Perceived health and alcohol use in individuals with HIV and Hepatitis C who use drugs

•We assessed perceived health in drug users with HIV or Hepatitis C Virus (HCV).•In drug users with HIV or HCV, those reporting poorer health drank at riskier levels•These associations were only significant when demographics were controlled.•For the smaller HIV/HCV sample, the similar association did not reach significance.•HIV and HCV-infected drug users in poor health should be screened for risky drinking.

BackgroundIndividuals who use illicit drugs are at heightened risk for HIV and/or Hepatitis C Virus (HCV). Despite the medical consequences of drinking for drug-using individuals with these infections, many do drink. In other studies, how individuals perceive their health relates to their engagement in risk behaviors such as drinking. However, among drug-using individuals with HIV and HCV, whether perceived health relates to drinking is unknown.ObjectiveWe examine the association between perceived health and drinking among drug-using individuals with HIV and/or HCV.MethodsIn a large, cross-sectional study, we utilized samples of individuals with HIV (n = 476), HCV (n = 1145), and HIV/HCV co-infection (n = 180), recruited from drug treatment centers from 2005 to 2013. In each sample, we investigated the relationship between perceived health and drinking, using ordinal logistic regressions. We present uncontrolled models as well as models controlled for demographic characteristics.ResultsAmong samples of drug using individuals with HIV and with HCV, poorer perceived health was associated with risky drinking only when demographic characteristics were taken into account (Adjusted Odds Ratios: 1.32 [1.05, 1.67] and 1.16 [1.00, 1.34], respectively). In the smaller HIV/HCV co-infected sample, the association of similar magnitude was not significant (AOR = 1.32 [0.90, 1.93]).ConclusionsDrug using patients with HIV or HCV with poor perceived health are more likely to drink heavily, which can further damage health. However, when demographics are not accounted for, these effects can be masked. Patients' reports of poor health should remind providers to assess for health risk behaviors, particularly heavy drinking.