Risk of Heavy Drinking among Sexual Minority Adolescents: Indirect Pathways through Sexual Orientation-Related Victimization & Affiliation with Substance-Using Peers

AIMS:

To test two indirect pathways through which sexual minority adolescents (SMAs) may be at risk for heavy episodic drinking (HED) including a socialization pathway via substance-using peer affiliations and social marginalization pathway via sexual minority-specific victimization and subsequent substance-using peer affiliations.

DESIGN:

Analysis of the first three waves (six-months apart) of a longitudinal adolescent health risk study (2011-2014). Participants were referred by medical providers or a screening system in providers' waiting rooms.

SETTING:

Two large urban adolescent health clinics in Pennsylvania and Ohio, USA.

PARTICIPANTS:

290 adolescents (ages 14-19, mean: 17) who were 71% female, 33% non-Hispanic White, and 34% SMAs.

MEASUREMENTS:

Self-reported sexual minority status (wave 1) and affiliation with substance-using peers (waves 1 and 2), and latent sexual-minority specific victimization (waves 1 and 2) and HED (waves 1 and 3) variables.

FINDINGS:

Using mediation analyses in a structural equation modeling framework, there was a significant indirect effect of sexual minority status (wave 1) on HED (wave 3) via affiliation with substance-using peers (wave 2; indirect effect = 0.03, 95%CI: 0.01, 0.07), after accounting for the indirect effect of sexual-orientation related victimization (wave 2; indirect effect = .10, 95%CI: 0.02-0.19). The social marginalization pathway was not supported as victimization (wave 1) was not associated with affiliation with substance-using peers (wave 2; β = -.04, p = .66). Sex differences in the indirect effects were not detected (ps > .10).

CONCLUSIONS:

Sexual minority adolescents in the US appear to exhibit increased heavy episodic drinking via an indirect socialization pathway including affiliations with substance-using peers and a concurrent indirect pathway involving sexual minority-related victimization. The pathways appear to operate similarly for boys and girls.

Purchase full article at:   http://goo.gl/n3m99C

By:  Dermody SS1, Marshal MP2,3, Burton CM2, Chisolm DJ4.

• 1Department of Psychology, University of Pittsburgh.
• 2Department of Psychiatry, School of Medicine, University of Pittsburgh.
• 3Department of Pediatrics, School of Medicine, University of Pittsburgh.
• 4Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital. 
• Addiction. 2016 Mar 28. doi: 10.1111/add.13409. 

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Alcohol Abuse Increases the Risk of HIV Infection & Diminishes Health Status of Clients Attending HIV Testing Services in Vietnam

BACKGROUND:

Vietnam is among those countries with the highest drinking prevalence. In this study, we examined the prevalence of alcohol use disorders (AUDs) and its associations with HIV risky behaviors, health care utilization, and health-related quality of life (HRQOL) among clients using voluntary HIV testing and counseling services (VCT).

METHODS:

A cross-sectional survey of 365 VCT clients (71 % male; mean age 34) was conducted in Hanoi and Nam Dinh province. AUD and HRQOL were measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and EuroQol-five dimensions-five levels (EQ-5D-5L). Risky sexual behaviors, concurrent opioid use, and inpatient and outpatient service use were self-reported.

RESULTS:

67.2 % clients were lifetime ever drinkers of those 62.9 % were hazardous drinkers and 82.0 % were binge drinkers. There were 48.8 % respondents who had ≥2 sex partners over the past year and 55.4, 38.3, and 46.1 % did not use condom in the last sex with primary/casual/commercial sex partners, respectively. Multivariate models show that AUD was significantly associated with risky sexual behaviors, using inpatient care and lower HRQOL among VCT clients.

CONCLUSIONS:

AUD was prevalent, was associated with increased risks of HIV infection, and diminished health status among VCT clients. It may be efficient to screen for AUD and refer at-risk clients to appropriate AUD counseling and treatment along with HIV-related services.

Sexual risk behaviors and history of drug use among VCT clients in 2013 (n = 365)

Factors	Rural		Urban		Total		p value
	N	%	N	%	N	%
Ever had sex	90	90.9	257	96.6	347	95.1	0.03
Number of sex partners (in the last 12 months)
Not had anyone	34	34.3	18	6.8	52	14.3	<0.01
One sex partners	52	52.5	118	44.4	170	46.6
2–3 sex partners	6	6.1	94	35.3	100	27.4
>4 sex partners	7	7.1	36	13.5	43	11.8
Type of sex partners
Primary partners	68	68.7	238	89.5	306	83.8	<0.01
Casual sex partners	0	0.0	64	24.1	64	17.5	<0.01
Sex workers	16	16.2	64	24.1	80	21.9	0.10
Non-condom use with last sex
With primary sex partners (n = 305)	42	62.3	127	53.4	169	55.4	0.18
With casual sex partners (n = 60)	0	0.0	23	38.3	23	38.3	-
With sex workers (n = 76)	16	100.0	19	31.7	35	46.1	<0.01
Ever drug use	4	4.0	34	12.8	38	10.4	0.02
Ever inject drug	2	2.0	23	8.7	25	6.9	0.03
Current drug use	2	50.0	13	38.2	15	39.5	0.65

Full article at:   http://goo.gl/3cJBg1

By:  Tran BX1,2, Nguyen LH3,4, Nguyen CT5, Phan HT6, Latkin CA7.

• 1Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam. bach@hmu.edu.vn.
• 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. bach@hmu.edu.vn.
• 3Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
• 4School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
• 5Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
• 6Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
• 7Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 
• Harm Reduct J. 2016 Feb 16;13(1):6. doi: 10.1186/s12954-016-0096-z.

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Prevalence of Binge Drinking & Associated Behaviours among 3,286 College Students in France

BACKGROUND:

Studies conducted on characteristics of binge drinking and associated behaviours in college student populations are scarce especially in France. Hence, it is important to identify risk factors for binge drinking at university, especially those which may be changed. The aim of this study was to assess the prevalence of binge drinking and associated behaviours across a large sample of college students in Upper Normandy (France).

METHODS:

A cross sectional study was performed between November 2009 and February 2013 and data on socioeconomic characteristics and behavioural risk factors were collected: alcohol (consumption and misuse of alcohol, occasional and frequent binge drinking), tobacco, cannabis, cyberaddiction, stress and depression. An anonymous self-administered questionnaire was filled out by college student volunteers from Upper Normandy (France) either online or by paper questionnaire. Analyses were performed using multivariate logistic regression models.

RESULTS:

A total of 3286 students were included. The mean (Standard Deviation (SD)) age of students was 20.8 years (SD = 2.1) with a male-female ratio of 0.60. The prevalence of binge drinking in the never, occasional and frequent categories was respectively 34.9 %, 51.3 %, and 13.8 %. The mean number of units of alcohol consumed per week (except BD episodes) was 0.78 for never, 3.7 for occasional and 10.5 for frequent binge drinkers (p < 0.0001). A positive relation was observed between frequent binge drinking and the following: male gender, living in rented accommodation, attending business school, regular practice of sport, smoking, occasional cannabis use, and alcohol abuse. A negative association was observed between frequent binge drinking and grant holder status, living in couples, and stress.

CONCLUSIONS:

This study highlights the spread of binge drinking among college students and identifies student populations at risk: male gender, living in rented accommodation, regular practice of sport, and other risk behaviours such as use of tobacco, cannabis and alcohol. These behaviours increase with the frequency of binge drinking.

Below:  Frequency of consumption of binge drinking according to the gender of college students (France; 2010-2012) (N=3286)

Full article at:   http://goo.gl/xH28Bs

By:  Tavolacci MP1,2, Boerg E3, Richard L4, Meyrignac G5, Dechelotte P6,4, Ladner J6,7.

• 1Rouen University Hospital, Clinical Investigation Center 1404, 1 Rue de Germont, Rouen Cedex, 76031, France. marie-pierre.tavolacci@chu-rouen.fr.
• 2Rouen University Hospital, IRIB, Inserm U1073, Rouen, France. marie-pierre.tavolacci@chu-rouen.fr.
• 3Rouen University Hospital, Clinical Investigation Center 1404, 1 Rue de Germont, Rouen Cedex, 76031, France.
• 4Department of Nutrition, Rouen University Hospital, Rouen, France.
• 5Department of Preventive Medicine of University, Rouen University, Rouen, France.
• 6Rouen University Hospital, IRIB, Inserm U1073, Rouen, France.
• 7Department of Epidemiology and Health Promotion, Rouen University Hospital, Rouen, France. 
• BMC Public Health. 2016 Feb 23;16(1):178. doi: 10.1186/s12889-016-2863-x.

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Substance Misuse and Older Adults - Slides

More information at and via: http://goo.gl/2nSg1Q 

Links from presentation:  
www.psattc.org
www.uclaisap.org

http://www.hivguidelines.org/clinical-guidelines/hiv-and-aging/hiv-in-older-adults-a-quick-reference-guide-for-hiv-primary-care-clinicians/

http://www.hivguidelines.org/clinical-guidelines/quick-reference-cards/mental-health-screening-a-quick-reference-guide-for-hiv-primary-care-clinicians/

http://www.hivguidelines.org/clinical-guidelines/quick-reference-cards/substance-use-screening-a-quick-reference-guide-for-hiv-primary-care-clinicians/