Prevalence of HIV Risk Behaviors Between Binge Drinkers and Non-binge Drinkers Aged 18- to 64-Years in US, 2008

Xiao-Jun Wen; Lina Balluz; Machell Town


J Community Health. 2012;37(1):72-79. 

In This Article

Abstract and Introduction


Using data from the 2008 Behavioral Risk Factor Surveillance System on 281,303 adults aged 18–64 years in the United States, we examined the relationship between HIV risk behaviors and binge drinking of alcoholic beverages and the frequency of binge drinking among a subgroup of 41,073 respondents who were acknowledged binge drinkers (bingers), based on reported drinking behavior in the year preceding survey. Our findings show that the weighted prevalence of HIV risk behaviors (including injection drug use, exchange of sex for money/drugs, and anal sex without a condom) among binge bingers [7.0%, 95% confidence interval (95% CI): 6.4–7.6%] is twice that among nonbingers (2.9%, 95% CI: 2.7–3.0%). The highest prevalence of HIV risk behaviors is among the bingers aged 18–20 years (14%, 95% CI: 11.2–18.2%). After adjusting for covariates, bingers are 1.77 (95% CI: 1.58–2.00) times more likely than nonbingers to report HIV risk behaviors. Risk increases in bingers with the number of episodes. Compared with bingers reporting 1–2 binge episodes in the month proceeding survey, the adjusted odds of reporting HIV risk behaviors among bingers are 1.27 (1.08–1.49), 1.68 (1.35–2.10), 1.67 (1.08–2.57), and 1.70 (1.34–2.16), respectively for bingers with 3–4, 5–6, 7–8, and ≥9 episodes in the same period. Our results suggest that HIV risk behaviors are strongly linked with binge drinking and its frequency. Effective measures to prevent binge drinking are essential to HIV prevention, especially among youth aged 18–20 years.


Injection drug use, exchange of sex for money or drugs, and anal sex without a condom are some of the well-known risk behaviors that lead to HIV infections.[1–7] It is also well known that alcohol use including binge drinking are linked to high-risk sexual behaviors.[8–17]

Binge drinking is the practice of consuming an excessive quantity of alcoholic beverages defined as 5 or more drinks for men, or 4 or more drinks for women within an episode of about 2 h.[18] It is a prevalent form of excessive alcohol abuse in the United States (US), where approximately 92% of adults aged 18 or older who drink excessively reported binge drinking.[19] In the general population of US, 17% of adults[20] reported excessive drinking during the 30 days preceding survey. The impact among full-time college students is staggering. In 2001, for example, 599,000 (10.5%) full-time 4-year college students were injured because of drinking, 696,000 (12%) were hit or assaulted by another drinking college student, and 97,000 (2%) were victims of alcohol-related sexual assault or date rape.[21] According to national surveys,[19] binge drinking is associated with many health problems including unintentional injuries (e.g., car crashes, falls, burns, drowning), intentional injuries (e.g., firearm injuries, sexual assault, domestic violence), alcohol poisoning, sexually transmitted diseases, unintended pregnancy, children born with Fetal Alcohol Spectrum Disorders, high blood pressure, stroke, and other cardiovascular diseases, liver disease, neurological damage, sexual dysfunction, and poor control of diabetes.

Studies have demonstrated the excessive alcohol use including binge drinking is associated with sexual risk behavior and HIV infection.[13,15,22–24] Despite the large amount of data[13,15,22–24] supporting the linkage between excessive alcohol use/abuses and HIV risk behaviors, large scale population-based studies on the HIV risk behaviors among the US binge-drinking population have been lacking. In particular, we need national data on the linkage of binge drinking and HIV risk behaviors by demographic characteristics. We propose that this information gap must be filled in order to plan and implement effective intervention programs to reduce HIV risk behaviors and binge drinking as well in the US.

From a methodological perspective, alcohol use is a general term for a variety of usage patterns, such as chronic heavy drinking and binge drinking. The measurements of alcohol use can be complicated and they can be analyzed from several aspects. For example, binge drinking is by nature extreme-intensity alcohol use, binge drinking can still be measured by the intensity of each episode and by the frequency of episodes during a certain time frame, as well. The association of alcohol use with HIV risk behaviors has been well established by numerous studies using a variety of measurements of alcohol use/abuse, e.g. by intensity, frequency, or length of time of alcohol use; however, the association of the frequency of binge drinking episodes with the HIV risk behaviors has not been fully examined. We believe that understanding such association is essential to development of effective HIV prevention programs that target binge drinkers.

The objectives of our study were to examine the difference(s), if any, in HIV risk behaviors of 18- to 64-year-old binge drinkers versus nonbingers in the US general population, and to assess the association between HIV risk behaviors in bingers and the frequency of binge drinking episodes during the 30 days preceding survey.


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