性病门诊患者的酒精及其他物质使用情况：与性病及HIV现患感染的关系

Alcohol and other substance use in STD clinic patients: relationships with STDs and prevalent HIV infection.

作者信息

Zenilman J M, Hook E W, Shepherd M, Smith P, Rompalo A M, Celentano D D

机构信息

Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore.

出版信息

Sex Transm Dis. 1994 Jul-Aug;21(4):220-5. doi: 10.1097/00007435-199407000-00008.

DOI:10.1097/00007435-199407000-00008

PMID:7974074

Abstract

BACKGROUND AND OBJECTIVES

Sexually transmitted diseases have been epidemiologically linked to a variety of high-risk behaviors, including substance abuse. However, the relationship between alcohol consumption and risk for specific STDs has not been explored previously.

GOAL OF THIS STUDY

We hypothesized that alcohol use is a risk factor for STD acquisition.

METHODS

Cross-sectional analysis of enrollment visits in a prospective cohort study evaluating behavioral and biological risk factors for STD in an inner-city STD clinic population. Subjects were administered a comprehensive behavioral and questionnaire which included a detailed sexual history and evaluation for substance use. Alcohol users were classified as "frequent drinkers" (> 2 times/week) and "infrequent" drinkers. Clinical exam included laboratory evaluation for syphilis, gonorrhea, chlamydia, and human immunodeficiency virus infection (HIV).

RESULTS

In 1990-1992, 1,145 patients were enrolled; 245 (21%) were "frequent" drinkers. "Frequent" drinkers were more likely in the past month to have had more than 2 sex partners (OR = 3.3; 95% confidence interval [95% CI]2.4-4.7), and use cocaine or injecting drugs. Frequent drinkers were more likely to be diagnosed with HIV (OR = 2.5; 95% CI 1.6-4.0) and syphilis (OR = 1.74, 95% CI 1.1-2.8), but not with gonorrhea or chlamydia. Similar patterns were seen in cocaine and injecting drug users. In a multivariate analysis controlling for gender, syphilis, injecting drug, cocaine use, and sexual orientation, there was a borderline association between frequent alcohol use and HIV infection (OR = 1.63; 95% CI 0.95-2.8; P = .07).

CONCLUSIONS

Alcohol is frequently used in individuals at risk for STD, and is associated with other risk variables for HIV infection. Use of multiple drugs, including alcohol, is common. Nevertheless, these data suggest that alcohol use may have an independent behavioral effect that would increase the risk for HIV infection.

摘要

背景与目的

性传播疾病在流行病学上与多种高危行为相关，包括药物滥用。然而，饮酒与特定性传播疾病风险之间的关系此前尚未得到探讨。

本研究的目标

我们假设饮酒是获得性传播疾病的一个风险因素。

方法

对一项前瞻性队列研究中的入组访视进行横断面分析，该研究评估了市中心性传播疾病诊所人群中性传播疾病的行为和生物学风险因素。研究对象接受了一份全面的行为问卷，其中包括详细的性病史和药物使用评估。饮酒者被分为“频繁饮酒者”（每周超过2次）和“不频繁饮酒者”。临床检查包括梅毒、淋病、衣原体和人类免疫缺陷病毒感染（HIV）的实验室评估。

结果

在1990 - 1992年，共有1145名患者入组；其中245名（21%）为“频繁饮酒者”。“频繁饮酒者”在过去一个月内更有可能有超过2个性伴侣（比值比[OR]=3.3；95%置信区间[95%CI]2.4 - 4.7），并使用可卡因或注射毒品。频繁饮酒者更有可能被诊断出感染HIV（OR = 2.5；95%CI 1.6 - 4.0）和梅毒（OR = 1.74，95%CI 1.1 - 2.8），但淋病或衣原体感染的情况并非如此。在可卡因使用者和注射毒品使用者中也观察到类似模式。在控制了性别、梅毒、注射毒品、可卡因使用和性取向的多变量分析中，频繁饮酒与HIV感染之间存在临界关联（OR = 1.63；95%CI 0.95 - 2.8；P = 0.07）。