Revista de SIDA e investigación clínica

The Influence of Alcohol Use Disorders on Sex and Mood in an HIV- infected Population in the State of Ceará, Northeastern Brazil

Abstract

Background: This study assesses among 200 HIV-infected outpatients the prevalence of positive alcohol use disorder (AUD) and its correlations with socio-demographic characteristics, life habits, sexual behavior and (hypo) manic symptoms. Methods: Between December 2009 and June 2011, patients were interviewed at the specialized clinic for HIV care located in Walter Cantídio’s University Hospital, Fortaleza, Ceará, Brazil. Screening for AUD was performed with the Alcohol Use Disorders Identification Test (AUDIT). A socio-demographic questionnaire based on WHO’s Behavioral Surveillance Surveys was used to track risky sexual behaviors. The Mood Disorder Questionnaire (MDQ) was used to screen for symptoms of mania and hypomania. Results: One hundred thirty-three patients (66.5%) were male, mean age of 37.4 years (standard deviation, SD=10.9) and mean years of study of 9.5(SD=3.5). Ninety nine patients (49.5%) had AUD: 80 (40%) had hazardous drinking and 19 (9.5%) had alcohol dependence. AUD patients had higher rates of male gender (OR=2.8; 95%CI=1.5, 5.2), living alone (OR=4.5; 95%CI=1.6, 12.7), use of tobacco (OR=3.0; 95%CI=1.4, 6.6), use of illicit drugs (OR=3.5; 95%CI=1.7, 7.1) and (hypo)manic symptoms (OR=6.4; 95%CI=2.3, 17.7). Regarding sexual behavior, AUD was associated with lower age at first sex (OR=1.1; 95%CI=1.05, 1.2) and higher prevalence of commercial (OR=2.7; 95%CI=1.3, 5.8) and non-regular sex partners (OR=4.3; 95%CI=2.1, 8.6). In multivariate analysis, independent associations between AUD and the following variables were found: manic symptoms (adjusted Odds Ratio [aOR]=10.1; 95%CI=2.3, 44.7), living alone (aOR=7.8; 95%CI=1.5, 39.0), tobacco use (aOR=3.9; 95%CI=1.2, 12.2), male gender (aOR=3.4; 95%CI=1.4, 8.3), sex with non-regular partners (aOR=2.7; 95%CI=1.1, 6.6), lower education (aOR=1.1; 95%CI=1.03, 1.2) and lower age (aOR=1.03; 95%CI=1.002, 1.076). Conclusion: Therefore, there is a significantly high prevalence of AUD among HIV-infected patients. AUD showed the following profile: young males, living alone, with lower education, higher rates of (hypo) manic symptoms and drug and sexual risk behaviors. A better understanding of AUD comorbidity and its implications on behavioral aspects of HIV-positive individuals may help in providing better long term outcomes of these patients.