-negative PWID in Vancouver, Canada. We used the U.S. National Institute on Alcohol Abuse and Alcoholism definition of hazardous alcohol use (i.e., >14 drinks/wk or >4 drinks on 1 occasion for men, and >7 drinks/wk or >3 drinks on 1 occasion for women). We used multivariable generalized estimating equations (GEE) to identify the factors associated with hazardous alcohol use.
Between 2006 and 2012, 1,114 HIV-negative individuals were recruited, and 186 (16.7%) reported hazardous alcohol use in the previous 6 months at baseline. In multivariable GEE analyses, having multiple sex partners (adjusted odds ratio [AOR] = 1.25), history of sexually transmitted infection (AOR = 1.50), experiencing violence (AOR = 1.36), and incarceration (AOR = 1.29) were each independently associated with hazardous alcohol use. Caucasian ethnicity (AOR = 0.56), ≥ daily heroin injection (AOR = 0.81), and engagement in addiction treatment (AOR = 0.84) were negatively associated with hazardous alcohol use (all p < 0.05).
A considerable proportion of PWID reported hazardous alcohol use, which was independently associated with reporting sexual, but not drug-related, HIV risk behaviors and experiencing recent violence. Findings suggest a need to integrate regular screening and evidence-based alcohol interventions into treatment efforts for PWID.
酒精与多种严重的健康后果相关。虽然与非法药物使用相关的风险行为在注射吸毒者（PWID）中普遍受到研究，但酒精使用在这一人群中的作用却很少受到关注。我们探讨了在一组注射吸毒者中，药物和性风险行为以及暴力经历是否与危险饮酒有关。
使用来自加拿大温哥华一个社区招募的HIV阴性注射吸毒者前瞻性队列的观察数据进行分析。我们采用美国国立酒精滥用与酒精中毒研究所对危险饮酒的定义（即男性每周饮酒超过14杯或单次饮酒超过4杯，女性每周饮酒超过7杯或单次饮酒超过3杯）。我们使用多变量广义估计方程（GEE）来确定与危险饮酒相关的因素。
在2006年至2012年期间，招募了1114名HIV阴性个体，其中186人（16.7%）在基线时报告在过去6个月中有危险饮酒行为。在多变量GEE分析中，有多个性伴侣（调整后的优势比[AOR]=1.25）、性传播感染史（AOR=1.50）、经历暴力（AOR=1.36）和监禁（AOR=1.29）均与危险饮酒独立相关。白人种族（AOR=0.56）、每天至少注射海洛因（AOR=0.81）和接受成瘾治疗（AOR=0.84）与危险饮酒呈负相关（所有p<0.05）。
相当一部分注射吸毒者报告有危险饮酒行为，这与报告性方面而非与药物相关的HIV风险行为以及近期经历暴力独立相关。研究结果表明，有必要将定期筛查和基于证据的酒精干预措施纳入注射吸毒者的治疗工作中。
