ALCOHOL-RELATED RISK-FACTORS ASSOCIATED WITH HIV-INFECTION AMONG PATIENTS ENTERING ALCOHOLISM-TREATMENT - IMPLICATIONS FOR PREVENTION

Objective: Reports suggest that alcoholics may be at risk for HIV infe ction. In this article we examine several alcohol-related risk factors for HIV infection among patients entering alcoholism treatment in an AIDS epicenter. Our objective was to identify key factors for HIV prev ention and screening among populations receiving treatment for alcohol abuse or alcohol dependence. Method: Clients (N = 921) entering five alcoholism treatment centers in the San Francisco Bay area underwent a n interview and blind serotesting for HIV antibodies (76% were male, 1 6% men who had sex with men, 50% black, 10% Latinos and 6.5% were HIV seropositive). Logistic regression was used to predict HIV serostatus from five possible alcohol-associated risk factors, controlling for de mographics and traditional HIV risk factors. These were alcohol impair ment, attitudes about socializing in bars, increased sexual risk expec tancies when drinking, enhanced sexual expectancies when drinking and decreased nervousness when drinking. Male and female heterosexuals and men with a history of homosexuality were analyzed separately. Results : Among male and female heterosexuals, HIV infection was positively as sociated with higher alcohol impairment (OR = 2.69, p = .031) and nega tively associated with higher sexual risk expectancies when drinking ( OR = 0.24, p = .075). Among men who had sex with men, HIV infection wa s positively associated with higher bar socializing orientations (OR = 10.06, p = .004). Infection was also negatively associated with highe r alcohol impairment (OR = 0.34, p = .052) and higher sexual risk expe ctancies when drinking (OR = 0.26, p = .024) for these men. Conclusion s: Since these associations were independent of demographics and tradi tional HIV risk factors, our research suggests it may be important to also focus HIV screening and prevention on alcohol-related risk factor s in AIDS epicenters. For heterosexual alcoholics, the focus should be on those with higher alcohol dependence. For male alcoholics who had sex with men, the focus should be on those who primarily socialize in bars. Further research is needed to determine why higher sexual risk p erceptions when drinking were associated with lower rates of HIV infec tion for both groups, since this discovery may have important preventi on implications. The negative association between infection and alcoho l impairment among homosexual men also warrants further investigation. z