Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
AIDS Behav. 2024 Jul;28(7):2427-2437. doi: 10.1007/s10461-024-04341-y. Epub 2024 Apr 25.
Among people living with HIV (PLWH), heavy alcohol use is associated with many negative health consequences. However, the impacts of heavy alcohol use are not well described for PLWH who use drugs. Thus, we investigated the prevalence and correlates of heavy alcohol use among a cohort of people who use drugs (PWUD) living with HIV in Vancouver, Canada. We accessed data from an ongoing community-recruited prospective cohort of PLWH who use drugs with linked comprehensive HIV clinical monitoring data. We used generalized linear mixed-effects modeling to identify factors longitudinally associated with periods of heavy alcohol use between December 2005 and December 2019. Of the 896 participants included, 291 (32.5%) reported at least one period with heavy alcohol use. Periods of recent incarceration (Adjusted Odds Ratio [AOR] = 1.48, 95% Confidence Interval [CI]: 1.01-2.17), encounters with police (AOR = 1.87, 95% CI: 1.37-2.56), and older age (AOR = 1.05, 95% CI: 1.02-1.07) were positively associated with heavy alcohol use. Engagement in drug or alcohol treatment (AOR = 0.54, 95% CI: 0.42-0.70) and male gender (AOR = 0.46; 95% CI: 0.27-0.78) were negatively associated with heavy alcohol use. We observed that heavy alcohol use was clearly linked to involvement with the criminal justice system. These findings, together with the protective effects of substance use treatment, suggest the need to expand access for drug and alcohol treatment programs overall, and in particular through the criminal justice system to reduce alcohol-related harms among PLWH who use drugs.
在感染艾滋病毒的人群中（PLWH），大量饮酒与许多不良健康后果有关。然而，对于同时使用毒品的 PLWH 来说，大量饮酒的影响还没有很好地描述。因此，我们调查了加拿大温哥华的一个同时感染 HIV 和使用毒品的人群（PWUD）队列中大量饮酒的流行情况和相关因素。我们使用了正在进行的社区招募的、有 HIV 临床监测数据链接的 PLWH 前瞻性队列数据。我们使用广义线性混合效应模型，在 2005 年 12 月至 2019 年 12 月期间，确定与大量饮酒期相关的纵向因素。在纳入的 896 名参与者中，291 名（32.5%）报告至少有一个时期大量饮酒。最近被监禁（调整后的优势比[OR] = 1.48，95%置信区间[CI]：1.01-2.17）、与警察接触（AOR = 1.87，95% CI：1.37-2.56）和年龄较大（AOR = 1.05，95% CI：1.02-1.07）与大量饮酒有关。参与药物或酒精治疗（AOR = 0.54，95% CI：0.42-0.70）和男性（AOR = 0.46；95% CI：0.27-0.78）与大量饮酒呈负相关。我们发现，大量饮酒与参与刑事司法系统明显相关。这些发现，加上药物和酒精治疗的保护作用，表明需要扩大药物和酒精治疗方案的获得机会，特别是通过刑事司法系统，以减少同时感染 HIV 和使用毒品者的酒精相关危害。
