Differential effects of perceived stress on alcohol consumption in moderate versus heavy drinking HIV-infected women

- Women with the human immunodeficiency virus (HIV) have high levels of perceived stress.
- Influence of stress on alcohol use depends on preexisting drinking patterns.
- Alcohol use increases with stress only if women were already heavy/binge drinkers.
- Alcohol use decreases with stress if women were already moderate drinkers.
- Following stress exposure, treatment should target subset of heavy drinkers.

ObjectiveTo examine the association between perceived stress and subsequent alcohol use in women living with HIV.MethodsWomen (n = 338) receiving HIV care between April 2006 and July 2010 who enrolled in either a brief intervention for hazardous drinking or a cohort of non-hazardous drinkers completed a 90-day drinking and drug use history, and completed stress, depression and anxiety measures at 0, 6, and 12 months. We examined the association between perceived stress at months 0 or 6 and measures of quantity and frequency of alcohol use in months 3-6 and 9-12, respectively.ResultsThe association between perceived stress and subsequent alcohol use depended on whether women were heavy or moderate drinkers at index visit. Among women reporting ≥7 drinks/week at index visit, high levels of perceived stress were associated with subsequent increased alcohol intake. However, among women reporting >0 but <7 drinks/week at index visit, high levels of perceived stress were associated with a subsequent reduction in drinking.ConclusionsBaseline drinking status moderates the relationship between perceived stress and subsequent alcohol use. Perceived stress is an important therapeutic target in women who are heavy drinkers.