Skip to main content

Advertisement

Log in

Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objective

To analyze the relationship between alcohol consumption and incident HIV infection.

Methods

Articles were identified via electronic and hand searches. Inclusion criteria were: incident HIV infection, preceding alcohol consumption, and association relating the two. The DerSimonian and Laird random effects model was used. For studies with more than one estimate of a given type, estimates were combined using the inverse variance weighted method. Publication bias was assessed using Begg’s and Egger’s tests. Heterogeneity was assessed using Q and I 2 statistics.

Results

Ten studies were included. Overall alcohol consumption (any of the three types identified) increased the risk of HIV (RR 1.98, 95% CI 1.59–2.47). Alcohol consumers were at 77% higher risk (RR 1.77, 95% CI 1.43–2.19). Those consuming alcohol prior to, or at the time of, sexual relations were at an 87% increased risk (RR 1.87, 95% CI 1.39–2.50). For binge drinkers, the risk was double that of non-binge drinkers (RR 2.20, 95% CI 1.29–3.74).

Conclusions

Alcohol consumption is associated with an increased risk of incident HIV infection. Additional research is required to further investigate a possible causal role.

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.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Bagasra O, Bachman SE, Jew L, Tawadros R, Cater J, Boden G, Ryan I, Pomerantz RJ (1996) Increased human immunodeficiency virus type 1 replication in human peripheral blood mononuclear cells induced by ethanol: potential immunopathogenic mechanisms. J Infect Dis 173:550–558

    CAS  PubMed  Google Scholar 

  • Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101

    Article  CAS  PubMed  Google Scholar 

  • Benotsch EG, Kalichman SC, Kelly JA (1999) Sexual compulsivity and substance use in HIV-seropositive men who have sex with men: prevalence and predictors of high-risk behaviors. Addict Behav 24:857–868

    Article  CAS  PubMed  Google Scholar 

  • Benotsch EG, Kalichman SC, Pinkerton SD (2001) Sexual compulsivity in HIV-positive men and women: prevalence, predictors, and consequences of high-risk behaviors. Sexual Addict Compuls 8:83–99

    Article  Google Scholar 

  • Bryan A, Ray LA, Cooper ML (2007) Alcohol use and protective sexual behaviors among high-risk adolescents. J Stud Alcohol Drugs 68:327–335

    PubMed  Google Scholar 

  • Celentano DD, Nelson KE, Suprasert S, Eiumtrakul S, Tulvatana S, Kuntolbutra S, Akarasewi P, Matanasarawoot A, Wright NH, Sirisopana N (1996) Risk factors for HIV-1 seroconversion among young men in northern Thailand. JAMA 275:122–127

    Article  CAS  PubMed  Google Scholar 

  • Chesney MA, Barrett DC, Stall R (1998) Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men. Am J Public Health 88:113–116

    Article  CAS  PubMed  Google Scholar 

  • Cook RL, Clark DB (2005) Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sex Transm Dis 32:156–164

    Article  PubMed  Google Scholar 

  • Crowe LC, George WH (1989) Alcohol and human sexuality: review and integration. Psychol Bull 105:374–386

    Article  CAS  PubMed  Google Scholar 

  • Dingle GA, Oei TP (1997) Is alcohol a cofactor of HIV and AIDS? Evidence from immunological and behavioral studies. Psychol Bull 122:56–71

    Article  CAS  PubMed  Google Scholar 

  • Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. Br Med J 315:629–634

    CAS  Google Scholar 

  • Figueroa JP, Ward E, Morris J, Brathwaite AR, Peruga A, Blattner W, Vermund SH, Hayes R (1997) Incidence of HIV and HTLV-1 infection among sexually transmitted disease clinic attenders in Jamaica. J Acquir Immune Defic Syndr Hum Retrovirol 15:232–237

    CAS  PubMed  Google Scholar 

  • Fisher JC, Bang H, Kapiga SH (2007) The association between HIV infection and alcohol use: a systematic review and meta-analysis of African studies. Sex Transm Dis 34:856–863

    Article  PubMed  Google Scholar 

  • Fisher JC, Cook PA, Sam NE, Kapiga SH (2008) Patterns of alcohol use, problem drinking, and HIV infection among high-risk African women. Sex Transm Dis 35:537–544

    Article  PubMed  Google Scholar 

  • George WH, Stoner SA (2000) Understanding acute alcohol effects on sexual behavior. Annu Rev Sex Res 11:92–124

    CAS  PubMed  Google Scholar 

  • Gordon CM, Carey MP, Carey KB (1997) Effects of a drinking event on behavioral skills and condom attitudes in men: implications for HIV risk from a controlled experiment. Health Psychol 16:490–495

    Article  CAS  PubMed  Google Scholar 

  • Halpern-Felsher BL, Millstein SG, Ellen JM (1996) Relationship of alcohol use and risky sexual behavior: a review and analysis of findings. J Adolesc Health 19:331–336

    Article  CAS  PubMed  Google Scholar 

  • Kalichman SC, Cain D (2004) The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic. J Sex Res 41:235–241

    Article  PubMed  Google Scholar 

  • Kalichman SC, Rompa D (1995) Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior. J Pers Assess 65:586–601

    Article  CAS  PubMed  Google Scholar 

  • Kalichman SC, Johnson JR, Adair V, Rompa D, Multhauf K, Kelly JA (1994) Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men. J Pers Assess 62:385–397

    Article  CAS  PubMed  Google Scholar 

  • Kalichman SC, Heckman T, Kelly JA (1996) Sensation seeking as an explanation for the association between substance use and HIV-related risky sexual behavior. Arch Sex Behav 25:141–154

    Article  CAS  PubMed  Google Scholar 

  • Kalichman SC, Weinhardt L, DiFonzo K, Austin J, Luke W (2002) Sensation seeking and alcohol use as markers of sexual transmission risk behavior in HIV-positive men. Ann Behav Med 24:229–235

    Article  PubMed  Google Scholar 

  • Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S (2007a) Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci 8:141–151

    Article  PubMed  Google Scholar 

  • Kalichman SC, Simbayi LC, Vermaak R, Cain D, Jooste S, Peltzer K (2007b) HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa. J Acquir Immune Defic Syndr 44:594–600

    Article  PubMed  Google Scholar 

  • Kalichman SC, Simbayi LC, Vermaak R, Cain D, Smith G, Mthebu J, Jooste S (2008) Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa. Ann Behav Med 36:270–279

    Article  PubMed  Google Scholar 

  • Kapiga SH, Lyamuya EF, Lwihula GK, Hunter DJ (1998) The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania. AIDS 12(1):75–84

    Article  CAS  PubMed  Google Scholar 

  • Kippax S, Campbell D, Van de Ven P, Crawford J, Prestage G, Knox S, Culpin A, Kaldor J, Kinder P (1998) Cultures of sexual adventurism as markers of HIV seroconversion: a case control study in a cohort of Sydney gay men. AIDS Care 10(6):677–688

    Article  CAS  PubMed  Google Scholar 

  • Koblin BA, Husnik MJ, Colfax G, Huang Y, Madison M, Mayer K, Barresi PJ, Coates TJ, Chesney MA, Buchbinder S (2006) Risk factors for HIV infection among men who have sex with men. AIDS 20(5):731–739

    Article  PubMed  Google Scholar 

  • Krantz SR, Lynch DA, Russell JM (2002) Gender-specific profiles of self-reported adolescent HIV risk behaviors. J Assoc Nurses AIDS Care 13(6):25–33

    Article  PubMed  Google Scholar 

  • LaBrie J, Earleywine M, Schiffman J, Pedersen E, Marriot C (2005) Effects of alcohol, expectancies, and partner type on condom use in college males: event-level analyses. J Sex Res 42:259–266

    Article  PubMed  Google Scholar 

  • Leigh BC (2002) Alcohol and condom use: a meta-analysis of event-level studies. Sex Transm Dis 29:476–482

    Article  PubMed  Google Scholar 

  • Leigh BC, Stall R (1993) Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention. Am Psychol 48:1035–1045

    Article  CAS  PubMed  Google Scholar 

  • Leigh BC, Morrison DM, Hoppe MJ, Beadnell B, Gillmore MR (2008) Retrospective assessment of the association between drinking and condom use. J Stud Alcohol Drugs 69:773–776

    PubMed  Google Scholar 

  • Maisto SA, Carey MP, Carey KB, Gordon CM (2002) The effects of alcohol and expectancies on risk perception and behavioral skills relevant to safer sex among heterosexual young adult women. J Stud Alcohol 63:476–485

    PubMed  Google Scholar 

  • Murphy ST, Monahan J, Miller LC (1998) Inference under the influence: the impact of alcohol and inhibition conflict on women’s sexual decision making. Pers Soc Psychol Bull 24:517–528

    Article  Google Scholar 

  • Nopkesorn T, Mock PA, Mastro TD, Sangkharomya S, Sweat M, Limpakarnjanarat K, Laosakkitiboran J, Young NL, Morse SA, Schmid S, Weniger BG (1998) HIV-1 subtype E incidence and sexually transmitted diseases in a cohort of military conscripts in northern Thailand. J Acquir Immune Defic Syndr Hum Retrovirol 18(4):372–379

    CAS  PubMed  Google Scholar 

  • Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ (1997) Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982–1994. Am J Epidemiol 146:531–542

    CAS  PubMed  Google Scholar 

  • Plankey MW, Ostrow DG, Stall R, Cox C, Li X, Peck JA, Jacobson LP (2007) The relationship between methamphetamine and popper use and risk of HIV seroconversion in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr 45(1):85–92

    Article  CAS  PubMed  Google Scholar 

  • Read TR, Hocking J, Sinnott V, Hellard M (2007) Risk factors for incident HIV infection in men having sex with men: a case-control study. Sex Health 4(1):35–39

    Article  PubMed  Google Scholar 

  • Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J (2009) Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 373:2223–2233

    Article  PubMed  Google Scholar 

  • Room R, Babor T, Rehm J (2005) Alcohol and public health. Lancet 365:519–530

    PubMed  Google Scholar 

  • StataCorp (2008) Stata Statistical Software: Release 10.1. Stata Corporation, College Station

    Google Scholar 

  • Steele CM, Josephs RA (1990) Alcohol myopia. Its prized and dangerous effects. Am Psychol 45:921–933

    Article  CAS  PubMed  Google Scholar 

  • Szabo G (1997) Alcohol’s contribution to compromised immunity. Alcohol Health Res World 21:30–41

    CAS  PubMed  Google Scholar 

  • UNAIDS (2008) 2008 Report on the global AIDS epidemic. UNAIDS, Geneva

    Google Scholar 

  • Wang C, Vlahov D, Galai N, Cole SR, Bareta J, Pollini R, Mehta SH, Nelson KE, Galea S (2005) The effect of HIV infection on overdose mortality. AIDS 19:935–942

    Article  PubMed  Google Scholar 

  • Weinhardt LS, Carey MP (2000) Does alcohol lead to sexual risk behavior? Findings from event-level research. Annu Rev Sex Res 11:125–157

    CAS  PubMed  Google Scholar 

  • World Health Organization (2002) World Health Report 2002. WHO, Geneva

    Google Scholar 

  • World Health Organization (2008) Towards universal access : scaling up priority HIV/AIDS interventions in the health sector : progress report 2008. World Health Organization, Geneva

    Google Scholar 

  • Zablotska IB, Gray RH, Serwadda D, Nalugoda F, Kigozi G, Sewankambo N, Lutalo T, Mangen FW, Wawer M (2006) Alcohol use before sex and HIV acquisition: a longitudinal study in Rakai, Uganda. AIDS 20:1191–1196

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the attendees of the Alcohol and Infectious Diseases Technical meeting held in Cape Town, South Africa in July 2008 and hosted by the South African Medical Research Council in collaboration with the World Health Organization. The research work was funded by the South African Medical Research Council (MRC) through a grant received from the US President’s Emergency Fund for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dolly Baliunas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baliunas, D., Rehm, J., Irving, H. et al. Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis. Int J Public Health 55, 159–166 (2010). https://doi.org/10.1007/s00038-009-0095-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-009-0095-x

Keywords

Navigation