Coping Strategies and Patterns of Alcohol and Drug Use among HIV-Infected Patients in the United States Southeast

Abstract

Alcohol and drug use are common among HIV-infected patients and are important determinants of secondary transmission risk and medication adherence. As part of the Coping with HIV/AIDS in the Southeast (CHASE) Study, 611 HIV-infected patients were consecutively recruited from eight clinical care sites in five southeastern U.S. states in 2001-2002. We examined the distribution and predictors of alcohol and drug use in this sample with an emphasis on psychosocial predictors of use. In the prior 9 months, 27% of participants drank alcohol and 7% drank to intoxication at least weekly. The most common drugs used at least weekly were marijuana (12%) and crack (5%); 11% used a non-marijuana drug. 7% reported polysubstance use (use of multiple substances at one time) at least weekly. Injection drug use was rare (2% injected at least once in the past 9 months). There were few differences in alcohol and drug use across sociodemographic characteristics. Stronger adaptive coping strategies were the most consistent predictor of less frequent alcohol and drug use, in particular coping through action and coping through relying on religion. Stronger maladaptive coping strategies predicted greater frequency of drinking to intoxication but not other measures of alcohol and drug use. Those with more lifetime traumatic experiences also reported higher substance use. Interventions that teach adaptive coping strategies may be effective in reducing alcohol and substance use among HIV-positive persons.

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

“…Higher frequency of alcohol consumption induces a stronger maladaptive coping strategy among HIV-positive people because the alcohol may be associated with other behavioral disorders that lead to non-adherence to ART [13]. Alcohol users may also be less likely to seek support from their family, friends, and caregivers, which may lead to non-adherence to ART [36].…”

“…In addition, HIV-positive people who use alcohol frequently can experience more conflict with their partners, which can impact negatively on spousal support and lead to poor compliance with ART [12]. Harmful alcohol drinking can also reduce coping skills and increase the likelihood of opportunistic infections [13]. Moreover, HIV-positive people who used illicit substances also had alcohol-use disorders resulting in non-adherence to ART [14].…”

A Systematic Review of Studies Using the Brief COPE: Religious Coping in Factor Analyses

“…As with Tables 1 and 2, when at least two studies reported results based on the same dataset, only summaries are shown for the study that provided the most detail. Summaries for the following eight studies are therefore not listed in Table 3: Cooper et al [69][70][71], Gillen [72], Gore-Felton et al [73], Gow et al [74], Pence et al [75], and Piazza-Waggoner et al [76]. Compared to the studies that had conducted their own exploratory factor analyses, those that based their factor structure on previous research tended to have smaller samples sizes.…”

Medicine for the Spirit: Religious Coping in Individuals with Medical Conditions

“…Religious well-being is positively related to self-efficacy to use condoms [42], and religious coping is associated with reduced likelihood of recent unprotected sex among men but not women [47]. Religious coping and attendance at religious services in particular have been negatively related to substance use, including use of alcohol, crack cocaine, and other non-marijuana substances [7,48]. In a similar vein, a study of congestive heart failure patients found that spiritual support and positive religious coping were related to less substance use [44].…”