Prevalence and correlates of hazardous alcohol consumption and binge drinking among men who have sex with men (MSM) in San Francisco

Yu Liu,H Fisher Raymond,Willi Mcfarland,Marcial Ornelaz,Arsheen Ali,Christopher Rowe,John E Walker,Jaclyn Hern,Maximo Prescott,Glenn-Milo Santos,Phillip Coffin

doi:10.1371/journal.pone.0202170

Abstract

ObjectivesTo describe heavy alcohol use patterns and correlates in a diverse sample of MSM.MethodsWe used respondent-driven sampling (RDS) to enroll 252 alcohol-using MSM in San Francisco from March 2015-July 2017. We examined heavy alcohol use patterns and conducted RDS-adjusted multivariable analyses to characterize correlates of hazardous alcohol consumption and binge drinking.ResultsRDS-adjusted prevalence of weekly and at least weekly binge drinking was 24.9% and 19.3%, respectively. Hazardous consumption was common; prevalence of mid- and high-levels of hazardous drinking was 11.4% and 29.9%, respectively. In multivariable analyses, identifying as Hispanic/Latino or mixed/other race; being moderately or extremely interested in reducing alcohol use; ever receiving alcohol treatment; using ecstasy; reporting syphilis diagnosis; and having more than 5 male partners were independently associated with hazardous alcohol consumption. Less hazardous consumption was associated with having a bachelor's degree or completing post-graduate studies; and not being in a relationship. Reporting chlamydia infection; being somewhat, moderately or extremely interested in reducing alcohol use; and having multiple male sex partners were associated with higher odds of at least weekly binge drinking. Lower odds of binge drinking were associated with completing post-graduate studies. Moreover, for the outcomes of hazardous alcohol consumption and binge-drinking, we observed significant interaction effects between race/ethnicity and interest in reducing alcohol, past receipt of alcohol treatment, use of ecstasy, syphilis diagnosis, and number of male partners.ConclusionAmong alcohol-using MSM in San Francisco, heavy drinking patterns were common and independently associated with greater number of male sexual partners and sexually transmitted infections (STI). Moreover, significant racial/ethnic and socioeconomic disparities related to heavy alcohol use were observed and race/ethnicity modified the effect of the risk factors associated with these outcomes. These findings underscore the need to develop more MSM-specific interventions that jointly address heavy alcohol use and HIV/STI risk, as well as culturally-tailored and targeted strategies to alleviate health disparities.

Highlights

Heavy alcohol use, including binge drinking and hazardous alcohol consumption, has been linked to a wide range of negative health problems [1,2] and is the fourth leading lifestyle-related cause of death in the United States (US) [3]
In multivariable analyses, identifying as Hispanic/Latino or mixed/other race; being moderately or extremely interested in reducing alcohol use; ever receiving alcohol treatment; using ecstasy; reporting syphilis diagnosis; and having more than 5 male partners were independently associated with hazardous alcohol consumption
Significant racial/ethnic and socioeconomic disparities related to heavy alcohol use were observed and race/ethnicity modified the effect of the risk factors associated with these outcomes

Summary

Introduction

Heavy alcohol use, including binge drinking (i.e., five or more drinks in a single occasion for men) and hazardous alcohol consumption (i.e., as classified by the alcohol use disorders identification test [AUDIT]), has been linked to a wide range of negative health problems [1,2] and is the fourth leading lifestyle-related cause of death in the United States (US) [3]. Studies have described the prevalence and examined the demographic, social and clinical correlates of alcohol use disorders for the general adult population using large epidemiologic surveys These analyses were guided by the exploratory data analysis conceptual framework with the goal of identifying potential health disparities among racial/ethnic and age groups, identify comorbidities related to heavy alcohol use, and inform the planning and delivery of public health services [6,7]. We are unaware of MSM-specific studies that have explored the demographic, social, and clinical correlates of heavy alcohol use patterns, similar to those conducted among the Prevalence and correlates of hazardous alcohol consumption and binge drinking among men who have sex with men adult general population. More empirical studies are needed to further explore the wide range of drinking patterns among alcohol-using MSM, and inform planning and delivery of services for these individuals

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Discussion

Conclusion