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The National Institute on Alcohol Abuse and Alcoholism reports that at the end of 2000, an estimated 900,000 Americans were living with HIV (Human Immunodeficiency Virus-the virus that causes AIDS). Approximately 40,000 new cases are diagnosed annually. Concerns about HIV have increased as recent trends suggest a rise in heterosexually transmitted cases which almost equals the proportion of cases attributable to injection drug use.

So what does HIV have to do with alcohol use? Studies have shown that people who abuse alcohol are more likely to engage in risky behaviors—behaviors that put them at risk for HIV. For example, increasing levels of alcohol ingestion are associated with greater injection drug related risk behavior, such as needle sharing. Other studies show that heavy alcohol consumption has been correlated with a lifetime tendency towards high risk sexual behavior, such as multiple sexual partners, unprotected intercourse, and sex with high risk partners (i.e., injection drug users). Keep in mind that this association does not necessarily imply that alcohol plays a direct role in this behavior or that every time one drinks, one will engage in high risk behavior.

Medical connections between HIV and alcohol also exist. For individuals infected with HIV, alcohol increases the susceptibility to some infections that can occur as complications to AIDS. Infections associated with both alcohol and HIV include tuberculosis and Hepatitis C. Alcohol may increase the severity of AIDS-related dementia, as well.

In addition, people with HIV are more likely to use alcohol at some time during their lives. In persons already infected, t he combination of heavy drinking and HIV has been associated with increased medical and psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and poorer HIV treatment outcomes.

Can treating alcoholism be seen as HIV prevention, as well? Yes. Studies show that decreasing alcohol use among HIV patients not only reduces the medical and psychiatric consequences associated with alcohol consumption but also decreases other drug use and HIV transmission. Thus, alcohol and other drug abuse treatment can be considered primary HIV prevention as well.

Alcoholism prevention among youth is especially important. According to a 2001 study by Malow, et al., AIDS is one of the leading causes of death among people ages 15-24. Studies have shown that the prevalence of current binge, and heavy drinking peaks between the ages of 18 and 24, which is a high-risk period for initiating injection drug use. In addition, high rates of risky sexual practices have been reported among adolescents and may be correlated with alcohol consumption. Therefore, it has been suggested that HIV prevention programs for youth should target alcohol consumption in addition to injection drug use and sexual risk reduction.

For more information, contact:

The Alcohol & Drug Council 274-6288
Southern Tier Aids Program 274-0079

For free and confidential HIV testing, contact:

Tompkins County Health Department 274-6683

Sober Talk is a monthly column by the Alcohol & Drug Council and runs in the Journal on the first Thursday of each month. Stacy Cangelosi, MSW is the Director of Education & Prevention at the Alcohol & Drug Council