Document 0658
 DOCN  M94A0658
 TI    Alcoholism as a risk factor.
 DT    9412
 AU    Strain J
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:54 (abstract no. SP5).
       Unique Identifier : AIDSLINE ASHM5/94348997
 AB    Individuals who use alcohol have been found to be at higher risk for HIV
       infection than those who do not. The San Francisco Gay Men's Health
       Study, the Multicenter AIDS Cohort Study (MACS), and the Newark Medical
       Center Alcoholic Assessment Study, all describe that the use of alcohol,
       and, in particular, if there is an alcohol abuse disorder, to be a
       significant risk factor for contracting HIV infection. In the Newark
       research, blood samples from 99 alcohol treatment center patients were
       tested; 76% were males. Sixty-eight percent reported alcohol use
       exclusively, and 27% described current or past intravenous drug use in
       addition to alcohol use. HIV-1Ab seropositivity was found in 4.5% of
       patients who abused alcohol exclusively. Although the alcohol exclusive
       group may not have been truthful in reporting their intravenous drug
       abuse, the most likely source of HIV transmission is high risk sexual
       behaviour; the likelihood of such behaviour is increased by the
       disinhibiting effects of alcohol. 83% of sexually active men and women
       had engaged in unsafe sex during the preceding year. One hundred percent
       of sexually active subjects reported that they always used alcohol
       before or during sex and readily acknowledged the role alcohol played in
       facilitating unsafe sexual practices. The apparent determining factor in
       being at risk for HIV was not the absolute number of the subject's sex
       partners, but rather the number with whom the subject had shared alcohol
       or drugs. The disinhibiting effects of alcohol is an important mediator
       of the association. Men who expect alcohol to diminish tension are more
       likely to engage in HIV transmitting behaviour while intoxicated than
       are men who do not have such an expectation. The public health
       consequences of the 4.5% prevalence of HIV seropositivity in alcoholics
       who do use intravenous drugs will be discussed. Adequate history taking
       and counselling on the use of alcohol and the risk of acquiring HIV is
       mandatory, and must be a part of the routine examination in all medical
       settings.
 DE    Adult  Alcoholism/COMPLICATIONS/*EPIDEMIOLOGY/PSYCHOLOGY  Cohort Studies
       Cross-Sectional Studies  Female  Homosexuality/PSYCHOLOGY/STATISTICS &
       NUMER DATA  Human  HIV Infections/*EPIDEMIOLOGY/PREVENTION &
       CONTROL/PSYCHOLOGY/  TRANSMISSION  *HIV-1  Incidence  Male  Risk Factors
       Sex Behavior  Substance Abuse, Intravenous/COMPLICATIONS/EPIDEMIOLOGY/
       PSYCHOLOGY  United States/EPIDEMIOLOGY  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).