Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania.
Alcohol Clin Exp Res. 2018 Mar;42(3):561-570. doi: 10.1111/acer.13583. Epub 2018 Jan 29.
Our aim was to describe alcohol consumption trajectories in a cohort of people living with HIV and determine clinical and sociodemographic predictors of each trajectory.
This is a prospective cohort study of 7,906 patients in the 7 Centers for AIDS Research Network of Integrated Clinical Systems sites. Alcohol consumption was categorized as none, moderate, and alcohol misuse. Predictors included age, race/ethnicity, depressive or anxiety symptoms, illicit drug use (opioids, methamphetamines, cocaine/crack), marijuana use, hepatitis C virus (HCV) infection, HIV transmission risk factor, and HIV disease progression. We estimated sex-stratified alcohol consumption trajectories and their predictors.
We found 7 trajectories of alcohol consumption in men: stable nondrinking and increased drinking (71% and 29% of initial nondrinking); stable moderate, reduced drinking, and increased alcohol misuse (59%, 21%, and 21% of initial moderate alcohol use); and stable alcohol misuse and reduced alcohol misuse (75% and 25% of initial alcohol misuse). Categories were similar in women, except lack of an increase to alcohol misuse trajectory among women that begin with moderate use. Older men and women were more likely to have stable nondrinking, while younger men were more likely to increase to or remain in alcohol misuse. Minorities, people with depressive or anxiety symptoms, HCV-infected individuals, and people who injected drugs were more likely to reduce use. Illicit drug use was associated with a reduction in overall drinking, while marijuana use was associated with stable moderate drinking or misuse.
Longitudinal trajectories of increasing alcohol use and stable misuse highlight the need to integrate routine screening and alcohol misuse interventions into HIV primary care.
我们的目的是描述艾滋病毒感染者队列中的酒精消费轨迹，并确定每种轨迹的临床和社会人口统计学预测因素。
这是一项对 7 个艾滋病研究网络综合临床系统中心的 7906 名患者进行的前瞻性队列研究。酒精摄入量分为不饮酒、适量饮酒和酒精滥用。预测因素包括年龄、种族/民族、抑郁或焦虑症状、非法药物使用（阿片类药物、冰毒、可卡因/快克）、大麻使用、丙型肝炎病毒（HCV）感染、艾滋病毒传播风险因素和艾滋病毒疾病进展。我们估计了男性的酒精消费轨迹及其预测因素，并进行了性别分层。
我们在男性中发现了 7 种酒精消费轨迹：稳定不饮酒和饮酒增加（71%和 29%的初始不饮酒）；稳定适量饮酒、减少饮酒和增加酒精滥用（59%、21%和 21%的初始适量饮酒）；以及稳定的酒精滥用和减少的酒精滥用（75%和 25%的初始酒精滥用）。女性的类别相似，只是女性中没有一个从适量饮酒开始增加到酒精滥用的轨迹。年龄较大的男性和女性更有可能保持不饮酒，而年轻男性更有可能增加或保持酒精滥用。少数民族、有抑郁或焦虑症状的人、HCV 感染者和注射毒品的人更有可能减少使用。非法药物使用与总饮酒量减少有关，而大麻使用与稳定适量饮酒或滥用有关。
酒精使用量增加和稳定滥用的纵向轨迹突出表明，需要将常规筛查和酒精滥用干预措施纳入艾滋病毒初级保健。
