AIDS and Behavior

, Volume 17, Issue 5, pp 1705–1712 | Cite as

Alcohol Consumption Trajectory Patterns in Adult Women with HIV Infection

  • Robert L. Cook
  • Fang Zhu
  • Bea Herbeck Belnap
  • Kathleen M. Weber
  • Stephen R. Cole
  • David Vlahov
  • Judith A. Cook
  • Nancy A. Hessol
  • Tracey E. Wilson
  • Michael Plankey
  • Andrea A. Howard
  • Gerald B. Sharp
  • Jean L. Richardson
  • Mardge H. Cohen
Original Paper


HIV-infected women with excessive alcohol consumption are at risk for adverse health outcomes, but little is known about their long-term drinking trajectories. This analysis included longitudinal data, obtained from 1996 to 2006, from 2,791 women with HIV from the Women’s Interagency HIV Study. Among these women, the proportion in each of five distinct drinking trajectories was: continued heavy drinking (3 %), reduction from heavy to non-heavy drinking (4 %), increase from non-heavy to heavy drinking (8 %), continued non-heavy drinking (36 %), and continued non-drinking (49 %). Depressive symptoms, other substance use (crack/cocaine, marijuana, and tobacco), co-infection with hepatitis C virus (HCV), and heavy drinking prior to enrollment were associated with trajectories involving future heavy drinking. In conclusion, many women with HIV change their drinking patterns over time. Clinicians and those providing alcohol-related interventions might target those with depression, current use of tobacco or illicit drugs, HCV infection, or a previous history of drinking problems.


Alcohol consumption Women HIV-infection Trajectories 


Las mujeres infectadas con VIH que consumen alcohol excesivamente están a riesgo de resultados de salud adversos, pero muy poco se conoce acerca de sus trayectorias de consumo de alcohol a largo plazo. Este análisis incluye data longitudinal obtenida desde 1996 al 2006, de 2791 mujeres con VIH del Estudio Interinstitucional de Mujeres con VIH. Entre estas mujeres, la proporción en cada una de las distintas trayectorias de consumo de alcohol fueron: continuación de consumo excesivo (3 %), reducción de consumo excesivo a consumo no excesivo (4 %), aumento de consumo no excesivo a consumo excesivo (8 %), continuación de consumo no excesivo (36 %), y continuación de ningún consumo (49 %). Síntomas depresivos, uso de otras substancias (crack/cocaína, mariguana, y tabaco), co-infección con VHC, y consumo excesivo antes de inscripción fueron asociados con trayectorias que involucran consumo excesivo en el futuro. En conclusión, muchas mujeres con VIH cambian su patrón de consumo de alcohol con el tiempo. Clínicos y otras personas que proveen intervenciones relacionadas al consumo de alcohol podrían enfocarse en personas con depresión, uso actual de tabaco o drogas ilícitas, infección de VHC, o un historial previo de problemas de consumo de alcohol.



Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington, DC, Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange). The WIHS is funded by the National Institute of Allergy and Infectious Diseases (UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, UO1-AI-34989, UO1-AI-34993, and UO1-AI-42590) and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (UO1-HD-32632). The study is co-funded by the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders. Funding is also provided by the National Center for Research Resources (UCSF-CTSI Grant Number UL1-RR-024131). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. R Cook was supported in part by NIH Grants R01-AA018934 and U01-AA-020797; S Cole was supported in part through NIH Grant R01-AA-01759; and K Weber was supported in part by NIH Grant P30 AI082151.


  1. 1.
    Galvan FH, Bing EG, Fleishman JA, London AS, Caetano R, Burnam MA, et al. The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV cost and services utilization study. J Stud Alcohol. 2002;63:179–86.PubMedGoogle Scholar
  2. 2.
    Theall KP, Clark RA, Powell A, Smith H, Kissinger P. Alcohol consumption, ART usage and high-risk sex among women infected with HIV. AIDS Behav. 2007;11:205–15.PubMedCrossRefGoogle Scholar
  3. 3.
    Cook RL, Zhu F, Belnap BH, Weber K, Cook JA, Vlahov D, et al. Longitudinal trends in hazardous alcohol consumption among women with human immunodeficiency virus infection, 1995–2006. Am J Epidemiol. 2009;169:1025–32.PubMedCrossRefGoogle Scholar
  4. 4.
    NIAAA: National Institute of Alcohol Abuse and Alcoholism. Helping patients who drink too much: a clinician’s guide. Rockville, MD: NIAAA Publications Distribution Center; 2005. Available from:, accessed July 7, 2012.
  5. 5.
    Braithwaite RS, McGinnis KA, Conigliaro J, Maisto SA, Crystal S, Day N, et al. A temporal and dose-response association between alcohol consumption and medication adherence among veterans in care. Alcohol Clin Exp Res. 2005;29:1190–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Chander G, Lau B, Moore RD. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr. 2006;43:411–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Cook RL, Sereika SM, Hunt SC, Woodward WC, Erlen JA, Conigliaro J. Problem drinking and medication adherence among persons with HIV infection. J Gen Intern Med. 2001;16:83–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Samet JH, Horton NJ, Traphagen ET, Lyon SM, Freedberg KA. Alcohol consumption and HIV disease progression: are they related? Alcohol Clin Exp Res. 2003;27:862–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Wilson TE, Massad LS, Riester KA, Barkan S, Richardson J, Young M, et al. Sexual contraceptive, and drug use behaviors of women with HIV and those at high risk for infection: results from the Women’s Interagency HIV Study. AIDS. 1999;13:591–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Neblett RC, Hutton HE, Lau B, McCaul ME, Moore RD, Chander G. Alcohol consumption among HIV-infected women: impact on time to antiretroviral therapy and survival. J Women’s Health. 2011;20:279–86.CrossRefGoogle Scholar
  11. 11.
    Marianna K, Baum C, Lai S, Sales S, Page JB, Campa A. Alcohol use accelerates HIV disease progression. AIDS Res Hum Retroviruses. 2010;26:511–8.CrossRefGoogle Scholar
  12. 12.
    Bacon MC, von Wyl V, Alden C, Sharp G, Robison E, Hessol N, et al. The Women’s Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol. 2005;12:1013–9.PubMedGoogle Scholar
  13. 13.
    Barkan SE, Melnick SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, et al. The Women’s Interagency HIV Study. Epidemiology. 1998;9:117–24.PubMedCrossRefGoogle Scholar
  14. 14.
    Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRefGoogle Scholar
  15. 15.
    Jones B, Nagin D, Roeder K. A SAS procedure based on mixture models for estimating developmental trajectories. Social Method Res. 2001;29:374–93.CrossRefGoogle Scholar
  16. 16.
    Li F, Duncan T, Hops H. Examining developmental trajectories in adolescent alcohol use using piecewise growth mixture modeling analysis. J Stud Alcohol. 2001;62:199–210.PubMedGoogle Scholar
  17. 17.
    Chung T, Maisto SA, Cornelius JR, Martin CS, Jackson KM. Joint trajectory analysis of treated adolescents’ alcohol use and symptoms over 1 year. Addict Behav. 2005;30:1690–701.PubMedCrossRefGoogle Scholar
  18. 18.
    Jacob T, Bucholz K, Sartor C, Howell DN, Wood PK. Drinking trajectories from adolescence to the mid-forties among alcohol dependent males. J Stud Alcohol. 2005;66:745–55.PubMedGoogle Scholar
  19. 19.
    Wiesner M, Weichold K, Silbereisen R. Trajectories of alcohol use among adolescent boys and girls: identification, validation, and sociodemographic characteristics. Psychol Addict Behav. 2007;21(1):62–75.PubMedCrossRefGoogle Scholar
  20. 20.
    Warner LA, White HR, Johnson V. Alcohol initiation experiences and family history of alcoholism as predictors of problem-drinking trajectories. J Stud Alcohol Drugs. 2007;68:56–65.PubMedGoogle Scholar
  21. 21.
    Van Der Vorst H, Vermulst AA, Meeus WH, Dekovic M, Engels RC. Identification and prediction of drinking trajectories in early and mid-adolescence. J Clin Child Adolesc Psychol. 2009;38(3):329–41.CrossRefGoogle Scholar
  22. 22.
    Karlamangla A, Zhou K, Reuben D, Greendale G, Moore A. Longitudinal trajectories of heavy drinking in adults in the United States of America. Addiction. 2006;101:91–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Platt A, Sloan F, Costanzo P. Alcohol-consumption trajectories and associated characteristics among adults older than age 50. J Stud Alcohol Drugs. 2010;71:169–79.PubMedGoogle Scholar
  24. 24.
    Bobo JK, Greek AK, Klepinger DH, Herting JR. Alcohol use trajectories in two cohorts of U.S. women ages 50 to 65 at baseline. J Am Geriatr Soc. 2010;58:2375–80.PubMedCrossRefGoogle Scholar
  25. 25.
    Bobo JK, Greek AK. Increasing and decreasing alcohol use trajectories among older women in the U.S. across a 10-year interval. Int J Enrivon Res Public Health. 2011;8:3263–76.CrossRefGoogle Scholar
  26. 26.
    Cook JA, Burke-Miller JK, Cohen MH, Cook RL, Vlahov D, Wilson TE, et al. Crack cocaine, disease progression, and mortality in a multicenter cohort of HIV-1 positive women. AIDS. 2008;22:1355–63.PubMedCrossRefGoogle Scholar
  27. 27.
    Goldberg D, Weber K, Orsi J, Hessol NA, D’souza G, Watts DM, et al. Smoking cessation among women with and at risk for HIV: are they quitting? J Gen Intern Med. 2010;25:39–44.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Robert L. Cook
    • 1
  • Fang Zhu
    • 2
  • Bea Herbeck Belnap
    • 3
  • Kathleen M. Weber
    • 4
  • Stephen R. Cole
    • 5
  • David Vlahov
    • 6
  • Judith A. Cook
    • 7
  • Nancy A. Hessol
    • 8
  • Tracey E. Wilson
    • 9
  • Michael Plankey
    • 10
  • Andrea A. Howard
    • 11
  • Gerald B. Sharp
    • 12
  • Jean L. Richardson
    • 13
  • Mardge H. Cohen
    • 14
  1. 1.Departments of Epidemiology and MedicineUniversity of FloridaGainesvilleUSA
  2. 2.Biostatistics FacilitiesFox Chase Cancer CenterPhiladelphiaUSA
  3. 3.School of MedicineUniversity of PittsburghPittsburghUSA
  4. 4.The CORE Center, Cook County Bureau of Health ServicesChicagoUSA
  5. 5.University of North CarolinaChapel HillUSA
  6. 6.New York Academy of MedicineNew YorkUSA
  7. 7.Department of PsychiatryUniversity of IllinoisChicagoUSA
  8. 8.Departments of Clinical Pharmacy and MedicineUniversity of CaliforniaSan FranciscoUSA
  9. 9.Department of Preventive Medicine and Community HealthSUNY Downstate Medical CenterBrooklynUSA
  10. 10.Department of MedicineGeorgetown University Medical CenterWashingtonUSA
  11. 11.Department of EpidemiologyMailman School of Public Health, Columbia UniversityNew YorkUSA
  12. 12.Division of AIDSNational Institute of Allergy and Infectious DiseasesBethesdaUSA
  13. 13.Department of Preventive MedicineUniversity of Southern CaliforniaLos AngelesUSA
  14. 14.Department of MedicineCook County Health and Hospitals System and Rush UniversityChicagoUSA

Personalised recommendations