Daily alcohol use as an independent risk factor for HIV seroconversion among people who inject drugs Young, Samantha; Wood, Evan; Dong, Huiru; Kerr, Thomas; Hayashi, Kanna
Aims: To estimate the relationship between daily alcohol use and HIV seroconversion among people who inject drugs (PWID) in a Canadian setting. Design and Setting: Data from an open prospective cohort study of PWID in Vancouver, Canada, recruited via snowball sampling and street outreach between May 1996 and November 2013. An interviewer-administered questionnaire including standardized behavioural assessment and HIV antibody testing were conducted semi-annually. Baseline HIV-seronegative participants completing ≥ 1 follow-up visits were eligible for the present analysis. Participants: A total of 1683 eligible participants, were followed for a median of 79.8 [interquartile range (IQR) = 33.3-119.1] months. Measurements: The primary end-point was time to HIV seroconversion, with the date of HIV seroconversion estimated as the mid-point between the last negative and the first positive antibody test results. The primary explanatory variable was self-reported daily alcohol use in the previous 6 months assessed semiannually. Other covariates considered included demographic, behavioural, social/structural and environmental risk factors for HIV infection among PWID (e.g. daily cocaine injection, methadone use, etc.). Findings: Of 1683 PWID, there were 176 HIV seroconversions during follow-up with an incidence density of 1.5 [95% confidence interval (CI) = 1.3-1.7] cases per 100 person-years. At baseline, 339 (20.1%) consumed alcohol at least daily in the previous 6 months. In multivariable extended Cox regression analyses, daily alcohol use remained associated independently with HIV seroconversion (adjusted hazard ratio: 1.48; 95% CI = 1.00-2.17). Conclusions: Daily alcohol use appears to be an independent risk factor for HIV seroconversion among our cohort of PWID.
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