Recorded presentation

Robert C. Freeman, PhD, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Room 2088 MSC 9304, Bethesda, MD 20892-9304, 301-443-8820, rfreeman@mail.nih.gov

BACKGROUND: While drug treatment programs can reduce the HIV risk behavior involvement of injection drug users (IDUs), relatively little attention has been paid to understanding the independent effects of alcohol consumption on IDU's involvement in risky injection and sexual behaviors. METHODS: Study subjects were respondents (N=10,010) in a non-experimental study conducted in 96 U.S. drug treatment programs purposively sampled to reflect typical clinical approaches across 4 treatment modalities. Risk behavior analyses were conducted on intake data obtained from those reporting drug use with a needle/syringe (N/S) in the 12 months before program admission (N=2,524). RESULTS: 65.7% of these IDUs were male. 36.4% of male IDUs and 25.8% of females reported heavy alcohol use (i.e., drank at least 3-4 days/week) in the 12 months pre-admission. Heavy-drinking male IDUs were significantly more likely than non-heavy drinkers to report using a N/S that had been used by someone else (OR=1.55, CI=1.26,1.92), and less likely to always use a condom during vaginal intercourse (OR=0.65; CI=0.46,0.91) and more likely to report multiple women anal sex partners during the previous year (OR=2.41, CI=1.55,3.75). Women heavy-drinking IDUs were, compared to less-heavy drinkers, marginally significantly less likely to clean used N/Ss prior to use (OR=0.52, CI=0.28,1.01) and significantly more likely to report multiple male sex partners in the previous year (OR=1.92, CI=1.35,2.73). CONCLUSIONS: In a large sample of drug treatment program entrants, heavy-drinking IDUs had elevated odds of involvement in HIV risk practices. Drug treatment program efforts to reduce HIV risk should not overlook IDUs' alcohol use patterns.

Learning Objectives: At the end of the session, the learner in this session will be able to

• Describe the study subjects in terms of at least 3 sociodemographic variables.
• List at least 3 behaviors that the heavy-drinking IDUs in this study participated in that placed them at elevated HIV risk in comparison to lighter-drinking IDUs.
• Discuss 2 ways that drug treatment programs might address the HIV risks of heavy alcohol-using IDUs.

Keywords: Alcohol Use, Injection Drug Users

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation