Heavy Drinking Trajectories Among Men Who Have Sex with Men: A Longitudinal, Group-Based Analysis

作者：Marshall Brandon D L^*; Shoveller Jean A; Kahler Christopher W; Koblin Beryl A; Mayer Kenneth H; Mimiaga Matthew J; van den Berg Jacob J; Zaller Nickolas D; Operario Don

来源：Alcoholism: Clinical and Experimental Research , 2015, 39(2): 380-389.

DOI：10.1111/acer.12631

• Alcohol
• Men Who Have Sex With Men
• Depression
• Substance Use
• Educational Attainment

BackgroundHeavy episodic drinking (HED) is associated with sexual risk behavior and HIV seroconversion among men who have sex with men (MSM), yet few studies have examined heavy drinking typologies in this population.
MethodsWe analyzed data from 4,075 HIV-uninfected MSM (aged 16 to 88) participating in EXPLORE, a 48-month behavioral intervention trial, to determine the patterns and predictors of HED trajectories. HED was defined as the number of days in which 5 alcohol drinks were consumed in the past 6months. Longitudinal group-based mixture models were used to identify HED trajectories, and multinomial logistic regression was used to determine correlates of membership in each group.
ResultsWe identified 5 distinct HED trajectories: nonheavy drinkers (31.9%); infrequent heavy drinkers (i.e., <10 heavy drinking days per 6-month period, 54.3%); regular heavy drinkers (30 to 45 heavy drinking days per 6months, 8.4%); drinkers who increased HED over time (average 33days in the past 6months to 77days at end of follow-up, 3.6%); and very frequent heavy drinkers (>100days per 6months, 1.7%). Intervention arm did not predict drinking trajectory patterns. Younger age, self-identifying as white, lower educational attainment, depressive symptoms, and stimulant use were associated with reporting heavier drinking trajectories. Compared to nonheavy drinkers, participants who increased HED more often experienced a history of childhood sexual abuse (CSA). Over the study period, depressive symptomatology increased significantly among very frequent heavy drinkers.
ConclusionsSocioeconomic factors, substance use, depression, and CSA were associated with heavier drinking patterns among MSM. Multicomponent interventions to reduce HED should seek to mitigate the adverse impacts of low educational attainment, depression, and early traumatic life events on the initiation, continuation, or escalation of frequent HED among MSM.

• 出版日期2015-2