Utilization of Alcohol Treatment among HIV-Positive Women with Hazardous Drinking

Highlights

• Less than one in five HIV+ women with hazardous drinking reported recent use of any alcohol treatment.
• Half of HIV+ women receiving any alcohol treatment reported receiving multiple treatment services among which Alcoholic Anonymous (AA) was the most common.
• A mixture of factors (income levels, social support, drinking levels, and drug use) was important in explaining utilization of alcohol treatment among HIV+ women with hazardous drinking.

Hazardous alcohol consumption has been frequently reported among women with HIV infection and is associated with a variety of negative health consequences. Treatments to reduce alcohol use may bring in health benefits. However, little is known regarding the utilization of alcohol treatment services among HIV+ women with hazardous drinking. Using data from the Women's Interagency HIV Study (WIHS), this study assessed utilization of any alcohol treatment in the past 6months and performed multivariable logistic regression to determine correlates of receipt of any alcohol treatment. 

Among 474 HIV+ women reporting recent hazardous drinking, less than one in five (19%) reported recent utilization of any alcohol treatment. Alcoholics Anonymous (AA) was the most commonly reported (12.9%), followed by inpatient detoxification (9.9%) and outpatient alcohol treatment program (7.0%). Half (51%) receiving any alcohol treatment reported utilization of multiple treatments. 

Multivariable analyses found alcohol treatment was more often utilized by those who had social support, fewer economic resources (income ≤$12,000 vs. >$12,000), higher levels of drinking (16-35 drinks/week vs. 12-15 drinks/week; 36+ drinks/week vs. 12-15 drinks/week), and those who reported any illicit drug use (OR=2.77, 95% CI=1.44 to 5.34). More efforts are needed to enhance the utilization of alcohol treatment. 

Our findings highlight the unique profile of those who utilized alcohol treatment. Such information is vital to improve treatment delivery to address unmet need in this particular population.

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

By:  Hu X1, Harman J2, Winterstein AG3, Zhong Y4, Wheeler AL5, Taylor TN6, Plankey M7, Rubtsova A8, Cropsey K9, Cohen MH10, Adimora AA11, Milam J12,Adedimeji A13, Cook RL14.

• 1Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA. Electronic address: xingdi.hu@gmail.com.
• 2Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.
• 3Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA; Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA.
• 4The Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
• 5Department of Medicine, University of California, San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
• 6College of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
• 7Georgetown University Medical Center, Department of Medicine, Division of Infectious Diseases, Washington, DC, USA.
• 8Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
• 9Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
• 10Department of Medicine, Stroger Hospital of Cook County Health and Hospital System and Rush University, Chicago, IL, USA.
• 11Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
• 12Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
• 13Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
• 14Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA.
• J Subst Abuse Treat. 2016 May;64:55-61. doi: 10.1016/j.jsat.2016.01.011. Epub 2016 Feb 15.

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Unintended Pregnancy, Depression, and Hazardous Drinking in a Community-Based Sample of Sexual Minority Women

CONTEXT:

Unintended pregnancy is a stressful life event with important implications for women's health. Little research has examined sexual minority women's (SMW; lesbian, bisexual, mostly heterosexual) experiences of unintended pregnancy, and no studies have examined the relationship between unintended pregnancy, mental health, and negative coping behaviors in this population.

METHODS:

We used the Chicago Health and Life Experiences of Women (CHLEW) Study (n = 454), a diverse sample of SMW, to examine the relationship between self-reported unintended pregnancy, depressive symptoms, and hazardous drinking. We used generalized linear model-building techniques and adjusted for key sociodemographic controls, as well as unintended pregnancy risk factors, including childhood physical and sexual abuse and age of sexual debut.

RESULTS:

Twenty-four percent of the sample reported an unintended pregnancy. SMW who reported unintended pregnancies also reported significantly more depressive symptoms and greater risk of hazardous drinking. Adjusting for childhood abuse explained the relationship between unintended pregnancy and depressive symptoms, but not the relationship between unintended pregnancy and hazardous drinking.

CONCLUSIONS:

Unintended pregnancy among SMW is an understudied topic. Our results suggest that unintended pregnancy is not uncommon among SMW and highlight the need for more research to investigate the mechanisms that link unintended pregnancy to depression and to hazardous drinking within this population.

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By:  Everett BG1, McCabe KF2, Hughes TL3.

• 1 Department of Sociology, University of Utah, Salt Lake City, Utah.
• 2 Department of Sociology, University of Illinois at Chicago, Chicago, Illinois.
• 3 Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois. 
• J Womens Health (Larchmt). 2016 Mar 15.

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Religiosity as a Protective Factor for Hazardous Drinking and Drug Use among Sexual Minority and Heterosexual Women

OBJECTIVE:

Despite research documenting disparities in risk for alcohol-related problems among sexual minority women, few studies explore potential protective factors within this population. This study examines how religiosity may function as a protective or risk factor for alcohol-problems or other substance use among sexual minorities compared to heterosexuals.

METHOD:

Data from 11,169 women who responded to sexual identity and sexual behavior questions from three population-based National Alcohol Survey waves (2000, 2005, 2010) were utilized for analyses of religiosity in relation to lifetime drinking, past year hazardous drinking, and past year drug use.

RESULTS:

Religiosity was significantly greater among exclusively heterosexual women compared to all sexual minority groups (lesbian, bisexual and heterosexual women who report same sex partners). Lesbians reported the lowest rates of affiliation with religions/denominations discouraging alcohol use. Past year hazardous drinking and use of any illicit drugs were significantly lower among exclusively heterosexual women compared to all sexual minority groups. High religiosity was associated with lifetime alcohol abstention and was found to be protective against hazardous drinking and drug use among both sexual minority and heterosexual women. Reporting religious norms unfavorable to drinking was protective against hazardous drinking among exclusively heterosexual women but not sexual minority women.

CONCLUSIONS:

Findings reveal the importance of considering sexual minority status in evaluation of religion or spirituality as protective among women. Future studies should explore religiosity in the context of other individual and environmental factors, such as positive identity development and community-level acceptance, which may be salient to resiliency among sexual minorities.

Purchase full article at:   http://goo.gl/mSwrk1

By:  Drabble L1, Trocki KF2, Klinger JL3.

• 1San José State University School of Social Work, One Washington Square, San José, CA 95192-0124, United States. Electronic address: laurie.drabble@sjsu.edu.
• 2Alcohol Research Group, Public Health Institute, 6475 Christie Ave. Suite 400, Emeryville, CA 94608, United States. Electronic address: ktrocki@arg.org.
• 3Alcohol Research Group, Public Health Institute, 6475 Christie Ave. Suite 400, Emeryville, CA 94608, United States. Electronic address: jklinger@arg.org. 
• Drug Alcohol Depend. 2016 Feb 2. pii: S0376-8716(16)00050-8. doi: 10.1016/j.drugalcdep.2016.01.022.

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Where do College Drinkers Draw the Line? A Qualitative Study

Alcohol use among college students has received nationwide recognition as a public health concern. The primary aim of this study was to explore students’ opinions of when drinking “crosses the line” from acceptable to unacceptable. This study used qualitative methods to: (a) examine unappealing aspects of drinking by relationship type (potential dating partner, friend, self), and (b) determine whether this differs by gender. Seventy-eight interviews were conducted with college students who violated campus-alcohol policy. The semi-structured interview included open-ended questions related to reactions to other’s excessive drinking. Qualitative analyses revealed that college males and females find lack of control as unappealing, including lack of physical, verbal, and sexual control. More females than males indicated negative perceptions of same-sex friends and self who displayed poor sexual control. Future research might also consider integration of themes in measures of negative expectancies and consequences to more accurately capture unappealing aspects of college drinking behavior.

…This study revealed three primary themes regarding college students’ negative reactions to excessive drinking. These included (a) negative reactions to a lack of control, (b) female participant’s dislike of uncontrolled sexual behavior by self and others, and (c) alcohol-induced aggression. First, the majority of male and female participants found behaviors that indicated a lack of general control (e.g., being “sloppy,” stumbling, impaired consciousness, etc.) as unappealing in a potential dating partner, in same-sex friends, and in oneself...

A second theme emerging from these qualitative interviews related to how females in the sample viewed a lack of sexual control by same-sex friends or themselves such as engaging unplanned sexual behavior, and/or betraying a friend by having relations with his/her romantic partner. Negative perceptions of casual or spontaneous sexual encounters are consistent with data exploring perceptions of casual sexual encounters. Research examining gender differences in sex or “hook-ups” among young adults suggests that females are less likely to report the experience as positive compared to men (Owen, Rhoades, Stanley, & Fincham, 2010). Qualitative data suggest that women are aware of a double standard and believe that other women who engage in casual sex are disrespected and stigmatized (Bradshaw, Kahn, & Saville, 2010; Paul, 2006)...

Third, both male and female students noted that alcohol-induced aggression was a behavior that “crossed the line.” Females identified that dating partners who were sexual aggressive or “pushy” were unattractive, and males indicated that they would lose respect for a same-sex friend who acted in a sexually aggressive way. Acts of sexual aggression and assault are most prevalent among women ages 16–24 years, with an estimated 38% of women reporting some form of sexual violence during the previous academic year (Nasta, et al., 2005). Furthermore, an estimated 39–50% sexual assault victims and 50% of perpetrators report using alcohol at the time of the assault (Abbey, Zawacki, Buck, Clinton, & McAuslan, 2001; Gross, Winslett, Roberts, & Gohm, 2006). More recent estimates have suggested that 96% of drug-related assaults involved use of alcohol prior to assault (Lawyer, Resnick, Bakanic, Burkett, & Kilpatrick, 2010). Alcohol use and sexual assault often occur in conjunction with each other; both genders reported prohibitions related to alcohol-induced aggression. Reinforcing these prohibitions may aid in prevention efforts that target early warning signs and ways to avoid situations likely to lead to aggressive behavior…

Full article at: http://goo.gl/Xnpcyc

By:  Danielle L. Terry, M.S., Lorra Garey, B.A., and Kate B. Carey, Ph.D.

Center for Health and Behavior, Syracuse University

Please Address Correspondence To: Danielle K. Seigers or Kate B. Carey, Department of Psychology, Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244-2340, Email: ude.rys@regieskd, Email: ude.rys@yeracbk, Phone: 315-443-2877, Fax: 315-443-4123

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High Levels of Persistent Problem Drinking in Women at High Risk for HIV in Kampala, Uganda

The aim of this study was to describe the epidemiology of problem drinking in a cohort of women at high-risk of HIV in Kampala, Uganda. 

Overall, 1027 women at high risk of HIV infection were followed from 2008 to 2013. The CAGE and AUDIT questionnaires were used to identify problem drinkers in the cohort. Interviewer-administered questionnaires were used to ascertain socio-demographic and behavioural factors. Blood and genital samples were tested for HIV and other sexually transmitted infections. 

At enrollment, most women (71%) reported using alcohol at least weekly and about a third reported having drunk alcohol daily for at least 2 weeks during the past 3 months. Over half (56%) were problem drinkers by CAGE at enrollment, and this was independently associated with vulnerability (being divorced/separated/widowed, less education, recruiting clients at bars/clubs, and forced sex at first sexual experience). 

Factors associated with problem drinking during follow-up included younger age, meeting clients in bars/clubs, number of clients, using drugs and HSV-2 infection. HIV prevalence was associated with drinking at enrollment, but not during follow-up. 

This longitudinal study found high levels of persistent problem drinking. Further research is needed to adapt and implement alcohol-focused interventions in vulnerable key populations in sub-Saharan Africa.

Full article at:   http://goo.gl/yT7hIa

By:  Weiss HA1, Vandepitte J2, Bukenya JN3, Mayanja Y4, Nakubulwa S5, Kamali A6, Seeley J7,8, Grosskurth H9.

• 1MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK. helen.weiss@lshtm.ac.uk.
• 2Uganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Entebbe, Uganda. jvdpitte@hotmail.co.uk.
• 3Department of Community Health and Behavioral Sciences, School of Public Health, Colleges of Health Sciences, Makerere University, Kampala, Uganda. jbukenya@musph.ac.ug.
• 4Uganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Entebbe, Uganda. yunia.mayanja@mrcuganda.org.
• 5Uganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Entebbe, Uganda. Susan.nakubulwa@mrcuganda.org.
• 6Uganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Entebbe, Uganda. anatoli.kamali@mrcuganda.org.
• 7Uganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Entebbe, Uganda. janet.seeley@lshtm.ac.uk.
• 8Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London WC1E 9RE, UK. janet.seeley@lshtm.ac.uk.
• 9MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK. heiner.grosskurth@lshtm.ac.uk. 
• Int J Environ Res Public Health. 2016 Jan 22;13(2). pii: E153. doi: 10.3390/ijerph13020153.

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Social Interactions, Trust & Risky Alcohol Consumption

Background

The association of social capital and alcohol consumption is one of the most robust empirical findings in health economics of the past decade. However, the direction of the relationship between the two is heavily dependent on which dimension of social capital is studied and which alcohol measure is used. In this paper, we examine the effect of social interactions and generalised trust on drinking in the general Danish population survey.

Methods

Participants (n = 2569) were recruited as part of a larger study. The double-hurdle model for the volume of alcohol consumption and the multivariate logistic model for heavy episodic drinking were estimated.

Results

We found evidence that social networking with male friends, membership in voluntary organisations, and generalised trust were significantly associated with the mean volume of alcohol consumption and heavy drinking. We also observed that social support at the community level had a buffering effect against heavy episodic drinking.

Conclusions

The findings support previous findings in which social interactions and generalised trust were found to predict individuals’ volume of drinking and heavy episodic drinking. However, the results varied across the indicators.

Full article at:   http://goo.gl/t9xECa

By:  Abdu Kedir Seid

Centre for Alcohol and Drug Research, Aarhus University, Artillerivej 90, 2. 2300 København S, Denmark

Abdu Kedir Seid, Phone: +4531847979, Email: kd.ua.ysp@frc.ka.

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Alcohol Use and Transactional Sex among Women in South Africa: Results from a Nationally Representative Survey

Background

Transactional sex is a risk factor for HIV infection. Alcohol use may increase the risk of transactional sex. No nationally-representative studies have examined the relationship between multiple dimensions of alcohol use and transactional sex in women in South Africa. The aim of the study was to examine the relationship between alcohol dependence, binge drinking and frequency of drinking in the past month and transactional sex in adult women in South Africa.

Methods

A cross-sectional study using multi-stage, cluster sampling collected data from a nationally representative sample of 5,969 women aged 16–55 years in 2012. The analysis conducted for this paper was restricted to women reporting sexual activity in the past 12 months (n = 3,594). Transactional sex was defined as having received money/gifts in exchange for sex with any sex partner in the past year. Alcohol use measures included: alcohol dependence (≥2 positive responses to the CAGE questionnaire); binge drinking (≥4 drinks for women on one occasion); and drinking frequency in the previous month. Logistic regression models were built to test the hypotheses that each dimension of alcohol use was associated with transactional sex.

Results

About 6.3% (n = 225) of sexually active women reported transactional sex. Almost a third (30.6%) of sexually active women had ever drunk alcohol, and 19.2% were current (past month) drinkers. Among lifetime drinkers, 28.0% were alcohol dependent and 56.6% were binge drinkers. Alcohol dependent women were twice as likely to report transactional sex (AOR 2.0, 95% CI 1.1–4.3, p<0.05) than those not alcohol dependent. Binge drinkers were 3.1 times more likely to have had transactional sex (95% CI 1.5–6.6, p<0.01) than non-binge drinkers. There was no significant relationship between frequency of drinking in the past month and transactional sex.

Conclusion

Alcohol dependency and binge drinking are significantly associated with transactional sex in South African women. HIV prevention programmes need to target these women, and address both their alcohol use, as well as the HIV risks associated with transactional sex.

Below:  The relationship between hazardous drinking and transactional sex based on the results of this study

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

By:   

Sarah Magni, Nicola Christofides, Renay Weiner

University of the Witwatersrand, Johannesburg, South Africa

Sarah Magni, Saul Johnson

Anansi Health Consulting, Johannesburg, South Africa

Renay Weiner

Soul City Institute for Health and Development Communication, Johannesburg, South Africa

 

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Social Inequality and Substance Use and Problematic Gambling among Adolescents and Young Adults: A Review of Epidemiological Surveys in Germany

The current review provides an overview of socioepidemiological research in Germany about the prevalence of addictive behaviours (smoking, binge and hazardous drinking, consumption of cannabis and other illegal drugs, the non-medical use of prescription drugs and problematic gambling) among adolescents (11-17 years) and young adults (18-25 years), also differentiating between different socioeconomic status (SES) indicators (attended school type, family affluence, parental occupational status, parental SES, employment status) and migration background. 

The authors evaluated data from ten national surveys and one regional survey conducted between 2002 and 2012, which included different samples. The trends over this time frame reveal that the proportion of adolescents who smoke tobacco, show problematic patterns of alcohol consumption, use cannabis or other illegal drugs has generally declined over the investigated time span in Germany. 

The results nevertheless suggest that some strong associations still exist between social inequalities and the prevalence of substance use. The detailed results are summarised in twelve tables. The main results are as follows: 

• Low SES (school type, employment status) was consistently associated with more cigarette smoking, and, where such data was available, this pattern was observed in both males and females. 
• With regard to family affluence, two surveys show that boys with low and middle FAS are significantly less likely to have binge drinking experience compared to boys with high FAS. 
• There were no significant associations between problematic alcohol use and parental SES, and not all results of the surveys show that binge drinking is more prevalent among HS-students. 
• Employment status was associated with gender differences; problematic patterns of alcohol consumption were significantly more prevalent among young unemployed males compared to GY-students (secondary high school/grammar school) of the same age. 
• The opposite was true for females. 
• Another consistent finding was that among adolescents and young adults with a Turkish/Asian migration background, a problematic use of alcohol was significantly less common compared to adolescents and young adults of the same age without a migration background. 
• In terms of the consumption of cannabis, the unemployed and students with low educational level (`Hauptschule´) emerge as high-risk groups. 
• The results concerning problematic gambling significantly overlap with and reflect the findings of international research: 
• being male, of low educational attainment, 
• unemployed, 
• receiving social welfare, 
• and having a migration background significantly increased the risk of problematic gambling habits. 
• The highest lifetime prevalence rates for the consumption of illegal drugs (other than cannabis) were observed among students with low educational level. 

It should be noted that other SES indicators, in addition to school type, have not been examined to date. The review concludes by outlining gaps and future research areas, as well as presenting several implications for prevention initiatives.

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By:   Henkel D1, Zemlin U.

• 1Institute of Addiction Research, Frankfurt University of Applied Sciences, Frankfurt a.M., Germany. 

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HIV & Alcohol Knowledge, Self-Perceived Risk for HIV & Risky Sexual Behavior among Young HIV-Negative Men Identified as Harmful or Hazardous Drinkers in Katutura, Namibia

Background

Namibia’s HIV prevalence is 13.3 %. Alcohol is associated with sexual risk-taking, leading to increased HIV risk. Baseline sexual behaviors, HIV and alcohol knowledge, and self-perceived HIV risk were examined among men reporting high-risk drinking in Katutura, Namibia.

Methods

HIV negative men, ≥ 18 years, were screened for harmful or hazardous levels of drinking and >1 recent sex partner prior to randomization into control or intervention arm. SAS 9.3 and R 3.01 were used for descriptive baseline cohort analyses.

Results

A total of 501 participants who met criteria were included in analysis (mean Alcohol Use Disorders Identification Test [AUDIT] =12.4). HIV and alcohol knowledge were high with the majority (>85 and 89.8–98 %, respectively) of respondents correctly answering assessment questions. Despite high knowledge levels, 66.7 % of men felt they were at some or high risk of HIV acquisition. Among those respondents, 56.5 % stated often wanting to have sex after drinking and 40.3 % stated sex was better when drunk. Among respondents with non-steady partners [n = 188], 44.1 % of last sexual encounters occurred while the participant was drunk and condoms were not used 32.5 % of those times. Among persons who were not drunk condoms were not used 13.3 % of those times.

Conclusions

Sex with casual partners was high. Inconsistent condom use and alcohol use before sex were frequently reported. Increased emphasis on alcohol risk-reduction strategies, including drinking due to peer pressure and unsafe sexual behaviors, is needed.

Full article at:  http://goo.gl/hPwU0T

By:  Amee Schwitters^1*, Jennifer Sabatier¹, Puja Seth¹, Mary Glenshaw¹, Dietrich Remmert²,Sonal Pathak³ and Naomi Bock¹

¹Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-30, Atlanta 30329-1902, GA, USA

²Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Windhoek, Namibia

³ICF International, Atlanta, GA, USA

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Prevalence & Correlates of Hazardous Drinking among Female Sex Workers in 13 Mexican Cities

To describe the prevalence and correlates of hazardous drinking among female sex workers (FSWs) at 13 sites throughout Mexico.

FSWs (N = 1089) who were enrolled in a brief sexual risk reduction intervention (Mujer Segura) were queried about their sexual risk and substance use practices and their work contexts. Participants were classified as hazardous or non-hazardous drinkers based on the Alcohol Use Disorders test (AUDIT-C). Logistic regression models were used to examine individual, contextual, and community-level factors as correlates of hazardous drinking.

Ninety-two percent of participants reported alcohol consumption in the past month. Among drinkers (N = 1001), 83% met AUDIT-C criteria for hazardous drinking. Factors that were independently associated with hazardous drinking included: drug use in the past month, being a cigarette smoker, being a barmaid or dance hostess, alcohol use before or during sex with clients, and working in a city with a higher marginalization index.

Findings support the high prioritization by public health authorities of alcohol prevention and treatment programs for FSWs.

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By:  Semple SJ1, Pitpitan EV2, Chavarin CV1, Strathdee SA2, Zavala RI3, Aarons GA1, Patterson TL4.

• 1Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
• 2Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
• 3Evaluation and Research Department, Mexican Foundation for Family Planning (Mexfam), Juárez 208, Tlalpan, Mexico, D.F. 14000, Mexico.
• 4Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA tpatterson@ucsd.edu.
• 
  

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Hazardous Drinking & HIV-Risk-Related Behavior among Male Clients of Female Sex Workers in Tijuana, Mexico

Male clients of female sex workers (FSWs) are at high risk for HIV. Whereas the HIV risks of alcohol use are well understood, less is known about hazardous alcohol use among male clients of FSWs, particularly in Mexico. We sought to identify risk factors for hazardous alcohol use and test associations between hazardous alcohol use and HIV risk behavior among male clients in Tijuana.

Male clients of FSWs in Tijuana (n = 400) completed a quantitative interview in 2008. The AUDIT was used to characterize hazardous alcohol use. Multivariate logistic regression was used to determine independent associations of demographic and HIV risk variables with hazardous alcohol use (vs. non-hazardous).

Forty percent of our sample met criteria for hazardous alcohol use. Variables independently associated with hazardous drinking were reporting any sexually transmitted infection (STI), having sex with a FSW while under the influence of alcohol, being younger than 36 years of age, living in Tijuana, and ever having been jailed. Hazardous drinkers were less likely ever to have been deported or to have shared injection drugs.

Hazardous alcohol use is associated with HIV risk, including engaging in sex with FSWs while intoxicated and having an STI among male clients of FSWs in Tijuana.

Via: http://ht.ly/S77CK 

By: Goodman-Meza D1, Pitpitan EV, Semple SJ, Wagner KD, Chavarin CV, Strathdee SA, Patterson TL.

• 1Division of Global Public Health, Department of Medicine, University of California at San Diego, La Jolla, California.