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Heavy Drinking Trajectories Among Men Who Have Sex with Men: A Longitudinal, Group‐Based Analysis
Author(s) -
Marshall Brandon D. L.,
Shoveller Jean A.,
Kahler Christopher W.,
Koblin Beryl A.,
Mayer Kenneth H.,
Mimiaga Matthew J.,
den Berg Jacob J.,
Zaller Nickolas D.,
Operario Don
Publication year - 2015
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.12631
Subject(s) - binge drinking , demography , heavy drinking , medicine , poison control , injury prevention , longitudinal study , suicide prevention , population , men who have sex with men , depression (economics) , logistic regression , psychology , human immunodeficiency virus (hiv) , environmental health , syphilis , pathology , family medicine , sociology , economics , macroeconomics
Background Heavy 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. Methods We 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 6 months. 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. Results We 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 6 months, 8.4%); drinkers who increased HED over time (average 33 days in the past 6 months to 77 days at end of follow‐up, 3.6%); and very frequent heavy drinkers (>100 days per 6 months, 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. Conclusions Socioeconomic 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 .