Skip to main content

Advertisement

Log in

HIV, Hepatitis C, and Abstinence from Alcohol Among Injection and Non-injection Drug Users

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Individuals using illicit drugs are at risk for heavy drinking and infection with human immunodeficiency virus (HIV) and/or hepatitis C virus (HCV). Despite medical consequences of drinking with HIV and/or HCV, whether drug users with these infections are less likely to drink is unclear. Using samples of drug users in treatment with lifetime injection use (n = 1309) and non-injection use (n = 1996) participating in a large, serial, cross-sectional study, we investigated the associations between HIV and HCV with abstinence from alcohol. About half of injection drug users (52.8 %) and 26.6 % of non-injection drug users abstained from alcohol. Among non-injection drug users, those with HIV were less likely to abstain [odds ratio (OR) 0.55; adjusted odds ratio (AOR) 0.58] while those with HCV were more likely to abstain (OR 1.46; AOR 1.34). In contrast, among injection drug users, neither HIV nor HCV was associated with drinking. However, exploratory analyses suggested that younger injection drug users with HIV or HCV were more likely to drink, whereas older injection drug users with HIV or HCV were more likely to abstain. In summary, individuals using drugs, especially non-injection users and those with HIV, are likely to drink. Age may modify the risk of drinking among injection drug users with HIV and HCV, a finding requiring replication. Alcohol intervention for HIV and HCV infected drug users is needed to prevent further harm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Degenhardt L, Hall W, Warner-Smith M, Lynskey M. Illicit drug use. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: global and regional burden of diseases attributable to selected major risk factors. Geneva: World Health Organization; 2004.

    Google Scholar 

  2. Field CA, Klimas J, Barry J, et al. Alcohol screening and brief intervention among drug users in primary care: a discussion paper. Ir J Med Sci. 2012;181(2):165–70.

    Article  CAS  PubMed  Google Scholar 

  3. Klimas J, Cullen W, Field CA; Problem Alcohol/Drug Use Guideline Development Group. Problem alcohol use among problem drug users: development and content of clinical guidelines for general practice. Ir J Med Sci. 2014;183(1):89–101.

    Article  CAS  PubMed  Google Scholar 

  4. Hartzler B, Donovan DM, Huang Z. Comparison of opiate-primary treatment seekers with and without alcohol use disorder. J Subst Abuse Treat. 2010;39(2):114–23.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Senbanjo R, Wolff K, Marshall J. Excessive alcohol consumption is associated with reduced quality of life among methadone patients. Addiction. 2007;102(2):257–63.

    Article  PubMed  Google Scholar 

  6. Campbell JV, Hagan H, Latka MH, et al. High prevalence of alcohol use among hepatitis C virus antibody positive injection drug users in three US cities. Drug Alcohol Depend. 2006;81(3):259–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Barve S, Kapoor R, Moghe A, et al. Focus on the liver: alcohol use, highly active antiretroviral therapy, and liver disease in HIV-infected patients. Alcohol Res Health. 2010;33(3):229–36.

    PubMed  PubMed Central  Google Scholar 

  8. Azar MM, Springer SA, Meyer JP, Altice FL. A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug Alcohol Depend. 2010;112(3):178–93.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hahn JA, Samet JH. Alcohol and HIV disease progression: weighing the evidence. Curr HIV/AIDS Rep. 2010;7(4):226–33.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Schiavini M, Angeli E, Mainini A, et al. Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985-2002. HIV Med. 2006;7(5):331–7.

    Article  CAS  PubMed  Google Scholar 

  11. Bini EJ, Currie S, Anand BS, et al. Prevalence and impact of alcohol use among patients with HIV-HCV coinfection: a prospective national multicenter study. Washington: National Academy Press; 2007.

    Google Scholar 

  12. Tsui JI, Cheng DM, Libman H, Bridden C, Saitz R, Samet JH. Risky alcohol use and serum aminotransferase levels in HIV-infected adults with and without hepatitis C. J Stud Alcohol Drugs. 2013;74(2):266–70.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Marcellin P, Pequignot F, Delarocque-Astagneau E, et al. Mortality related to chronic hepatitis B and chronic hepatitis C in France: evidence for the role of HIV coinfection and alcohol consumption. J Hepatol. 2008;48(2):200–7.

    Article  CAS  PubMed  Google Scholar 

  14. Benhamou Y, Bochet M, Di Martino V, et al. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. Hepatology. 1999;30(4):1054–8.

    Article  CAS  PubMed  Google Scholar 

  15. Maier MM, He H, Schafer SD, Ward TT, Zaman A. Hepatitis C treatment eligibility among HIV-hepatitis C virus coinfected patients in Oregon: a population-based sample. AIDS Care. 2014;26:1178–85.

    Article  PubMed  Google Scholar 

  16. Klein MB, Rollet KC, Hull M, et al. Who needs direct-acting antivirals for HCV? Challenges faced in advancing HCV therapy for HIV-HCV-coinfected individuals. Antivir Ther. 2013;18(5):717–21.

    Article  CAS  PubMed  Google Scholar 

  17. Bassols AM, Boni R, Pechansky F. Alcohol, drugs, and risky sexual behavior are related to HIV infection in female adolescents. Rev Bras Psiquiatr. 2010;32(4):361–8.

    Article  PubMed  Google Scholar 

  18. Scott-Sheldon LA, Carey MP, Carey KB, et al. Does perceived life stress mediate the association between HIV status and alcohol use? Evidence from adults living in Cape Town, South Africa. AIDS Care. 2013;25(8):1026–32.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sullivan LE, Goulet JL, Justice AC, Fiellin DA. Alcohol consumption and depressive symptoms over time: a longitudinal study of patients with and without HIV infection. Drug Alcohol Depend. 2011;117(2–3):158–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Mbulaiteye SM, Ruberantwari A, Nakiyingi JS, Carpenter LM, Kamali A, Whitworth JA. Alcohol and HIV: a study among sexually active adults in rural southwest Uganda. Int J Epidemiol. 2000;29(5):911–5.

    Article  CAS  PubMed  Google Scholar 

  21. Geis S, Maboko L, Saathoff E, et al. Risk factors for HIV-1 infection in a longitudinal, prospective cohort of adults from the Mbeya Region, Tanzania. J Acquir Immune Defic Syndr. 2011;56(5):453–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Mueses HF, Pinzon MV, Tello IC, Rincon-Hoyos HG, Galindo J. HIV and risk behaviors of persons of low socio-economic status, Popayan-Colombia (2008-2009). Colomb Med. 2013;44(1):7–12.

    PubMed  Google Scholar 

  23. Nuken A, Kermode M, Saggurti N, Armstrong G, Medhi GK. Alcohol and condom use among HIV-positive and HIV-negative female sex workers in Nagaland, India. Int J STD AIDS. 2013;24(9):695–702.

    Article  PubMed  Google Scholar 

  24. Villanti A, German D, Sifakis F, Flynn C, Holtgrave D. Smoking, HIV status, and HIV risk behaviors in a respondent-driven sample of injection drug users in Baltimore, Maryland: the be sure study. AIDS Educ Prev. 2012;24(2):132–47.

    Article  PubMed  Google Scholar 

  25. Fabris P, Tositti G, Giordani MT, et al. Assessing patients’ understanding of hepatitis C virus infection and its impact on their lifestyle. Aliment Pharmacol Ther. 2006;23(8):1161–70.

    Article  CAS  PubMed  Google Scholar 

  26. Mark KE, Murray PJ, Callahan DB, Gunn RA. Medical care and alcohol use after testing hepatitis C antibody positive at STD clinic and HIV test site screening programs. Public Health Rep. 2007;122(1):37–43.

    PubMed  PubMed Central  Google Scholar 

  27. Butt AA, Evans R, Skanderson M, Shakil AO. Comorbid medical and psychiatric conditions and substance abuse in HCV infected persons on dialysis. J Hepatol. 2006;44(5):864–8.

    Article  PubMed  Google Scholar 

  28. Butt AA, Khan UA, McGinnis KA, Skanderson M, Kent Kwoh C. Co-morbid medical and psychiatric illness and substance abuse in HCV-infected and uninfected veterans. J Viral Hepat. 2007;14(12):890–6.

    CAS  PubMed  Google Scholar 

  29. O’Leary MC, Hutchinson SJ, Allen E, et al. The association between alcohol use and hepatitis C status among injecting drug users in Glasgow. Drug Alcohol Depend. 2012;123(1–3):180–9.

    Article  PubMed  Google Scholar 

  30. Du J, Wang Z, Xie B, Zhao M. Hepatitis C knowledge and alcohol consumption among patients receiving methadone maintenance treatment in Shanghai, China. Am J Drug Alcohol Abuse. 2012;38(3):228–32.

    Article  PubMed  PubMed Central  Google Scholar 

  31. McCusker M. Influence of hepatitis C status on alcohol consumption in opiate users in treatment. Addiction. 2001;96(7):1007–14.

    Article  CAS  PubMed  Google Scholar 

  32. Des Jarlais DC, Arasteh K, Friedman SR. HIV among drug users at Beth Israel Medical Center, New York City, the first 25 years. Subst Use Misuse. 2011;46(2–3):131–9.

    Article  PubMed  Google Scholar 

  33. Scheinmann R, Hagan H, Lelutiu-Weinberger C, et al. Non-injection drug use and hepatitis C virus: a systematic review. Drug Alcohol Depend. 2007;89(1):1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Graham CS, Baden LR, Yu E, et al. Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis. Clin Infect Dis. 2001;33(4):562–9.

    Article  CAS  PubMed  Google Scholar 

  35. Curry MP. HIV and hepatitis C virus: special concerns for patients with cirrhosis. J Infect Dis. 2013;207(Suppl 1):S40–4.

    Article  PubMed  Google Scholar 

  36. Bonacini M. Alcohol use among patients with HIV infection. Ann Hepatol. 2011;10(4):502–7.

    CAS  PubMed  Google Scholar 

  37. Cook RL, Zhu F, Belnap BH, et al. Longitudinal trends in hazardous alcohol consumption among women with human immunodeficiency virus infection, 1995-2006. Am J Epidemiol. 2009;169(8):1025–32.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Justice AC, Lasky E, McGinnis KA, et al. Medical disease and alcohol use among veterans with human immunodeficiency infection: a comparison of disease measurement strategies. Med Care. 2006;44(8 Suppl 2):S52–60.

    Article  PubMed  Google Scholar 

  39. Tsui JI, Saitz R, Cheng DM, et al. Awareness of hepatitis C diagnosis is associated with less alcohol use among persons co-infected with HIV. J Gen Intern Med. 2007;22(6):822–5.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Des Jarlais DC, McKnight C, Arasteh K, et al. A perfect storm: crack cocaine, HSV-2, and HIV among non-injecting drug users in New York city. Subst Use Misuse. 2014;49(7):783–92.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Des Jarlais DC, McKnight C, Arasteh K, et al. Transitions from injecting to non-injecting drug use: potential protection against HCV infection. J Subst Abuse Treat. 2014;46(3):325–31.

    Article  PubMed  PubMed Central  Google Scholar 

  42. SAS Institute Inc. SAS/STAT, version 9.3. Cary, NC: SAS Institute Inc; 2011.

  43. Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on alcohol and related conditions. Arch Gen Psychiatry. 2007;64(7):830–42.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Courtney McKnight, MPH, and Kamyar Arasteh, PhD, for their assistance in coordinating collaboration. This study was funded by Grants R01DA003574, T32DA031099, R01AA023163, K23AA023753, and the New York State Psychiatric Institute. Dr. Elliott is now at the Department of Psychiatry, Columbia University Medical Center, and the Substance Dependence Research Group, New York State Psychiatric Institute.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah S. Hasin.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elliott, J.C., Hasin, D.S., Stohl, M. et al. HIV, Hepatitis C, and Abstinence from Alcohol Among Injection and Non-injection Drug Users. AIDS Behav 20, 548–554 (2016). https://doi.org/10.1007/s10461-015-1113-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-015-1113-z

Keywords

Navigation