Journal of Community Health

, Volume 37, Issue 1, pp 72–79 | Cite as

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
Original Paper


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.


Alcohol abuse and sexual risk behaviors Behavioral risk factor surveillance system Binge drinking HIV risk behavior Prevalence of youth risk behaviors 



Authors thank the BRFSS coordinators from 50 states and District of Columbia and members of the Survey Operation Team in the Division of Behavioral Surveillance, Public Health Surveillance Program Office (PHSPO), Office of Surveillance, Epidemiology and laboratory Services (OSELS), Centers for Disease Control and Prevention, for their help in collecting the data used in this study. The authors also thank Jane A. Zanca, CDC technical editor, for editing the manuscript.


  1. 1.
    Cooperman, N. A., Arnsten, J. H., & Klein, R. S. (2007). Current sexual activity and risky sexual behavior in older men with or at risk for HIV infection. AIDS Education and Prevention, 19(4), 321–333.PubMedCrossRefGoogle Scholar
  2. 2.
    de Azevedo, R. C., Botega, N. J., & Guimaraes, L. A. (2007). Crack users sexual behavior and risk of HIV infection. Rev Bras Psiquiatr, 29(1), 26–30.PubMedCrossRefGoogle Scholar
  3. 3.
    Jenness, S. M., et al. (2011). Patterns of exchange sex and HIV infection in high-risk heterosexual men and women. Journal of Urban Health, 88(2), 329–341.PubMedCrossRefGoogle Scholar
  4. 4.
    Kissinger, P., et al. (2008). HIV/STI risk behaviors among Latino migrant workers in New Orleans post-Hurricane Katrina disaster. Sexually Transmitted Diseases, 35(11), 924–929.PubMedCrossRefGoogle Scholar
  5. 5.
    Ramirez-Valles, J., et al. (2008). HIV infection, sexual risk behavior, and substance use among Latino gay and bisexual men and transgender persons. American Journal of Public Health, 98(6), 1036–1042.PubMedCrossRefGoogle Scholar
  6. 6.
    Smith, G. L., & Smith, K. F. (1986). Lack of HIV infection and condom use in licensed prostitutes. Lancet, 2(8520), 1392.PubMedCrossRefGoogle Scholar
  7. 7.
    Weir, S. S., et al. (1999). Association between condom use and HIV infection: A randomised study of self reported condom use measures. Journal of Epidemiology and Community Health, 53(7), 417–422.PubMedCrossRefGoogle Scholar
  8. 8.
    Chersich, M. F., et al. (2007). Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections. International Journal of STD and AIDS, 18(11), 764–769.PubMedCrossRefGoogle Scholar
  9. 9.
    Corbin, W. R., & Fromme, K. (2002). Alcohol use and serial monogamy as risks for sexually transmitted diseases in young adults. Health Psychology, 21(3), 229–236.PubMedCrossRefGoogle Scholar
  10. 10.
    Simbayi, L. C., et al. (2004). Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Town, South Africa. Journal of Studies on Alcohol, 65(4), 434–442.PubMedGoogle Scholar
  11. 11.
    Stein, M., et al. (2005). Alcohol use and sexual risk behavior among human immunodeficiency virus-positive persons. Alcoholism, Clinical and Experimental Research, 29(5), 837–843.PubMedCrossRefGoogle Scholar
  12. 12.
    Woolf, S. E., & Maisto, S. A. (2009). Alcohol use and risk of HIV infection among men who have sex with men. AIDS and Behavior, 13(4), 757–782.PubMedCrossRefGoogle Scholar
  13. 13.
    Weiser, S. D., et al. (2006). A population-based study on alcohol and high-risk sexual behaviors in Botswana. PLoS Medicine, 3(10), e392.PubMedCrossRefGoogle Scholar
  14. 14.
    Shuper, P. A., et al. (2009). Alcohol as a correlate of unprotected sexual behavior among people living with HIV/AIDS: Review and meta-analysis. AIDS and Behaviour, 13, 1021–1036.CrossRefGoogle Scholar
  15. 15.
    Rees, V., et al. (2001). Association of alcohol consumption with HIV sex- and drug-risk behaviors among drug users. Journal of Substance Abuse Treatment, 21(3), 129–134.PubMedCrossRefGoogle Scholar
  16. 16.
    Randolph, M. E., et al. (2009). Alcohol use and sexual risk behavior among college students: Understanding gender and ethnic differences. American Journal of Drug and Alcohol Abuse, 35(2), 80–84.PubMedCrossRefGoogle Scholar
  17. 17.
    Raj, A., et al. (2007). Associations between alcohol, heroin, and cocaine use and high risk sexual behaviors among detoxification patients. American Journal of Drug and Alcohol Abuse, 33(1), 169–178.PubMedCrossRefGoogle Scholar
  18. 18.
    National Institute of Alcohol Abuse and Alcoholism. (2004). NIAAA council approves definition of binge drinking. NIAAA Newsletter [cited 2011 4/8/2011]; 3: [Available from:
  19. 19.
    CDC. (2010). Alcohol and public health—fact sheet. [cited 2011 4/8/2011]; Available from:
  20. 20.
    Town, M., et al. (2006). Health care access among US adults who drink alcohol excessively: missed opportunities for prevention. Preventing Chronic Disease, 3(2), A53.PubMedGoogle Scholar
  21. 21.
    Hingson, R. W., Zha, W., & Weitzman, E. R. (2009). Magnitude of and trends in alcohol-related mortality and morbidity among US college students ages 18–24, 1998–2005. Journal of Studies on Alcohol and Drugs, Suppl.(16), 12–20.Google Scholar
  22. 22.
    Standerwick, K., et al. (2007). Binge drinking, sexual behaviour and sexually transmitted infection in the UK. International Journal of STD and AIDS, 18(12), 810–813.PubMedCrossRefGoogle Scholar
  23. 23.
    Wong, C. F., Kipke, M. D., & Weiss, G. (2008). Risk factors for alcohol use, frequent use, and binge drinking among young men who have sex with men. Addictive Behaviors, 33(8), 1012–1020.PubMedCrossRefGoogle Scholar
  24. 24.
    Zablotska, I. B., et al. (2009). Alcohol use, intimate partner violence, sexual coercion and HIV among women aged 15–24 in Rakai, Uganda. AIDS and Behavior, 13(2), 225–233.PubMedCrossRefGoogle Scholar
  25. 25.
    Remington, P. L., et al. (1988). Design, characteristics, and usefulness of state-based behavioral risk factor surveillance: 1981–87. Public Health Reports, 103(4), 366–375.PubMedGoogle Scholar
  26. 26.
    CDC. (2009). Behavioral risk factor surveillance system. June 18, 2009]; Available from:
  27. 27.
    CDC. (2009). Behavioral risk factor surveillance systemhistorical questions. 6/15/2009]; Available from:
  28. 28.
    CDC. (2009). BRFSS annual survey datasurvey data and documentation. 04/30/2009 [cited 2011 05/10/2011]; Available from:
  29. 29.
    Naimi, T. S., et al. (2003). Binge drinking among US adults. Journal of the American Medical Association, 289(1), 70–75.PubMedCrossRefGoogle Scholar
  30. 30.
    Okoro, C. A., et al. (2004). Binge drinking and health-related quality of life: Do popular perceptions match reality? American Journal of Preventive Medicine, 26(3), 230–233.PubMedCrossRefGoogle Scholar
  31. 31.
    Xing, Y., Ji, C., & Zhang, L. (2006). Relationship of binge drinking and other health-compromising behaviors among urban adolescents in China. Journal of Adolescent Health, 39(4), 495–500.PubMedCrossRefGoogle Scholar
  32. 32.
    Banta, J. E., et al. (2009). Mental health, binge drinking, and antihypertension medication adherence. American Journal of Health Behavior, 33(2), 158–171.PubMedGoogle Scholar
  33. 33.
    Shin, S. H., Edwards, E. M., & Heeren, T. (2009). Child abuse and neglect: Relations to adolescent binge drinking in the national longitudinal study of Adolescent Health (AddHealth) Study. Addictive Behaviors, 34(3), 277–280.PubMedCrossRefGoogle Scholar
  34. 34.
    Naimi, T. S., Nelson, D. E., & Brewer, R. D. (2010). The intensity of binge alcohol consumption among US adults. American Journal of Preventive Medicine, 38(2), 201–207.PubMedCrossRefGoogle Scholar
  35. 35.
    Miller, J. W., et al. (2007). Binge drinking and associated health risk behaviors among high school students. Pediatrics, 119(1), 76–85.PubMedCrossRefGoogle Scholar
  36. 36.
    CDC. (2010). Wireless substitution: State-level estimates from the national health interview survey, January 2007June 2010. [cited 2011 05/10/2011]; Available from:
  37. 37.
    Mokdad, A. H., Stroup, D. F., & Giles, W. H. (2003). Public health surveillance for behavioral risk factors in a changing environment. Recommendations from the Behavioral Risk Factor Surveillance Team. Morbidity and Mortality Weekly Report, 52(RR-9), 1–12.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of HIV/AIDS PreventionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Division of Behavioral Surveillance, Public Health Surveillance Program Office, Office of Surveillance, Epidemiology, and Laboratory ServicesCenters for Disease Control and PreventionAtlantaUSA

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