38 CFR 1.461 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1... alcohol or drug abuser, an individual tested for or infected with the human immunodeficiency virus (HIV), hereafter referred to as HIV, or an individual with sickle cell anemia, either directly, by reference to...

38 CFR 1.462 - Confidentiality restrictions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or..., infection with the HIV, or sickle cell anemia may be acknowledged only if the patient's written consent is... with the HIV, or sickle cell anemia. (2) Any answer to a request for a disclosure of patient records...

38 CFR 1.462 - Confidentiality restrictions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or..., infection with the HIV, or sickle cell anemia may be acknowledged only if the patient's written consent is... with the HIV, or sickle cell anemia. (2) Any answer to a request for a disclosure of patient records...

38 CFR 1.462 - Confidentiality restrictions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or..., infection with the HIV, or sickle cell anemia may be acknowledged only if the patient's written consent is... with the HIV, or sickle cell anemia. (2) Any answer to a request for a disclosure of patient records...

38 CFR 1.462 - Confidentiality restrictions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or..., infection with the HIV, or sickle cell anemia may be acknowledged only if the patient's written consent is... with the HIV, or sickle cell anemia. (2) Any answer to a request for a disclosure of patient records...

Alcohol use disorders among people living with HIV/AIDS in Southern Brazil: prevalence, risk factors and biological markers outcomes.

PubMed

da Silva, Cláudio Moss; Mendoza-Sassi, Raúl Andrés; da Mota, Luisa Dias; Nader, Maíba Mikhael; de Martinez, Ana Maria Barral

2017-04-11

Alcohol abuse is an important public health problem, frequently unrecognized among people living with HIV/AIDS (PLWHA), and requires investigation and intervention. It is usually associated with lower adherence to highly active antiretroviral therapy (HAART). It can also produce adverse clinical outcomes, such as changes in certain HIV markers, particularly CD4 cell counts and HIV viral loads (VLs). Thus, this study aimed to evaluate the prevalence of alcohol abuse among PLWHA, its associated risk factors and effects on CD4 cell counts and HIV VLs in southern Brazil. Between December 2012 and July 2013, 343 patients were interviewed at a reference hospital in southern Brazil. The instrument used was the Alcohol Use Disorder Identification Test (AUDIT), and a cutoff of eight points or more was applied. Socioeconomic, demographic, clinical and laboratory data were also collected. The statistical analysis included a Poisson regression to evaluate the factors associated with alcohol use disorder, and a linear regression was performed to assess the relationship between AUDIT scores and CD4 cell counts and HIV VLs. Alcohol abuse was present in 28.6% of the respondents, and possible dependence was present in 5%. The risk factors identified included being male, mixed or black skin color, low education and the use of intravenous or inhaled drugs. A higher AUDIT score was associated with a lower CD4 cell count but was not associated with higher HIV VL values. Our results show the importance of screening for alcohol abuse in this group. The prevalence of alcohol abuse was high, and it was associated with socioeconomic factors and the use of illicit drugs. Moreover, AUDIT score negatively affected CD4 cell counts as well.

78 FR 38353 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcohol Abuse and Alcoholism Special Emphasis Panel; Review of Applications on HIV- AIDS/Alcohol....273, Alcohol Research Programs; National Institutes of Health, HHS) Dated: June 19, 2013. Carolyn A...

Reductions in alcohol and cocaine use following a group coping intervention for HIV-positive adults with childhood sexual abuse histories.

PubMed

Meade, Christina S; Drabkin, Anya S; Hansen, Nathan B; Wilson, Patrick A; Kochman, Arlene; Sikkema, Kathleen J

2010-11-01

Few interventions exist to reduce alcohol and non-injection drug use among people living with HIV/AIDS. This study tested the effects of a coping group intervention for HIV-positive adults with childhood sexual abuse histories on alcohol, cocaine and marijuana use. Participants were assigned randomly to the experimental coping group or a time-matched comparison support group. Both interventions were delivered in a group format over 15 weekly 90-minute sessions. A diverse sample of 247 HIV-positive men and women with childhood sexual abuse were recruited from AIDS service organizations and community health centers in New York City. Substance use was assessed pre- and post-intervention and every 4 months during a 12-month follow-up period. Using an intent-to-treat analysis, longitudinal changes in substance use by condition were assessed using generalized estimating equations. At baseline, 42% of participants drank alcohol, 26% used cocaine and 26% used marijuana. Relative to participants in the support group, those in the coping group had greater reductions in quantity of alcohol use (Wald χ²(₄)=10.77, P = 0.029) and any cocaine use (Wald χ²(₄) = 9.81, P = 0.044) overtime. Many HIV patients, particularly those with childhood sexual abuse histories, continue to abuse substances. This group intervention that addressed coping with HIV and sexual trauma was effective in reducing alcohol and cocaine use, with effects sustained at 12-month follow-up. Integrating mental health treatment into HIV prevention may improve outcomes. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa.

PubMed

Sikkema, Kathleen J; Watt, Melissa H; Meade, Christina S; Ranby, Krista W; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree

2011-07-01

Alcohol-serving venues in South Africa provide a location for HIV prevention interventions due to risk factors of patrons in these establishments. Understanding the association between mental health and risk behaviors in these settings may inform interventions that address alcohol use and HIV prevention. Participants (n = 738) were surveyed in 6 alcohol-serving venues in Cape Town to assess post-traumatic stress disorder (PTSD) and depression symptoms, traumatic experiences, sexual behavior, and substance use. Logistic regression models examined whether traumatic experiences predicted PTSD and depression. Generalized linear models examined whether substance use, PTSD, and depressive symptoms predicted unprotected sexual intercourse. Men and women were analyzed separately. Participants exhibited high rates of traumatic experiences, PTSD, depression, alcohol consumption, and HIV risk behaviors. For men, PTSD was associated with being hit by a sex partner, physical child abuse, sexual child abuse and HIV diagnosis; depression was associated with being hit by a sex partner, forced sex and physical child abuse. For women, both PTSD and depression were associated with being hit by a sex partner, forced sex, and physical child abuse. Unprotected sexual intercourse was associated with age, frequency and quantity of alcohol use, drug use, and PTSD for men and frequency and quantity of alcohol use, depression, and PTSD for women. Mental health in this setting was poor and was associated with sexual risk behavior. Treating mental health and substance-use problems may aid in reducing HIV infection. Sexual assault prevention and treatment after sexual assault may strengthen HIV prevention efforts.

Violence and Abuse Among HIV-Infected Women and Their Children in Zambia

PubMed Central

Murray, Laura K.; Haworth, Alan; Semrau, Katherine; Singh, Mini; Aldrovandi, Grace M.; Sinkala, Moses; Thea, Donald M.; Bolton, Paul A.

2009-01-01

HIV and violence are two major public health problems increasingly shown to be connected and relevant to international mental health issues and HIV-related services. Qualitative research is important due to the dearth of literature on this association in developing countries, cultural influences on mental health syndromes and presentations, and the sensitive nature of the topic. The study presented in this paper sought to investigate the mental health issues of an HIV-affected population of women and children in Lusaka, Zambia, through a systematic qualitative study. Two qualitative methods resulted in the identification of three major problems for women: domestic violence (DV), depression-like syndrome, and alcohol abuse; and children: defilement, DV, and behavior problems. DV and sexual abuse were found to be closely linked to HIV and alcohol abuse. This study shows the local perspective of the overlap between violence and HIV. Results are discussed in relation to the need for violence and abuse to be addressed as HIV services are implemented in sub-Saharan Africa. PMID:16909070

Behavioral, metabolic, and immune consequences of chronic alcohol or cannabinoids on HIV/AIDs: Studies in the Non-Human Primate SIV model

PubMed Central

Molina, Patricia E.; Amedee, Angela M.; Winsauer, Peter; Nelson, Steve; Bagby, Gregory; Simon, Liz

2015-01-01

HIV-associated mortality has been significantly reduced with antiretroviral therapy (ART), and HIV infection has become a chronic disease that frequently coexists with many disorders, including substance abuse (Azar et al. 2010; Phillips et al. 2001). Alcohol and drugs of abuse may modify host-pathogen interactions at various levels including behavioral, metabolic, and immune consequences of HIV infection, as well as the ability of the virus to integrate into the genome and replicate in host cells. Identifying mechanisms responsible for these interactions is complicated by many factors, such as the tissue specific responses to viral infection, multiple cellular mechanisms involved in inflammatory responses, neuroendocrine and localized responses to infection, and kinetics of viral replication. An integrated physiological analysis of the biomedical consequences of chronic alcohol and drug use or abuse on disease progression is possible using rhesus macaques infected with simian immunodeficiency virus (SIV), a relevant model of HIV infection. This review will provide an overview of the data gathered using this model to show that chronic administration of two of the most commonly abused substances, alcohol and cannabinoids (Δ9-Tetrahydrocannabinol; THC), affect host-pathogen interactions. PMID:25795088

38 CFR 1.470-1.474 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROVISIONS Release of Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia...

38 CFR 1.470-1.474 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROVISIONS Release of Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia...

38 CFR 1.470-1.474 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROVISIONS Release of Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia...

38 CFR 1.470-1.474 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROVISIONS Release of Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia...

38 CFR 1.470-1.474 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROVISIONS Release of Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia...

Alcohol Enhances HIV Infection of Cord Blood Monocyte-Derived Macrophages

PubMed Central

Mastrogiannis, Dimitrios S.; Wang, Xu; Dai, Min; Li, Jieliang; Wang, Yizhong; Zhou, Yu; Sakarcan, Selin; Peña, Juliet Crystal; Ho, Wenzhe

2014-01-01

Alcohol consumption or alcohol abuse is common among pregnant HIV+ women and has been identified as a potential behavioral risk factor for the transmission of HIV. In this study, we examined the impact of alcohol on HIV infection of cord blood monocyte-derived macrophages (CBMDM). We demonstrated that alcohol treatment of CBMDM significantly enhanced HIV infection of CBMDM. Investigation of the mechanisms of alcohol action on HIV demonstrated that alcohol inhibited the expression of several HIV restriction factors, including anti-HIV microRNAs, APOBEC3G and APOBEC3H. Additionally, alcohol also suppressed the expression of IFN regulatory factor 7 (IRF-7) and retinoic acid-inducible gene I (RIG-I), an intracellular sensor of viral infection. The suppression of these IFN regulatory factors was associated with reduced expression of type I IFN. These experimental findings suggest that maternal alcohol consumption may facilitate HIV infection, promoting vertical transmission of HIV. PMID:25053361

Drug-drug interactions between anti-retroviral therapies and drugs of abuse in HIV systems.

PubMed

Kumar, Santosh; Rao, P S S; Earla, Ravindra; Kumar, Anil

2015-03-01

Substance abuse is a common problem among HIV-infected individuals. Importantly, addictions as well as moderate use of alcohol, smoking, or other illicit drugs have been identified as major reasons for non-adherence to antiretroviral therapy (ART) among HIV patients. The literature also suggests a decrease in the response to ART among HIV patients who use these substances, leading to failure to achieve optimal virological response and increased disease progression. This review discusses the challenges with adherence to ART as well as observed drug interactions and known toxicities with major drugs of abuse, such as alcohol, smoking, methamphetamine, cocaine, marijuana, and opioids. The lack of adherence and drug interactions potentially lead to decreased efficacy of ART drugs and increased ART, and drugs of abuse-mediated toxicity. As CYP is the common pathway in metabolizing both ART and drugs of abuse, we discuss the possible involvement of CYP pathways in such drug interactions. We acknowledge that further studies focusing on common metabolic pathways involving CYP and advance research in this area would help to potentially develop novel/alternate interventions and drug dose/regimen adjustments to improve medication outcomes in HIV patients who consume drugs of abuse.

38 CFR 1.475 - Form of written consent.

Code of Federal Regulations, 2010 CFR

2010-07-01

... or title of the individual or the name of the organization to which disclosure is to be made. (3) The... abuse, alcoholism or alcohol abuse, HIV, or sickle cell anemia program or activity. Where a person or...

HIV/AIDS and Alcohol

MedlinePlus

... Abuse and Alcoholism (NIAAA) Main Menu Search Search form Search Alcohol & Your Health Overview of Alcohol Consumption Alcohol's Effects on the Body Alcohol Use Disorder Fetal Alcohol Exposure Support & Treatment Alcohol Policy Special Populations & Co-occurring Disorders Publications & Multimedia Brochures & ...

38 CFR 1.468 - Relationship to Federal statutes protecting research subjects against compulsory disclosure of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.468 Relationship...

38 CFR 1.468 - Relationship to Federal statutes protecting research subjects against compulsory disclosure of...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.468 Relationship...

38 CFR 1.468 - Relationship to Federal statutes protecting research subjects against compulsory disclosure of...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.468 Relationship...

38 CFR 1.468 - Relationship to Federal statutes protecting research subjects against compulsory disclosure of...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.468 Relationship...

38 CFR 1.468 - Relationship to Federal statutes protecting research subjects against compulsory disclosure of...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Information from Department of Veterans Affairs (va) Records Relating to Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.468 Relationship...

Differences among Sexually Abused and Nonabused Youth Living with HIV

ERIC Educational Resources Information Center

Anaya, Henry D.; Swendeman, Dallas; Rotheram-Borus, Mary Jane

2005-01-01

Risk behaviors were compared between sexually abused and nonabused youth living with HIV (YLH). Abused YLH were significantly more likely to have attempted suicide, to have been admitted into an alcohol and/or drug treatment program, and to have engaged in crack cocaine use than were nonabused YLH and had a greater number of sexual partners. A…

38 CFR 1.463 - Criminal penalty for violations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.463 Criminal penalty for violations. Under 38 U.S.C. 7332(g), any person who...: 38 U.S.C. 7332(g)) ...

38 CFR 1.463 - Criminal penalty for violations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Drug Abuse, Alcoholism Or Alcohol Abuse, Infection with the Human Immunodeficiency Virus (hiv), Or Sickle Cell Anemia § 1.463 Criminal penalty for violations. Under 38 U.S.C. 7332(g), any person who...: 38 U.S.C. 7332(g)) ...

Drug–drug interactions between anti-retroviral therapies and drugs of abuse in HIV systems

PubMed Central

Rao, PSS; Earla, Ravindra; Kumar, Anil

2015-01-01

Introduction Substance abuse is a common problem among HIV-infected individuals. Importantly, addictions as well as moderate use of alcohol, smoking, or other illicit drugs have been identified as major reasons for non-adherence to antiretroviral therapy (ART) among HIV patients. The literature also suggests a decrease in the response to ART among HIV patients who use these substances, leading to failure to achieve optimal virological response and increased disease progression. Areas covered This review discusses the challenges with adherence to ART as well as observed drug interactions and known toxicities with major drugs of abuse, such as alcohol, smoking, methamphetamine, cocaine, marijuana, and opioids. The lack of adherence and drug interactions potentially lead to decreased efficacy of ART drugs and increased ART, and drugs of abuse-mediated toxicity. As CYP is the common pathway in metabolizing both ART and drugs of abuse, we discuss the possible involvement of CYP pathways in such drug interactions. Expert opinion We acknowledge that further studies focusing on common metabolic pathways involving CYP and advance research in this area would help to potentially develop novel/alternate interventions and drug dose/regimen adjustments to improve medication outcomes in HIV patients who consume drugs of abuse. PMID:25539046

Gender-based Violence and HIV Sexual Risk Behavior: Alcohol Use and Mental Health Problems as Mediators among Women in Drinking Venues, Cape Town

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Sikkema, Kathleen J.; Watt, Melissa H.; Skinner, Donald

2012-01-01

Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use. PMID:22832324

Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town.

PubMed

Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Sikkema, Kathleen J; Watt, Melissa H; Skinner, Donald

2012-10-01

Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use. Copyright © 2012 Elsevier Ltd. All rights reserved.

Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH) in HIV.

PubMed

Rockstroh, Jürgen Kurt

2017-04-01

Abnormal liver enzymes (LE) are common in patients infected with the human immunodeficiency virus (HIV) even in the absence of viral hepatitis or alcohol abuse. With availability of antiretroviral combination therapy, life expectancy has improved dramatically and as a consequence the spectrum of liver disease is changing. Increased reports on the development of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) in HIV coinfected patients raise questions around prevalence, clinical manifestations, and clinical outcome of these liver diseases in HIV coinfection. Moreover, the potential impact of combination antiretroviral therapy as well as direct HIV effects on the emergence of non-alcoholic fatty liver disease needs to be explored. This review summarizes the recent literature on NAFLD and NASH in HIV.

Clearinghouse: alcohol and poppers.

PubMed

1999-03-01

Ten articles from magazines and journals are referenced on the subjects of alcohol and poppers. Topics include alcohol consumption and HIV/AIDS-related risky sexual behavior, alcohol and drug abuse, and self-esteem, gender, and alcohol use. Contact information is provided.

Harmful alcohol consumption and patterns of substance use in HIV-infected patients receiving antiretrovirals (ANRS-EN12-VESPA Study): relevance for clinical management and intervention.

PubMed

Michel, Laurent; Carrieri, M Patrizia; Fugon, Lionel; Roux, Perrine; Aubin, Henri-Jean; Lert, France; Obadia, Yolande; Spire, Bruno

2010-09-01

Alcohol abuse affects secondary prevention and disease progression in HIV-infected patients, and adherence and response to treatment in those chronically treated. The objective of this study was to estimate the prevalence of harmful alcohol consumption (HAC) using various indicators and identify which groups of patients may require specific targeted interventions for HAC risk reduction. A cross-sectional survey, based on a random sample representative of people living with HIV/AIDS (PLWHA) was carried out in 102 French hospital departments delivering HIV care. As alcohol abuse is particularly detrimental to patients receiving highly active antiretroviral therapy (HAART), we focused only on those individuals receiving HAART with complete alcohol assessment (CAGE, AUDIT-C, regular binge drinking, N=2340). Collected information included medical and socio-demographic data, HIV risk behaviors, adherence to treatment and substance and alcohol use, together with depression, anxiety, and experience of attempted suicide or sex work. HAC prevalence was evaluated as follows: 12% (CAGE score > or =2), 27% (AUDIT-C), and 9% (regular binge drinking). Three groups were at higher risk of HAC: men who have sex with men using stimulants, polydrug users, and to a lesser degree, ex-drug users. Innovative intervention strategies to reduce HAC and improve HIV prevention and HAART adherence in various PLWHA populations need urgent testing and implementation. Such interventions for alcohol risk reduction remain central to promoting improved HIV prevention and assuring HAART effectiveness in these populations.

Work-related violence and inconsistent condom use with non-paying partners among female sex workers in Adama City, Ethiopia.

PubMed

Mooney, Alyssa; Kidanu, Aklilu; Bradley, Heather M; Kumoji, Evelyn Kuor; Kennedy, Caitlin E; Kerrigan, Deanna

2013-08-23

Although reported condom use between female sex workers and their clients is high in Ethiopia, condom use with regular, non-paying partners remains low, posing a substantial risk of HIV infection to sex workers, their partners and the general population. Previous studies have identified the synergistic effects of substance abuse, violence and HIV risk, but few have examined these inter-relationships among female sex workers and their regular, non-paying partners. This study explored the associations between work-related violence, alcohol abuse and inconsistent condom use among establishment-based female sex workers and their regular, non-paying partners in Adama City, Ethiopia. A cross-sectional survey was conducted with 350 establishment-based female sex workers, aged 15-35, at 63 bars, hotels and nightclubs. Multivariate logistic regression analysis was conducted to test the association between work-related violence and condom use with regular, non-paying partners, controlling for age, overall income, education and sex workers' total number of sexual partners in the past week. Alcohol abuse was explored as an effect modifier. Respondents reported a high prevalence of work-related violence (59%) and alcohol abuse (51%). Work-related violence was statistically significantly associated with unprotected sex with regular, non-paying partners among those who abused alcohol (OR: 6.34, 95% CI: 2.43-16.56) and among those who did not (OR: 2.98, 95% CI: 1.36-6.54). Alcohol abuse was not associated with inconsistent condom use within these partnerships, though it may strengthen the effect of work-related violence on unprotected sex. Findings suggest violence against establishment-based female sex workers is associated with HIV risk within regular, non-paying partnerships. Qualitative work is needed to better understand the links between a violent work environment and condom use with regular, non-paying partners and how interventions can be implemented in this context to prevent violence against sex workers and reduce HIV transmission.

Drugs, Women and Violence in the Americas: U.S. Quantitative Results of a Multi-Centric Pilot Project (Phase 2)

PubMed Central

González-Guarda, Rosa María; Peragallo, Nilda; Lynch, Ami; Nemes, Susanna

2011-01-01

Objectives To explore the collective and individual experiences that Latin American females in the U.S. have with substance abuse, violence and risky sexual behaviors. Methods This study was conducted in two phases from July 2006 to June 2007 in south Florida. This paper covers Phase 2. In Phase 2, questionnaires were provided to women to test whether there is a relationship between demographics, acculturation, depression, self-esteem and substance use/abuse; whether there is a relationship between demographics, acculturation, depression, self-esteem and violence exposure and victimization; whether there is a relationship between demographics, acculturation, depression, self-esteem, HIV knowledge and STD and HIV/AIDS risks among respondents; and whether there is a relationship between substance abuse, violence victimization and HIV/AIDS risks among respondents. Results Participants reported high rates of alcohol and drug abuse among their current or most recent partners. This is a major concern because partner alcohol use and drug use was related to partner physical, sexual and psychological abuse. Only two factors were associated with lifetime drug use: income and acculturation. Over half of the participants reported being victims of at least one form of abuse during childhood and adulthood. A substantial component of abuse reported during adulthood was perpetrated by a currently or recent intimate partner. Conclusions The results from this study suggest that substance abuse, violence and HIV should be addressed in an integrative and comprehensive manner. Recommendations for the development of policies, programs and services addressing substance abuse, violence and risk for HIV among Latinos are provided. PMID:22504304

Factors Associated with Motivation to Change HIV Risk and Substance Use Behaviors among Homeless Youth

PubMed Central

Collins, Jennifer; Slesnick, Natasha

2011-01-01

This study sought to identify and compare variables associated with motivation to change alcohol, drug use, and HIV risk behaviors among a sample of homeless youths. More frequent alcohol use, older age, and childhood sexual abuse was associated with greater motivation to change alcohol use; higher reported negative consequences of substance use was associated with higher motivation to reduce illicit drug use. Shorter periods of current homelessness predicted higher motivation to change HIV risk behaviors. Findings suggest these areas might be fruitful targets of intervention efforts to enhance motivation to reduce alcohol and illicit drug use and HIV risk behaviors. PMID:21765800

Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years.

PubMed

Davis, Emily C; Rotheram-Borus, Mary Jane; Weichle, Thomas W; Rezai, Roxana; Tomlinson, Mark

2017-11-01

Alcohol is a major contributor to the global burden of disease. In South Africa, alcohol abuse is hypothesized to correlate with women's HIV status, mental health, and partner relationships over time. All pregnant women in 12 urban, low-income, Cape Town neighborhoods were interviewed at baseline, post-birth, and at 6, 12, 36, and 60 months following delivery with retention rates from 82.5 to 94%. Women were assessed for any alcohol use, problematic drinking, depression, intimate partner violence, and HIV status. Prior to pregnancy discovery and 5 years after giving birth, alcohol use was 25.8 and 24.7%, respectively. Most women decreased their alcohol use during pregnancy. Twenty-one percent reported alcohol use on two or more assessments, and only 15% of the mothers drinking alcohol at 5 years were also drinking at baseline. Mothers with depression had a higher likelihood of drinking alcohol compared to mothers who were not depressed only at baseline and 6 months post-birth. Mothers who experienced IPV had more than twice the likelihood of drinking alcohol compared to non-IPV mothers at all assessments. HIV positive mothers were more likely to drink alcohol compared to mothers without HIV prior to pregnancy discovery and at 5 years post-birth. These longitudinal trends in alcohol use among young women in South Africa represent a large economic, social, and health burden and must be addressed in a comprehensive manner.

Latina Mother–Daughter Dyads: Relations Between Attachment and Sexual Behavior Under the Influence of Alcohol or Drugs

PubMed Central

Dillon, Frank R.; Rojas, Patria; Schwartz, Seth J.; Duan, Rui

2009-01-01

Associations among mother-daughter attachment, mother and daughter substance abuse, and daughter’s sexual behavior under the influence of drugs and alcohol were investigated among 158 adult U.S. Latina daughters. Latina daughters were sampled from four mother–daughter dyad types: substance abusing mother and daughter, substance abusing mother only, substance abusing daughter only, and nonsubstance-abusing mother and daughter. Substance abusing daughters with substance abusing mothers, and daughters who were less strongly attached to their mothers, reported more sex under the influence of drugs. Age, marital status, substance abuse, and mother’s substance abuse all influenced the daughter’s sex under the influence of alcohol. An unexpected positive association between attachment and sex under the influence of alcohol was found for daughters who were more closely attached to a substance abusing mother. Implications for future research, and HIV/AIDS and drug prevention and treatment programs for Latinas are discussed. PMID:19399605

76 FR 59708 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... and Alcoholism Special Emphasis Panel, Systems Biology of HIV/AIDS and Substance Use--RFA DA12-009..., PhD, Chief, Extramural Project Review Branch, EPRB, NIAAA, National Institutes of Health, 5365...

Should a psychiatrist report a bus driver's alcohol and drug abuse? An ethical dilemma.

PubMed

Leeman, C P; Cohen, M A; Parkas, V

2001-01-01

Denial of alcohol or drug abuse, and of its possible consequences, can complicate medical and psychiatric care. We present the case of an HIV-positive bus driver with substance abuse who initially denied ongoing use of alcohol and of other drugs, but later admitted to both. The psychiatrist's duty to protect the patient's confidentiality, coupled with concerns about public safety, created an ethical dilemma. In discussing this dilemma we stress the importance of preserving confidentiality, both to facilitate treatment and also to further the safety of others.

The Effects of Husband's Alcohol Consumption on Married Women in Three Low-Income Areas of Greater Mumbai

PubMed Central

Kremelberg, David; Dwivedi, Purva; Verma, Supriya; Schensul, Jean J.; Gupta, Kamla; Chandran, Devyani; Singh, S. K.

2010-01-01

Gender-based violence rooted in norms, socialization practices, structural factors, and policies that underlie men's abusive practices against married women in India is exacerbated by alcohol. The intersection of domestic violence, childhood exposure to alcohol and frustration, which contribute to drinking and its consequences including forced sex is explored through analysis of data obtained from 486 married men living with their wives in a low-income area of Greater Mumbai. SEM shows pathways linking work-related stress, greater exposure to alcohol as a child, being a heavy drinker, and having more sexual partners (a proxy for HIV risk). In-depth ethnographic interviews with 44 married women in the study communities reveal the consequences of alcohol on women's lives showing how married women associate alcohol use and violence with different patterns of drinking. The study suggests ways alcohol use leads from physical and verbal abuse to emotional and sexual violence in marriage. Implications for gendered multi-level interventions addressing violence and HIV risk are explored. PMID:20544380

The effects of husband's alcohol consumption on married women in three low-income areas of Greater Mumbai.

PubMed

Berg, Marlene J; Kremelberg, David; Dwivedi, Purva; Verma, Supriya; Schensul, Jean J; Gupta, Kamla; Chandran, Devyani; Singh, S K

2010-08-01

Gender-based violence rooted in norms, socialization practices, structural factors, and policies that underlie men's abusive practices against married women in India is exacerbated by alcohol. The intersection of domestic violence, childhood exposure to alcohol and frustration, which contribute to drinking and its consequences including forced sex is explored through analysis of data obtained from 486 married men living with their wives in a low-income area of Greater Mumbai. SEM shows pathways linking work-related stress, greater exposure to alcohol as a child, being a heavy drinker, and having more sexual partners (a proxy for HIV risk). In-depth ethnographic interviews with 44 married women in the study communities reveal the consequences of alcohol on women's lives showing how married women associate alcohol use and violence with different patterns of drinking. The study suggests ways alcohol use leads from physical and verbal abuse to emotional and sexual violence in marriage. Implications for gendered multi-level interventions addressing violence and HIV risk are explored.

Precipitating factors of porphyria cutanea tarda in Brazil with emphasis on hemochromatosis gene (HFE) mutations. Study of 60 patients.

PubMed

Vieira, Fatima Mendonça Jorge; Nakhle, Maria Cristina; Abrantes-Lemos, Clarice Pires; Cançado, Eduardo Luiz Rachid; Reis, Vitor Manoel Silva dos

2013-01-01

Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. Alcohol abuse, hepatitis C and estrogen intake are prevalent precipitating factors in our porphyria cutanea tarda population; however, hemochromatosis in itself can also contribute to the outbreak of porphyria cutanea tarda, which makes the research for HFE mutations necessary in these patients.

Maternal Substance Use and HIV Status: Adolescent Risk and Resilience

ERIC Educational Resources Information Center

Leonard, Noelle R.; Gwadz, Marya Viorst; Cleland, Charles M.; Vekaria, Pooja C.; Ferns, Bill

2008-01-01

We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in…

Maternal post-traumatic stress disorder, depression and alcohol dependence and child behaviour outcomes in mother-child dyads infected with HIV: a longitudinal study.

PubMed

Nöthling, Jani; Martin, Cherie L; Laughton, Barbara; Cotton, Mark F; Seedat, Soraya

2013-12-10

HIV and psychiatric disorders are prevalent and often concurrent. Childbearing women are at an increased risk for both HIV and psychiatric disorders, specifically depression and post-traumatic stress disorder (PTSD). Poor mental health in the peripartum period has adverse effects on infant development and behaviour. Few studies have investigated the relationship between maternal PTSD and child behaviour outcomes in an HIV vertically infected sample. The aim of this study was to investigate whether maternal postpartum trauma exposure and PTSD were risk factors for child behaviour problems. In addition, maternal depression, alcohol abuse and functional disability were explored as cofactors. The study was conducted in Cape Town, South Africa. 70 mother-child dyads infected with HIV were selected from a group of participants recruited from community health centres. The study followed a longitudinal design. Five measures were used to assess maternal trauma exposure, PTSD, depression, alcohol abuse and functional disability at 12 months postpartum: Life Events Checklist (LEC), Harvard Trauma Scale (HTS), Alcohol Use Disorders Identification Test (AUDIT), Center for Epidemiological Studies Depression (CESD) Scale and the Sheehan Disability Scale (SDS). Child behaviour was assessed at 42 months with the Child Behaviour Checklist (CBCL). The rate of maternal disorder was high with 50% scoring above the cut-off for depression, 22.9% for PTSD and 7% for alcohol abuse. Half of the children scored within the clinical range for problematic behaviour. Children of mothers with depression were significantly more likely to display total behaviour problems than children of mothers without depression. Maternal PTSD had the greatest explanatory power for child behaviour problems, although it did not significantly predict child outcomes. This study highlights the importance of identifying and managing maternal PTSD and depression in mothers of children infected with HIV. The relationship between maternal PTSD and child behaviour warrants further investigation.

Maternal post-traumatic stress disorder, depression and alcohol dependence and child behaviour outcomes in mother–child dyads infected with HIV: a longitudinal study

PubMed Central

Nöthling, Jani; Martin, Cherie L; Laughton, Barbara; Cotton, Mark F; Seedat, Soraya

2013-01-01

Objectives HIV and psychiatric disorders are prevalent and often concurrent. Childbearing women are at an increased risk for both HIV and psychiatric disorders, specifically depression and post-traumatic stress disorder (PTSD). Poor mental health in the peripartum period has adverse effects on infant development and behaviour. Few studies have investigated the relationship between maternal PTSD and child behaviour outcomes in an HIV vertically infected sample. The aim of this study was to investigate whether maternal postpartum trauma exposure and PTSD were risk factors for child behaviour problems. In addition, maternal depression, alcohol abuse and functional disability were explored as cofactors. Setting The study was conducted in Cape Town, South Africa. Participants 70 mother–child dyads infected with HIV were selected from a group of participants recruited from community health centres. Design The study followed a longitudinal design. Five measures were used to assess maternal trauma exposure, PTSD, depression, alcohol abuse and functional disability at 12 months postpartum: Life Events Checklist (LEC), Harvard Trauma Scale (HTS), Alcohol Use Disorders Identification Test (AUDIT), Center for Epidemiological Studies Depression (CESD) Scale and the Sheehan Disability Scale (SDS). Child behaviour was assessed at 42 months with the Child Behaviour Checklist (CBCL). Results The rate of maternal disorder was high with 50% scoring above the cut-off for depression, 22.9% for PTSD and 7% for alcohol abuse. Half of the children scored within the clinical range for problematic behaviour. Children of mothers with depression were significantly more likely to display total behaviour problems than children of mothers without depression. Maternal PTSD had the greatest explanatory power for child behaviour problems, although it did not significantly predict child outcomes. Conclusions This study highlights the importance of identifying and managing maternal PTSD and depression in mothers of children infected with HIV. The relationship between maternal PTSD and child behaviour warrants further investigation. PMID:24334155

Clinical correlates of HIV-associated neurocognitive disorders in South Africa.

PubMed

Joska, John A; Fincham, Dylan S; Stein, Dan J; Paul, Robert H; Seedat, Soraya

2010-04-01

Human immunodeficiency virus-associated neurocognitive disorders (HAND) occurs globally and across different genetic clades of the virus. However, few studies have examined HAND in South Africa, despite the prevalence of HIV in this region of the world, and the predominance of clade C. The present study examined the relationship between a number of demographic and clinical variables in a sample of 536 patients attending HIV clinics in South Africa. HAND was present in 23.5% of the sample and was associated with older age, a low educational level among those with post-traumatic stress disorder (PTSD) and alcohol abuse among those with many months since diagnosis. These results suggest that HAND is common among patients in South Africa, and is associated with clinical variables such as PTSD and alcohol abuse. This underlines the impact of HIV on the nervous system and the importance of screening for co morbid mental health conditions.

Gender Norms, Gender Role Conflict/Stress and HIV Risk Behaviors Among Men in Mpumalanga, South Africa.

PubMed

Gottert, Ann; Barrington, Clare; McNaughton-Reyes, Heath Luz; Maman, Suzanne; MacPhail, Catherine; Lippman, Sheri A; Kahn, Kathleen; Twine, Rhian; Pettifor, Audrey

2018-06-01

Men's gender role conflict and stress (GRC/S), the psychological strain they experience around fulfilling expectations of themselves as men, has been largely unexplored in HIV prevention research. We examined associations between both men's gender norms and GRC/S and three HIV risk behaviors using data from a population-based survey of 579 18-35 year-old men in rural northeast South Africa. Prevalence of sexual partner concurrency and intimate partner violence (IPV) perpetration in the last 12 months were 38.0 and 13.4%, respectively; 19.9% abused alcohol. More inequitable gender norms and higher GRC/S were each significantly associated with an increased odds of concurrency (p = 0.01; p < 0.01, respectively), IPV perpetration (p = 0.03; p < 0.01), and alcohol abuse (p = 0.02; p < 0.001), controlling for demographic characteristics. Ancillary analyses demonstrated significant positive associations between: concurrency and the GRC/S sub-dimension subordination to women; IPV perpetration and restrictive emotionality; and alcohol abuse and success, power, competition. Programs to transform gender norms should be coupled with effective strategies to prevent and reduce men's GRC/S.

Analyzing HIV/AIDS and Alcohol and Other Drug Use as a Social Problem

PubMed Central

PATTERSON, DAVID A.; Wolf (Adelv unegv Waya), Silver

2012-01-01

Most prevention and intervention activities directed toward HIV/AIDS and alcohol and other drug use separately as well as the combining of the two (e.g., those who are both HIV/AIDS and using alcohol and other drugs) comes in the form of specific, individualized therapies without consideration of social influences that may have a greater impact on this population. Approaching this social problem from the narrowed view of individualized, mi-cro solutions disregards the larger social conditions that affect or perhaps even are at the root of the problem. This paper analyzes the social problem of HIV/AIDS and alcohol and other drug abuse using three sociological perspectives—social construction theory, ethnomethodology, and conflict theory—informing the reader of the broader influences accompanying this problem. PMID:23264724

Precipitating factors of porphyria cutanea tarda in Brazil with emphasis on hemochromatosis gene (HFE) mutations. Study of 60 patients*

PubMed Central

Vieira, Fatima Mendonça Jorge; Nakhle, Maria Cristina; Abrantes-Lemos, Clarice Pires; Cançado, Eduardo Luiz Rachid; dos Reis, Vitor Manoel Silva

2013-01-01

BACKGROUND Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. OBJECTIVES Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. METHODS An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. RESULTS Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. CONCLUSIONS Alcohol abuse, hepatitis C and estrogen intake are prevalent precipitating factors in our porphyria cutanea tarda population; however, hemochromatosis in itself can also contribute to the outbreak of porphyria cutanea tarda, which makes the research for HFE mutations necessary in these patients PMID:24068123

Availability of HIV-related health services in adolescent substance abuse treatment programs.

PubMed

Knudsen, H K; Oser, C B

2009-10-01

Given that alcohol and drug abuse heightens the risk of adolescents acquiring HIV, substance abuse treatment programs for youths may represent an important site of HIV prevention. In this research, we explored the adoption of three HIV-related health services: risk assessment during intake, HIV prevention programing, and HIV testing. Data were collection through telephone interviews with 149 managers of adolescent-only substance abuse treatment programs in the USA. About half of these programs had adopted HIV risk assessment and HIV prevention. On-site HIV testing was less widely adopted, with only one in four programs offering this service. At the bivariate level, the availability of on-site primary medical care and the availability of an overnight level of care were positively associated with these three types of services. The association for the measure of an overnight level of care was no longer significant once medical services were controlled. However, in a separate analysis, it was found that programs offering an overnight level of care were much more likely to offer on-site medical care than outpatient-only facilities. There was also evidence that publicly funded treatment programs were more likely to offer HIV prevention and on-site HIV testing, after controlling for other organizational characteristics. Much more research about the adoption of HIV-related services in adolescent substance abuse treatment is needed, particularly to offer greater insight into why certain types of organizations are more likely to adopt these health services.

Commentary: if you drink alcohol, drink sensibly: is this guideline still appropriate?

PubMed

Jacobs, Liezille; Steyn, Nelia

2013-01-01

Alcohol abuse remains one of the most serious substance abuse disorders in South African society, resulting in inordinately large social, economic and health problems at all levels of society. Alcohol consumers in South Africa are estimated to drink 16.6L per annum with a per capita consumption of 7.1L. South Africa has one of the highest rates of death attributable to crime, violence, traffic accidents, and HIV/AIDS in the world. These rates have been directly related to the high prevalence of alcohol abuse and risky drinking patterns. A food-based dietary guideline that encourages alcohol consumption would appear to be not in the nation's best interest. We conducted a search of websites supported by the World Health Organization to find published literature on substance abuse in South Africa and also reviewed the website of the Medical Research Council of South Africa for studies on the social impact of alcohol abuse in humans. We used the search terms alcohol guidelines, alcohol abuse, non-communicable diseases, health benefits of alcohol, moderate drinking, alcohol, and intake patterns and reviewed studies that hade been published between 2002 and the current time. Based on evidence over the past two decades, messages that convey the positive health benefits of moderate alcohol consumption (eg, the increased levels of HDL cholesterol) should be raised and even encouraged for those who are very moderate drinkers (ie, one alcoholic drink/ day for women and a maximum of 2 drinks/day for men). For those who do not consume alcohol at all, even moderate drinking is not encouraged. Nutrition educators should emphasize the negative consequences of alcohol abuse. The current food-based dietary guideline, "If you drink alcohol, drink sensibly," from the South African Department of Health should not remain as is.

Sexual abuse during childhood and adolescence as predictors of HIV-related sexual risk during adulthood among female sexual partners of injection drug users.

PubMed

Klein, H; Chao, B S

1995-03-01

This study explores the relationship of sexual abuse during childhood and adolescence with HIV-related sexual risk behaviors during adulthood among female sexual partners of injection drug users. It analyzed data that was gathered between 1990 and 1993, which included a sample of 2794 women from the US, Mexico, and Puerto Rico. 6 HIV-related sexual risk behaviors that occurred during the month prior to interview were examined; namely, number of sexual partners, number of drug-injecting sexual partners, number of sexual intercourse while high on alcohol and/or other drugs, number of times trading sex for drugs and/or money, proportion of all sexual acts involving protection, and overall HIV-related sexual risk. The results showed that more than one-third of the women (36.3%) experienced some form of sexual abuse during childhood, whereas 34.4% reported that they had been abused sexually during adolescence; 1 in 5 women (18.4%) stated being abused during both periods. The results further indicate that there is a strong link between sexual abuse victimization early in life and involvement later in life in HIV-related sexual risk behaviors. It was found out that certain forms of sexual abuse, such as forced exposure and touching of one's sexual parts were more strongly related than other forms of sexual abuse to subsequent involvement in HIV-related sexual behaviors.

Condom Negotiation, HIV Testing, and HIV Risks among Women from Alcohol Serving Venues in Cape Town, South Africa

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Cain, Demetria; Eaton, Lisa A.; Carey, Kate B.; Carey, Michael P.; Harel, Ofer; Simbayi, Leickness C.; Mehlomakhulu, Vuyelwa; Mwaba, Kelvin

2012-01-01

Background Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. Purpose To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. Method Women (N = 1333) residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens) completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. Results Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. Conclusions For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues. PMID:23056211

Ethical issues in a stage 1 cognitive-behavioral therapy feasibility study and trial to reduce alcohol use among HIV-infected outpatients in western Kenya.

PubMed

Papas, Rebecca K; Gakinya, Benson N; Baliddawa, Joyce B; Martino, Steve; Bryant, Kendall J; Meslin, Eric M; Sidle, John E

2012-07-01

Epidemics of both HIV/AIDS and alcohol abuse in sub-Saharan Africa have spurred the conduct of local behavioral therapy trials for these problems, but the ethical issues involved in these trials have not been fully examined. In this paper, we discuss ethical issues that emerged during the conduct of a behavioral intervention adaptation and trial using cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. The study was performed within our multinational collaboration, the USAID-Academic Model Providing Access to Healthcare Partnership. We discuss relevant ethical considerations and how we addressed them.

Ethical Issues in a Stage 1 Cognitive-Behavioral Therapy Feasibility Study and Trial to Reduce Alcohol Use Among HIV-Infected Outpatients in Western Kenya

PubMed Central

Papas, Rebecca K.; Gakinya, Benson N.; Baliddawa, Joyce B.; Martino, Steve; Bryant, Kendall J.; Meslin, Eric M.; Sidle, John E.

2013-01-01

Epidemics of both HIV/AIDS and alcohol abuse in sub-Saharan Africa have spurred the conduct of local behavioral therapy trials for these problems, but the ethical issues involved in these trials have not been fully examined. In this paper, we discuss ethical issues that emerged during the conduct of a behavioral intervention adaptation and trial using cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. The study was performed within our multinational collaboration, the USAID-Academic Model Providing Access to Healthcare Partnership. We discuss relevant ethical considerations and how we addressed them. PMID:22850141

Pathways from Childhood Abuse and Neglect to HIV-Risk Sexual Behavior in Middle Adulthood

ERIC Educational Resources Information Center

Wilson, Helen W.; Widom, Cathy Spatz

2011-01-01

Objective: This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Method: Children with documented cases of…

Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth.

PubMed

Jewkes, Rachel K; Dunkle, Kristin; Nduna, Mzikazi; Jama, P Nwabisa; Puren, Adrian

2010-11-01

To describe prevalence of childhood experiences of adversity in rural South African youth and their associations with health outcomes. We analyzed questionnaires and blood specimens collected during a baseline survey for a cluster randomized controlled trial of a behavioral intervention, and also tested blood HIV and herpes simplex type 2 virus at 12- and 24-month follow up; 1,367 male and 1,415 female volunteers were recruited from 70 rural villages. Both women and men before 18 had experienced physical punishment (89.3% and 94.4%), physical hardship (65.8% and 46.8%), emotional abuse (54.7% and 56.4%), emotional neglect (41.6% and 39.6%), and sexual abuse (39.1% and 16.7%). Incident HIV infections were more common in women who experienced emotional abuse (IRR 1.96, 95% CI 1.25, 3.06, p=.003), sexual abuse (IRR 1.66 95% CI 1.04, 2.63, p=.03), and physical punishment (IRR 2.13 95% CI 1.04, 4.37, p=.04). Emotional neglect in women was associated with depression (aOR 1.82, 95% CI 1.15, 2.88, p=.01), suicidality (aOR 5.07, 95% CI 2.07, 12.45, p<.0001), alcohol abuse (aOR 2.17, 95% CI .99, 4.72, p=.05), and incident HSV2 infections (IRR 1.62, 95% CI 1.01, 2.59, p=.04). In men emotional neglect was associated with depression (aOR 3.41, 95% CI 1.87, 6.20, p<.0001) and drug use (aOR 1.98, 95% CI 1.37, 2.88, p<.0001). Sexual abuse was associated with alcohol abuse in men (aOR 3.68, 95% CI 2.00, 6.77, p<.0001) and depression (aOR 2.16, 95% CI 1.34, 3.48, p=.002) and alcohol abuse in women (aOR 3.94, 95% CI 1.90, 8.17, p<.0001). Childhood exposure to adversity is very common and influences the health of women and men. All forms of adversity, emotional, physical and sexual, enhance the risk of adverse health outcomes in men and women. Prevention of child abuse need to be included as part of the HIV prevention agenda in sub-Saharan Africa. Interventions are needed to prevent emotional, sexual, and physical abuse and responses from health and social systems in Africa to psychologically support exposed children must be strengthened. Copyright © 2010 Elsevier Ltd. All rights reserved.

Associations between childhood adversity and depression, substance abuse and HIV & HSV2 incident infections in rural South African youth

PubMed Central

Jewkes, Rachel K; Dunkle, Kristin; Nduna, Mzikazi; Jama, P Nwabisa; Puren, Adrian

2010-01-01

Objectives to describe prevalence of childhood experiences of adversity in rural South African youth and their associations with health outcomes. Methods we analysed questionnaires and blood specimens collected during a baseline survey for a cluster randomized controlled trial of behavioral intervention, and also tested blood HIV and herpes simplex type 2 virus at 12 and 24 month follow up; 1,367 male and 1,415 female volunteers were recruited from 70 rural villages. Results Both women and men before 18 had experienced physical punishment (89.3% & 94.4%), physical hardship (65.8% & 46.8%), emotional abuse (54.7% & 56.4%), emotional neglect (41.6% & 39.6%), and sexual abuse (39.1% & 16.7%). Incident HIV infections were more common in women who experienced emotional abuse (IRR 1.96, 95% CI 1.25, 3.06, p=0.003), sexual abuse (IRR 1.66 95%CI 1.04, 2.63, p=0.03), and physical punishment (IRR 2.13 95%CI 1.04, 4.37, p=0.04). Emotional neglect in women was associated with depression (aOR 1.82 (95% CI 1.15, 2.88, p= 0.01), suicidality (aOR 5.07 (95% CI 2.07, 12.45, p<0.0001), alcohol abuse (aOR 2.17 (95% CI 0.99, 4.72, p=0.05), and incident HSV2 infections (IRR 1.62, 95% CI 1.01, 2.59, p=0.04). In men emotional neglect was associated with depression (aOR 3.41 (95% CI1.87, 6.20, p<0.0001) and drug use (aOR 1.98 (95% CI 1.37, 2.88, p<0.0001). Sexual abuse was associated with alcohol abuse in men (aOR 3.68 (95% CI2.00, 6.77, p<0.0001) and depression (aOR 2.16 (95% CI1.34, 3.48, p=0.002) and alcohol abuse in women (aOR 3.94 (95% CI 1.90, 8.17, p<0.0001). Practice implications Childhood exposure to adversity is very common and influences the health of women and men. All forms of adversity, emotional, physical and sexual, enhance the risk of adverse health outcomes in men and women. Prevention of child abuse need to be included as part of the HIV prevention agenda in Sub-Saharan Africa. Interventions are needed to prevent emotional, sexual, and physical abuse and responses from health and social systems in Africa to psychologically support exposed children must be strengthened. PMID:20943270

Neurological function, information-motivation-behavioral skills factors, and risk behaviors among HIV-positive alcohol users.

PubMed

Malow, Robert M; Dévieux, Jessy G; Stein, Judith A; Rosenberg, Rhonda; Lerner, Brenda G; Attonito, Jennifer; Villalba, Karina

2012-11-01

The purpose of this study was to examine neurological impairment in combination with information-motivation-behavioral skills (IMB) variables. The study tests the role of IMB variables as mediators of antecedent variables of demographics, life stress, social support, and neurological impairment with outcome measures of HIV preventive and risk behaviors in a sample of HIV-positive, alcohol-using adults (n = 250) with a history of alcohol abuse/dependence. Neurological impairment was measured with the Color Trails Test (CTT). Average performance on the CTT by the sample was substantially worse than established norms. In a directional latent variable model, neurological impairment directly predicted lower transmission knowledge scores and poorer performance on an observational condom skills assessment. Greater neurological impairment was significantly associated with greater age. Future interventions geared toward HIV+ adults who use alcohol should take into consideration HIV-related and age-related neurological functioning which may impede the facilitation of safe sex behaviors.

Negative Affect and HIV Risk in Alcohol and Other Drug (AOD) Abusing Adolescent Offenders

ERIC Educational Resources Information Center

Lucenko, Barbara A.; Malow, Robert M.; Sanchez-Martinez, Mario; Jennings, Terri; Devieux, Jessy G.

2003-01-01

Various depressive symptoms have been linked to elevated levels of HIV risk across diverse adult populations in multiple studies. However, this link has been examined in a much more limited manner among adolescents, despite an exceedingly heightened risk of both HIV and negative affect in this age group. To address the current lack of clinically…

Type and severity of intimate partner violence and its relationship with PTSD in HIV-infected women.

PubMed

Hansrod, Fatima; Spies, Georgina; Seedat, Soraya

2015-01-01

HIV has an impact on the presence and severity of both intimate partner violence (IPV) and posttraumatic stress disorder (PTSD) in infected women. However, the relationship of type and severity of IPV with PTSD in this population has not been adequately explored. We focus on the association between the type and severity of IPV and HIV status and PTSD in a sample of South African women. One hundred and sixty-nine women (114 HIV-positive and 55 HIV-negative controls), matched for geographical area, education, and socio-economic status, were recruited from HIV clinics. Clinical and demographic data were collected, including data on childhood trauma, other traumatic life events, IPV, posttraumatic stress symptoms, problematic alcohol use, and depressive symptoms. HIV-positive women had significantly more depressive symptoms, alcohol abuse, and childhood trauma exposure as well as significantly higher rates of PTSD (25.4%) when compared with uninfected women (10.9%). No significant group differences in the rate, pattern, and severity of physical, sexual, psychological, injury, and negotiation IPV were found. In logistic regression analysis, the rate and severity category of IPV did not significantly predict PTSD in HIV-positive women when childhood trauma and life events were controlled for. Our results indicate the need for screening for alcohol abuse, PTSD and depressive symptoms at HIV wellness, and ARV clinics. The high rates of PTSD in HIV-positive women indicate the need for specialized programs to manage PTSD and minimize negative sequelae in this population. These results also highlight the need for improved screening and prevention of childhood trauma and IPV both in infected and uninfected women.

Childhood maltreatment histories, alcohol and other drug use symptoms, and sexual risk behavior in a treatment sample of adolescents.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Burnette, Mandi L

2012-05-01

We tested a structural model of relations among self-reported childhood maltreatment, alcohol and other drug abuse and dependence symptoms, and sexual risk behavior in a sample of adolescents receiving outpatient treatment of substance use problems. Structured interviews were administered to an ethnically diverse sample of 394 adolescents (114 girls, 280 boys; mean = 16.30 years; SD = 1.15 years; 44.9% Hispanic, 20.6% African American, 25.4% White non-Hispanic, and 9.1% other) in 2 outpatient treatment settings. Path analyses yielded findings consistent with a mediation model. Alcohol abuse and dependence symptoms mediated (1) relations between emotional neglect scores and sex with co-occurring alcohol use and (2) relations between sexual abuse scores and sex with co-occurring alcohol use. Drug abuse and dependence symptoms mediated relations between (1) neglect scores and (2) sexual intercourse with co-occurring alcohol or drug use, as well as unprotected sexual intercourse. Efforts to treat alcohol or drug use problems among adolescents or to prevent transmission of HIV or other sexually transmitted infections among youths with substance use problems may require tailoring treatment or prevention protocols to address client histories of maltreatment.

Awareness of HIV/AIDS and household environment of pregnant women in Pune, India.

PubMed

Shrotri, A; Shankar, A V; Sutar, S; Joshi, A; Suryawanshi, N; Pisal, H; Bharucha, K E; Phadke, M A; Bollinger, R C; Sastry, J

2003-12-01

Our objective was to determine the level of HIV/AIDS knowledge of pregnant women in India. In a sub-sample of these women, we documented the extent to which they experienced adverse social and physical difficulties within their home. The study was performed at an urban antenatal hospital clinic in Maharastra, India. From April to September 2001, structured interviews were conducted on 707 randomly selected antenatal clinic patients related to HIV/AIDS knowledge. Of these, 283 were further interviewed to document any social or physical difficulties they experienced. Over 75% of women displayed knowledge of primary transmission routes. Nearly 70% of women demonstrated knowledge of maternal to child transmission, however, only 8% knew of any methods of prevention. TV and written material were more strongly related to knowledge than access to radio messages or conversations with individuals. Thirty per cent of the women experienced physical or mental abuse or their spouse's alcohol and/or drug problems. Women reporting such abuse were more than twice as likely to have adequate HIV/AIDS knowledge compared with women reporting no such abuse. We found no relationship between reported household abuse and educational level of woman, husband, occupation of either partner, language or religion. We found no relationship between HIV status and knowledge of HIV and no relationship between HIV status and risk of abuse in the household. However, the total number of HIV patients in our sample was very small.

Child Sexual Abuse and Adult Mental Health, Sexual Risk Behaviors, and Drinking Patterns Among Latino Men Who Have Sex With Men.

PubMed

Levine, Ethan Czuy; Martinez, Omar; Mattera, Brian; Wu, Elwin; Arreola, Sonya; Rutledge, Scott Edward; Newman, Bernie; Icard, Larry; Muñoz-Laboy, Miguel; Hausmann-Stabile, Carolina; Welles, Seth; Rhodes, Scott D; Dodge, Brian M; Alfonso, Sarah; Fernandez, M Isabel; Carballo-Diéguez, Alex

2018-04-01

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals' likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.

Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.

PubMed

Guimarães, Patrícia M; Passos, Sonia R; Calvet, Guilherme A; Hökerberg, Yara H; Lessa, José L; Andrade, Carlos A de

2014-01-01

To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI) was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR) with 95% confidence intervals (95%CI) by multiple logistic regression. Seventy-six (60.8%) patients with HIV, 40 (32%) patients with Chagas disease, and nine (7.2%) patients with human T-lymphotropic virus were interviewed. The majority were women (64%), with up to 8 years of formal education (56%), and unemployed (81.6%). The median age was 49 years. Suicide risk (n=71) (56%), agoraphobia (n=65) (52%), major depressive episode (n=56) (44.8%), and alcohol/drug abuse (n=43) (34.4%) predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75) and HIV infection (OR = 5.24; 95%CI 1.56-17.61). Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75), unemployment (OR = 2.72; 95%CI 1.01-7.34), and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44). Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk.

Perception of risk of HIV and sexual risk behaviors among University students: implication for planning interventions.

PubMed

Shiferaw, Yitayal; Alemu, Abebe; Assefa, Abate; Tesfaye, Berihun; Gibermedhin, Etsegenet; Amare, Misiker

2014-03-19

The university environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. Despite recently gained decline of the overall incidence of HIV infection, still significant proportion of youth population are at high risk of HIV infection. The aims of this study were to assess the perception of HIV risk and factors associated with risk perception among students at University of Gondar, Northwest Ethiopia. A cross sectional study was conducted between February and April, 2012 among health science students. A total of 384 students were involved in the study using stratified sampling technique. Chi-square test and logistic regression analysis were employed. P-value < 0.05 was considered statistically significant for all cases. Of the total 384 participated students, 200(52.1%) were females. Out of the total study respondents, 202(52.6%) were sexually experienced. One hundred and nine (59.2%) out of 184 males and 93(46.5%) out of 200 females had had sexual experience. About 23(57.5%) of those age below 20 years, 70(52.2%) of 20-24 years old, and 13(61.9%) of those ages of 25 years or older were perceived themselves as if they have no chance of acquiring HIV infection. Students initiated sexual intercourse at early age (≤8 years) were significantly associated with having multiple partnerships (crude OR =3.6, p = 0.002 for male and crude OR = 1.7, p = 0.04 for female). Statistically significant difference was observed in the distribution of condom use during sexual intercourse among various age groups (p-value = 0.001). Sexual initiation at younger age, having multiple partnerships, inconsistent condom use and alcohol and/or drug abuse were significantly perceived as predictor for an increased risks for HIV infection. Students were engaged in various HIV risk behaviors. Early sexual initiation and alcohol and/or drug abuse were important factors for having multiple partnerships. Poor agreement between having HIV risk behaviors and perception of HIV risk were observed. Attention has to be given on the role of alcohol and/or drug abuse in the participation of HIV risk behaviors in the design and implementation of HIV prevention for university students.

Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

2011-11-01

Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

Factors associated with attendance in 12-step groups (Alcoholics Anonymous/Narcotics Anonymous) among adults with alcohol problems living with HIV/AIDS.

PubMed

Orwat, John; Samet, Jeffrey H; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Saitz, Richard

2011-01-15

Despite the value of 12-step meetings, few studies have examined factors associated with attendance among those living with HIV/AIDS, such as the impact of HIV disease severity and demographics. This study examines predisposing characteristics, enabling resources and need on attendance at Alcoholic Anonymous (AA) and Narcotics Anonymous (NA) meetings among those living with HIV/AIDS and alcohol problems. Secondary analysis of prospective data from the HIV-Longitudinal Interrelationships of Viruses and Ethanol study, a cohort of 400 adults living with HIV/AIDS and alcohol problems. Factors associated with AA/NA attendance were identified using the Anderson model for vulnerable populations. Generalized estimating equation logistic regression models were fit to identify factors associated with self-reported AA/NA attendance. At study entry, subjects were 75% male, 12% met diagnostic criteria for alcohol dependence, 43% had drug dependence and 56% reported attending one or more AA/NA meetings (past 6 months). In the adjusted model, female gender negatively associated with attendance, as were social support systems that use alcohol and/or drugs, while presence of HCV antibody, drug dependence diagnosis, and homelessness associated with higher odds of attendance. Non-substance abuse related barriers to AA/NA group attendance exist for those living with HIV/AIDS, including females and social support systems that use alcohol and/or drugs. Positive associations of homelessness, HCV infection and current drug dependence were identified. These findings provide implications for policy makers and treatment professionals who wish to encourage attendance at 12-step meetings for those living with HIV/AIDS and alcohol or other substance use problems. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Factors associated with attendance in 12-step groups (Alcoholics Anonymous/Narcotics Anonymous) among adults with alcohol problems living with HIV/AIDS

PubMed Central

Orwat, John; Samet, Jeffrey H.; Tompkins, Christopher P.; Cheng, Debbie M.; Dentato, Michael P.; Saitz, Richard

2013-01-01

Background Despite the value of 12-step meetings, few studies have examined factors associated with attendance among those living with HIV/AIDS, such as the impact of HIV disease severity and demographics. Objective This study examines predisposing characteristics, enabling resources and need on attendance at Alcoholic Anonymous (AA) and Narcotics Anonymous (NA) meetings among those living with HIV/AIDS and alcohol problems. Methods Secondary analysis of prospective data from the HIV-Longitudinal Interrelationships of Viruses and Ethanol study, a cohort of 400 adults living with HIV/AIDS and alcohol problems. Factors associated with AA/NA attendance were identified using the Anderson model for vulnerable populations. Generalized estimating equation logistic regression models were fit to identify factors associated with self-reported AA/NA attendance. Results At study entry, subjects were 75% male, 12% met diagnostic criteria for alcohol dependence, 43% had drug dependence and 56% reported attending one or more AA/NA meetings (past six months). In the adjusted model, female gender negatively associated with attendance, as were social support systems that use alcohol and/or drugs, while presence of HCV antibody, drug dependence diagnosis, and homelessness associated with higher odds of attendance. Conclusions Non-substance abuse related barriers to AA/NA group attendance exist for those living with HIV/AIDS, including females and social support systems that use alcohol and/or drugs. Positive associations of homelessness, HCV infection and current drug dependence were identified. These findings provide implications for policy makers and treatment professionals who wish to encourage attendance at 12-step meetings for those living with HIV/AIDS and alcohol or other substance use problems. PMID:20832197

'You already drank my beer, I can decide anything': using structuration theory to explore the dynamics of alcohol use, gender-based violence and HIV risk among female sex workers in Tanzania.

PubMed

Leddy, Anna M; Kerrigan, Deanna; Kennedy, Caitlin E; Mbwambo, Jessie; Likindikoki, Samuel; Underwood, Carol R

2018-03-16

Female sex workers experience high rates of gender-based violence and HIV. Alcohol has been shown to facilitate women's risk of both gender-based violence and HIV; however, little research has explored how aspects of the sex work environment shape this risk. Drawing on structuration theory, this study explored how social conduct is patterned across time and space within the sex work environment to influence alcohol consumption, gender-based violence and HIV risk among female sex workers. Qualitative in-depth interviews were conducted with 24 female sex workers enrolled in an ongoing community randomised controlled trial of a combination HIV prevention intervention in Iringa, Tanzania. Data were analysed using both inductive and deductive approaches. Findings reveal how routine interactions between female sex workers and their clients occur at three moments of time and space during the sex exchange process to facilitate alcohol consumption and increase women's risk of gender-based violence and HIV. Findings also highlight how sex workers utilise collective agency to address aspects of the sex work environment that place them at risk of alcohol abuse, gender-based violence and HIV. Implications for future interventions to prevent gender-based violence and HIV among female sex workers in Tanzania and similar contexts are discussed.

Determinants of domestic violence among women attending an human immunodeficiency virus voluntary counseling and testing center in Bangalore, India.

PubMed

Chandrasekaran, Varalakshmi; Krupp, Karl; George, Ruja; Madhivanan, Purnima

2007-05-01

Violence against women is a global phenomenon that cuts across all social and economic classes. This study was designed to measure the prevalence and correlates of domestic violence (DV) among women seeking services at a voluntary counseling and testing (VCT) center in Bangalore, India. A cross-sectional survey was conducted among women visiting an human immunodeficiency virus (HIV) VCT center in Bangalore, between September and November 2005. An interviewer-administered questionnaire was used to collect information about violence and other variables. Univariable associations with DV were made using Pearson Chi-squared test for categorical variables and Student t-test or the Mann-Whitney test for continuous variables. Forty-two percent of respondents reported DV, including physical abuse (29%), psychological abuse (69%) and sexual abuse (1%). Among the women who reported violence of any kind, 67% also reported that they were HIV seropositive. The most common reasons reported for DV included financial problems (38%), husband's alcohol use (29%) and woman's HIV status (18%). Older women (P < 0.001) and those with low income levels were the most likely to have experienced DV (P = 0.02). Other factors included husband's education, HIV seropositivity and alcohol or tobacco use (P < 0.001). This study found DV levels comparable to other studies from around the world. The findings highlight the need for additional training among health care providers in VCT centers in screening for DV, detection of signs of physical abuse and provisions and referrals for women suffering from domestic partner violence.

Childhood Maltreatment Histories, Alcohol and Other Drug Use Symptoms, and Sexual Risk Behavior in a Treatment Sample of Adolescents

PubMed Central

Tubman, Jonathan G.; Burnette, Mandi L.

2012-01-01

Objectives. We tested a structural model of relations among self-reported childhood maltreatment, alcohol and other drug abuse and dependence symptoms, and sexual risk behavior in a sample of adolescents receiving outpatient treatment of substance use problems. Methods. Structured interviews were administered to an ethnically diverse sample of 394 adolescents (114 girls, 280 boys; mean = 16.30 years; SD = 1.15 years; 44.9% Hispanic, 20.6% African American, 25.4% White non-Hispanic, and 9.1% other) in 2 outpatient treatment settings. Results. Path analyses yielded findings consistent with a mediation model. Alcohol abuse and dependence symptoms mediated (1) relations between emotional neglect scores and sex with co-occurring alcohol use and (2) relations between sexual abuse scores and sex with co-occurring alcohol use. Drug abuse and dependence symptoms mediated relations between (1) neglect scores and (2) sexual intercourse with co-occurring alcohol or drug use, as well as unprotected sexual intercourse. Conclusions. Efforts to treat alcohol or drug use problems among adolescents or to prevent transmission of HIV or other sexually transmitted infections among youths with substance use problems may require tailoring treatment or prevention protocols to address client histories of maltreatment. PMID:22401530

Trajectories of Childhood Sexual Abuse and Early Adolescent HIV/AIDS Risk Behaviors: The Role of Other Maltreatment, Witnessed Violence, and Child Gender

PubMed Central

Jones, Deborah J.; Runyan, Desmond K.; Lewis, Terri; Litrownik, Alan J.; Black, Maureen M.; Wiley, Tisha; English, Diana E.; Proctor, Laura J.; Jones, Bobby L.; Nagin, Daniel S.

2013-01-01

Childhood sexual abuse (CSA) has been associated with HIV/AIDS risk behavior; however, much of this work is retrospective and focuses on women. The current study used semiparametric mixture modeling with youth (n = 844; 48.8% boys) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine the link between trajectories of CSA (2 to 12 y.o.) and HIV/AIDS risk behavior at age 14 (i.e., sexual intercourse & alcohol use). Trajectory analyses revealed a link between a history of CSA and the development of risky behavior. In addition, trajectories for physical and emotional abuse, but not neglect or witnessed violence, contributed to risky behavior over and above the role of CSA. Child gender did not moderate the findings. Findings highlight the signficance of CSA histories, as well as the broader context of maltreatment, for better understanding the development of risk behaviors in both girls and boys. PMID:20706919

Male-on-male intimate partner violence and sexual risk behaviors among money boys and other men who have sex with men in Shanghai, China.

PubMed

Dunkle, Kristin L; Wong, Frank Y; Nehl, Eric J; Lin, Lavinia; He, Na; Huang, Jennifer; Zheng, Tony

2013-05-01

Intimate partner violence (IPV) is known to increase HIV risk among heterosexual women, but less is known about IPV and HIV among men who have sex with men (MSM), with almost no data from non-Western countries. This study examined the prevalence of IPV and links between IPV and HIV risks among MSM in Shanghai, China. A cross-sectional sample of 404 money boys (male sex workers) and other MSM were recruited via respondent-driven sampling. Overall, 51% of the sample reported emotional, physical, or sexual abuse from a male sexual partner. Money boys reported more overall abuse than did other MSM, and more were likely than other MSM to report experiencing multiple types of abuse. MSM who reported violence or abuse from male partners reported more overall sexual risk behavior, and specifically, more unprotected sex and more sex linked to alcohol and other substance use. The association between experience of abuse from male partners and increased HIV risk did not differ between money boys and other Chinese MSM. We conclude that violence and abuse from male partners are highly prevalent among Chinese MSM, and that experience of violence from male sexual partners is linked to increased HIV risk. HIV prevention targeting Chinese MSM must address the increased risk associated with experience of male-on-male IPV. Future research should explore links between HIV risk and MSM's perpetration of violence against male partners, as well as exploring the role of violence in the male-female relationships of men who have sex with and men and women.

Sociodemographic and Substance Use Disorder Determinants of HIV Sexual Risk Behavior in Men and Women in Outpatient Drug Treatment in the NIDA National Drug Abuse Treatment Clinical Trials Network.

PubMed

Kidd, Jeremy D; Tross, Susan; Pavlicova, Martina; Hu, Mei-Chen; Campbell, Aimee N C; Nunes, Edward V

2017-06-07

Sexual risk behavior is now the primary vector of HIV transmission among substance users in the United States with gender as a crucial moderator of risk behavior. The purpose of this study was to examine gender differences in factors (age, race/ethnicity, education) that predict main-partner unprotected sexual occasions (USO) using the unique platform of two parallel NIDA National Drug Abuse Treatment Clinical Trials Network gender-specific safer sex intervention trials. Baseline assessments of male (N = 430) and female (N = 377) participants included demographic characteristics; past 3-month sexual activity; and a diagnostic assessment for alcohol, cocaine/stimulant, and opioid use disorders. Using mixed effects generalized linear modeling of the main outcome USO, two-way interactions of gender with age, race/ethnicity, and education were evaluated and adjusted by alcohol, cocaine/stimulant, or opioid use disorder. When adjusted for alcohol use disorder, the interaction of education and gender was significant. For men, a high school or greater education was significantly associated with more USO compared to men with less than high school. For women, greater than high school education was significantly associated with less USO compared to women with a high school education. None of the other interactions were significant when adjusted for cocaine/stimulant or opioid use disorder. Conclusions/Importance: This study demonstrates gender differences in the relationship of education, alcohol use disorder, and main-partner USO in individuals in substance abuse treatment. This underscores the importance of considering demographic and substance use factors in HIV sexual risk behavior and in crafting prevention messages for this population.

Depression, suicidality, and alcohol use disorder among people living with HIV/AIDS in Nigeria.

PubMed

Egbe, Catherine O; Dakum, Patrick S; Ekong, Ernest; Kohrt, Brandon A; Minto, John G; Ticao, Cynthia J

2017-06-02

People Living with HIV/AIDS (PLHIV) face various day-to-day and long-term personal, interpersonal, social, physical and psychological challenges as a result of, and in addition to the health conditions they are susceptible to due to their HIV status. There is a dearth of large-scale research to provide robust prevalence estimates of mental health problems among PLHIV, especially in Nigeria. This study aimed to ascertain the prevalence and factors associated with major depressive episodes, suicidality, and alcohol use disorder among people living with HIV/AIDS in Nigeria. A survey of 1187 participants aged 18 years and above was conducted within three HIV treatment centres in Abuja, Nigeria. Depression, suicidality, and alcohol use disorder modules of the WHO World Mental Health Composite International Diagnostic Interview questionnaire were used for this study. A socio-demographic questionnaire was also used to collect other health and demographic data. Descriptive statistics (frequency distribution, percentage, mean, median, mode, and standard deviation) and regression analyses were conducted to explore associations between mental health problems and demographic and other health-related factors. Twelve-month prevalence rates were 28.2% for major depressive episodes, 2.9% for suicidal ideation, 2.3% for suicide attempts, 7.8% for harmful alcohol use, 7.0% for alcohol abuse, and 2.2% for alcohol dependence. Major depressive episodes were significantly associated with having planned suicide and marital status. Suicidal ideation was significantly associated with major depressive episodes, marital status, and religion. Females were less likely to be diagnosed with alcohol disorders. Some people living with HIV/AIDS also tend to suffer from depression, suicidality, and alcohol use disorders. These findings highlight the need for the integration of mental health services into HIV/AIDS care in Nigeria.

Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors

PubMed Central

Masho, Saba W.; Perera, Robert A.; Mezuk, Briana; Pugsley, River A.; Cohen, Steven A.

2017-01-01

HIV and other sexually transmitted infections (STIs) are important public health challenges in the US. Adverse childhood experiences (ACEs), including abuse (emotional, physical or sexual), witnessing violence among household members, may have an effect on sexual behaviors, which increase the risk of HIV/STIs. The aim of this study was to examine the sex differences in the role of posttraumatic stress disorder (PTSD), major depression (MD), substance use disorders (SUDs), early sexual debut, and intimate partner violence (IPV) perpetration as mediators in the association between ACEs and HIV/STIs. Data were obtained from Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the role of PTSD, MD, SUDs, early sexual debut, and IPV perpetration as mediators in the relationships between ACEs and HIV/STIs. Differences and similarities existed in the mediational roles of psychopathology and sexual behaviors. For example, among men, MD fully mediated physical/psychological abuse (β = 0.0002; p = 0.012) and sexual abuse (β = 0.0002; p = 0.006), and HIV/STIs while among women, MD fully mediated physical/psychological abuse (β = 0.0005; p < 0.001) and parental violence (β = −0.0002; p = 0.012). Among men, IPV perpetration fully mediated sexual abuse (β = −0.0005; p = 0.012) and HIV/STIs while among women, IPV perpetration was not a statistically significant mediator. HIV/STI prevention and intervention programs should use a life course approach by addressing adverse childhood events among men and women and consider the sex differences in the roles of psychopathology and sexual behaviors. PMID:27688144

Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors.

PubMed

Brown, Monique J; Masho, Saba W; Perera, Robert A; Mezuk, Briana; Pugsley, River A; Cohen, Steven A

2017-06-01

HIV and other sexually transmitted infections (STIs) are important public health challenges in the US. Adverse childhood experiences (ACEs), including abuse (emotional, physical or sexual), witnessing violence among household members, may have an effect on sexual behaviors, which increase the risk of HIV/STIs. The aim of this study was to examine the sex differences in the role of posttraumatic stress disorder (PTSD), major depression (MD), substance use disorders (SUDs), early sexual debut, and intimate partner violence (IPV) perpetration as mediators in the association between ACEs and HIV/STIs. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the role of PTSD, MD, SUDs, early sexual debut, and IPV perpetration as mediators in the relationships between ACEs and HIV/STIs. Differences and similarities existed in the mediational roles of psychopathology and sexual behaviors. For example, among men, MD fully mediated physical/psychological abuse (β = 0.0002; p = 0.012) and sexual abuse (β = 0.0002; p = 0.006), and HIV/STIs while among women, MD fully mediated physical/psychological abuse (β = 0.0005; p < 0.001) and parental violence (β = -0.0002; p = 0.012). Among men, IPV perpetration fully mediated sexual abuse (β = -0.0005; p = 0.012) and HIV/STIs while among women, IPV perpetration was not a statistically significant mediator. HIV/STI prevention and intervention programs should use a life course approach by addressing adverse childhood events among men and women and consider the sex differences in the roles of psychopathology and sexual behaviors.

HIV-1 gp120 as well as alcohol affect blood-brain barrier permeability and stress fiber formation: involvement of reactive oxygen species.

PubMed

Shiu, Carlum; Barbier, Elisabeth; Di Cello, Francescopaolo; Choi, Hee Jung; Stins, Monique

2007-01-01

HIV-1 infection commonly leads to serious HIV-1-associated neurological disorders, such as HIV-1-associated encephalopathy and dementia. In addition, alcohol is commonly used and/or abused among AIDS patients, but it is unclear whether alcohol affects the disease progression and if it affects it, how this occurs. We hypothesized that alcohol could affect the blood-brain barrier (BBB) integrity and thus could affect the onset and/or progression of HIV-associated neurological disorders. Human brain microvascular endothelial cells (HBMEC) in a BBB model system were pretreated with alcohol (17 and 68 mM) and subsequently coexposed with HIV-1 gp120. Expression of chemokine receptors CCR3, CCR5, and CXCR4 was assessed by enzyme-linked immunosorbent assay and real-time polymerase chain reaction. Changes in the permeability of the HBMEC monolayer were assessed using paracellular markers [(3)H]inulin or propidium iodide. Actin rearrangements in HBMEC were visualized by fluorescence microscopy and viability assessed using Live/Dead stain. Both gp120 and alcohol increased the permeability of the BBB model by up to 141%, without affecting HBMEC viability. Cotreatment with alcohol and gp120 did not result in a significant synergistic effect. Gp120 permeability involved chemokine receptor CCR5. Alcohol did not affect chemokine receptor expression on brain endothelial cells. Both gp120 and alcohol reorganized the cytoskeleton and induced stress fiber formation. Inhibition of reactive oxygen species (ROS) formation through NADPH blocked the effects of both gp120 and alcohol on permeability and stress fiber formation. These results indicate that both HIV-1 gp120 and alcohol induce stress fibers, causing increased permeability of the human BBB endothelium. Alcohol (68 mM)-mediated permeability increase was linked to ROS formation. The alcohol-mediated physiological changes in the HBMEC monolayers may increase diffusion of plasma components and viral penetration across the BBB. This suggests that alcohol, especially at levels attained in heavy drinkers, can potentially contribute in a negative fashion to HIV-1 neuropathogenesis.

Treat Jail Detainees' Drug Abuse to Lower HIV Transmission

MedlinePlus

... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter ... Illegal Drugs Inhalants K2/Spice Kratom LSD (Acid) Marijuana MDMA (Ecstasy) Methamphetamine Opioids Other Drugs Over-the- ...

Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings.

PubMed

Marotta, Phillip L

2017-05-12

Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

The Needs of Pregnant and Parenting American Indian Women at Risk for Problem Alcohol or Drug Use.

ERIC Educational Resources Information Center

Zahnd, Elaine; Klein, Dorie

1997-01-01

A survey of 171 American Indian women in California who were pregnant or parenting and were considered at risk for problem substance abuse covered demographic information; personal and family history; alcohol, tobacco, and drug use; HIV risk; and a needs assessment regarding health care, economic needs, and parenting and children's needs. (LP)

None of Us Will Get Out of Here Alive: The Intersection of Perceived Risk for HIV, Risk Behaviors and Survival Expectations among African American Emerging Adults.

PubMed

Edwards, Lorece V; Lindong, Ian; Brown, Lawrence; Hawkins, Anita S; Dennis, Sabriya; Fajobi, Olaoluwa; Rowel, Randolph; Braithwaite, Ronald; Sydnor, Kim D

2017-01-01

The Human Immunodeficiency Virus (HIV) significantly affects minority emerging adults, among whom the rate of new diagnoses is high and health disparities are more pronounced. Importantly, emerging adults today have limited knowledge of the earlier toll of the virus when it was identified as a killer. Among this population, perceptions of risk for HIV are low and sexual risk taking behaviors are high. The Get SMART Project is a behavioral intervention aimed to provide re-purposed HIV, alcohol, and substance abuse prevention education and HIV testing to African American emerging adults ages 18-24. The project was guided by the Health Belief Model, Community Promise, and Training for Institutional Procedures. Findings revealed that HIV testing is low. Marijuana and alcohol are drugs of choice. Emerging adults do not see themselves at risk for HIV, although they engaged in high-risk behaviors. Additionally, survival expectations influence behavior risk.

Predictors and moderators of outcomes of HIV/STD sex risk reduction interventions in substance abuse treatment programs: a pooled analysis of two randomized controlled trials.

PubMed

Crits-Christoph, Paul; Gallop, Robert; Sadicario, Jaclyn S; Markell, Hannah M; Calsyn, Donald A; Tang, Wan; He, Hua; Tu, Xin; Woody, George

2014-01-16

The objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs. Participants were recruited from community drug treatment programs participating in the National Institute on Drug Abuse Clinical Trials Network (CTN). Data were pooled from two parallel randomized controlled CTN studies (one with men and one with women) each examining the impact of a multi-session motivational and skills training program, in comparison to a single-session HIV education intervention, on the degree of reduction in unprotected sex from baseline to 3- and 6- month follow-ups. The findings were analyzed using a zero-inflated negative binomial (ZINB) model. Severity of drug use (p < .01), gender (p < .001), and age (p < .001) were significant main effect predictors of number of unprotected sexual occasions (USOs) at follow-up in the non-zero portion of the ZINB model (men, younger participants, and those with greater severity of drug/alcohol abuse have more USOs). Monogamous relationship status (p < .001) and race/ethnicity (p < .001) were significant predictors of having at least one USO vs. none (monogamous individuals and African Americans were more likely to have at least one USO). Significant moderators of intervention effectiveness included recent sex under the influence of drugs/alcohol (p < .01 in non-zero portion of model), duration of abuse of primary drug (p < .05 in non-zero portion of model), and Hispanic ethnicity (p < .01 in the zero portion, p < .05 in the non-zero portion of model). These predictor and moderator findings point to ways in which patients may be selected for the different HIV sexual risk reduction interventions and suggest potential avenues for further development of the interventions for increasing their effectiveness within certain subgroups.

Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort].

PubMed

Michel, L; Lions, C; Winnock, M; Lang, J-P; Loko, M-A; Rosenthal, E; Marchou, B; Valantin, M-A; Morlat, P; Roux, P; Sogni, P; Spire, B; Poizot-Martin, I; Lacombe, K; Lascoux-Combe, C; Duvivier, C; Neau, D; Dabis, F; Salmon-Ceron, D; Carrieri, M P

2016-11-01

The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-naïve patients. Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders. © 2016 British HIV Association.

Reported Physical and Sexual Abuse in Childhood and Adult HIV Risk Behaviour in Three African Countries: Findings from Project Accept (HPTN-043)

PubMed Central

Komárek, Arnošt; Desmond, Chris; Celentano, David; Morin, Steve; Sweat, Michael; Chariyalertsak, Suwat; Chingono, Alfred; Gray, Glenda; Mbwambo, Jessie; Coates, Tom

2013-01-01

Childhood sexual and physical abuse have been linked to adolescent and adult risky sexual behaviors, including early sexual debut, an increased number of sexual partners, unprotected sex, alcohol and drug use during sex and sexual violence. This paper explores these relationships among both men and women who report histories of childhood abuse from representative samples of communities in three countries in southern and eastern Africa (South Africa, Zimbabwe and Tanzania). Data were collected as part of a 3-year randomized community trial to rapidly increase knowledge of HIV status and to promote community responses through mobilisation, mobile testing, provision of same-day HIV test results and post-test support for HIV. The results indicate that reported childhood sexual and physical abuse is high in all three settings, also among men, and shows strong relationships with a range of sexual risk behaviors, including age at first sex (OR −0.6 (CI: −0.9, −0.4, p<0.003)—among men, OR −0.7 (CI: −0.9, −0.5, p<0.001)—among women), alcohol (OR 1.43 (CI: 1.22, 1.68, p<0.001)—men,OR1.83 (CI: 1.50, 2.24, p<0.001)— women) and drug use (OR 1.65 (CI: 1.38, 1.97, p<0.001)— men, OR 3.14 (CI: 1.95, 5.05, p<0.001)—women) and two forms of partner violence—recent forced sex (OR 2.22 (CI: 1.66, 2.95, p<0.001)—men, OR 2.76 (CI: 2.09, 3.64, p<0.001)—women) and ever being hurt by a partner (OR 3.88 (CI: 2.84, 5.29, p<0.001)—men, OR 3.06 (CI: 2.48, 3.76, p<0.001)—women). Individuals abused in childhood comprise between 6 and 29 % of young adult men and women living in these African settings and constitute a population at high risk of HIV infection. PMID:23474641

PEPFAR support of alcohol-HIV prevention activities in Namibia and Botswana: a framework for investigation, implementation and evaluation.

PubMed

Glenshaw, M; Deluca, N; Adams, R; Parry, C; Fritz, K; Du Preez, V; Voetsch, K; Lekone, P; Seth, P; Bachanas, P; Grillo, M; Kresina, T F; Pick, B; Ryan, C; Bock, N

2016-01-01

The association between harmful use of alcohol and HIV infection is well documented. To address this dual epidemic, the US President's Emergency Plan for AIDS Relief (PEPFAR) developed and implemented a multi-pronged approach primarily in Namibia and Botswana. We present the approach and preliminary results of the public health investigative and programmatic activities designed, initiated and supported by PEPFAR to combat the harmful use of alcohol and its association as a driver of HIV morbidity and mortality from 2008 to 2013. PEPFAR supported comprehensive alcohol programming using a matrix model approach that combined the socio-ecological framework and the Alcohol Misuse Prevention and Intervention Continuum. This structure enabled seven component objectives: (1) to quantify harmful use of alcohol through rapid assessments; (2) to develop and evaluate alcohol-based interventions; (3) to promote screening programs and alcohol abuse resource services; (4) to support stakeholder networks; (5) to support policy interventions and (6) structural interventions; and (7) to institutionalize universal prevention messages. Targeted PEPFAR support for alcohol activities resulted in several projects to address harmful alcohol use and HIV. Components are graphically conceptualized within the matrix model, demonstrating the intersections between primary, secondary and tertiary prevention activities and individual, interpersonal, community, and societal factors. Key initiative successes included leveraging alcohol harm prevention activities that enabled projects to be piloted in healthcare settings, schools, communities, and alcohol outlets. Primary challenges included the complexity of multi-sectorial programming, varying degrees of political will, and difficulties monitoring outcomes over the short duration of the program.

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial.

PubMed

Parcesepe, Angela M; L Engle, Kelly L; Martin, Sandra L; Green, Sherri; Sinkele, William; Suchindran, Chirayath; Speizer, Ilene S; Mwarogo, Peter; Kingola, Nzioki

2016-04-01

To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya. Randomized controlled trial. HIV prevention drop-in centers in Mombasa, Kenya. 818 women 18 or older in Mombasa who visited HIV prevention drop-in centers, were moderate-risk drinkers and engaged in transactional sex in past six months (410 and 408 in intervention and control arms, respectively). 6 session alcohol harm reduction intervention. 6 session non-alcohol related nutrition intervention. In-person interviews were conducted at enrollment, immediately post-intervention and 6-months post-intervention. General linear mixed models examined associations between intervention assignment and recent violence (physical violence, verbal abuse, and being robbed in the past 30 days) from paying and non-paying sex partners and engagement in sex work in the past 30 days. The alcohol intervention was associated with statistically significant decreases in physical violence from paying partners at 6 months post-intervention and verbal abuse from paying partners immediately post-intervention and 6-months post-intervention. Those assigned to the alcohol intervention had significantly reduced odds of engaging in sex work immediately post-intervention and 6-months post-intervention. The alcohol intervention was associated with reductions in some forms of violence and with reductions in engagement in sex work among FSWs in Mombasa, Kenya. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sexual sensation seeking, co-occurring sex and alcohol use, and sexual risk behavior among adolescents in treatment for substance use problems.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Morgan-Lopez, Antonio A; Saavedra, Lissette M; Csizmadia, Annamaria

2013-01-01

This study evaluated relations between sexual sensation seeking, co-occurring sex and alcohol use, and sexual risk behaviors (eg, unprotected intercourse and multiple sex partners) among adolescents receiving treatment for substance abuse problems. The ethnically diverse sample included 394 adolescents recruited from outpatient treatment (280 males; Mage  = 16.33 years, SDage  = 1.15). Structural equation modeling (SEM) was used to test direct and indirect paths between sexual sensation seeking and sexual risk behaviors via the frequency of co-occurring sex and alcohol use. Conditional indirect effects by gender were also tested. Analyses identified significant effects of sexual sensation seeking on co-occurring sex and alcohol use and sexual risk behaviors. The path from co-occurring sex and alcohol use to unprotected intercourse was significantly stronger among adolescent girls, suggesting a mediation effect moderated by gender. No gender difference was found for the indirect path from sexual sensation seeking and number of past year sexual partners via co-occurring sex and alcohol use. Selected prevention efforts are needed to promote HIV risk reduction among adolescents in substance abuse treatment. The documented conditional indirect effect for unprotected intercourse suggests that HIV prevention programs should pay special attention to gender-specific patterns of alcohol use and sexual risk behavior when tailoring program content. (Am J Addict 2013; 22:197-205). Copyright © American Academy of Addiction Psychiatry.

[Vulnerability to HIV: tourism and the use of alcohol and other drugs].

PubMed

Santos, Alessandro de Oliveira; Paiva, Vera

2007-12-01

To describe situations of alcohol and other drug use involving tourists, and their implications regarding vulnerability to HIV. This was an exploratory qualitative study conducted in communities that host tourism in the Vale do Ribeira, State of São Paulo, from October 2002 to February 2003. In the first stage of the study, 29 monitors in four host communities were interviewed to gather scenarios of drug use involving tourists. In the second stage, two workshops were held, bringing together 77 interviewees and health and education professionals from ten communities, in order to dramatize the scenarios gathered in the interviews and share repertoires for dealing with these situations and finding ways for preventing HIV. The scenarios showed that alcohol and other drug use by tourists increases their vulnerability to HIV transmission through favoring casual sexual intercourse without condoms and sexual harassment and abuse. HIV prevention work in these communities that host tourism needs to take into account the consumption of these substances which use creates difficulties regarding safe sex practices and, in the case of injecting drugs that are shared, constitutes a risk factor for HIV transmission. This study provided data to help in understanding how situations of alcohol and other drug use fit within daily life in these host communities, thereby extending the vulnerability to HIV. The study produced analysis of the social context of HIV transmission that may provide backing for drawing up prevention programs that are better adapted to these communities.

Targeted expansion project for outreach and treatment for substance abuse and HIV risk behaviors in Asian and Pacific Islander communities.

PubMed

Nemoto, Tooru; Iwamoto, Mariko; Kamitani, Emiko; Morris, Anne; Sakata, Maria

2011-04-01

Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence was 6% among MSM. Inconsistent condom use for vaginal sex with casual partners in the past 6 months was reported among substance users (43%) and incarcerated participants (60%), whereas 26% of men who have sex with men reported inconsistent condom use for anal sex with casual partners. Overall, 56% and 29% had engaged in sex with casual partners under the influence of alcohol and drugs in the past 6 months, respectively. Although API organizations in the Bay Area have spearheaded HIV prevention, future programs must address substance use issues in relation to sexual risk behaviors, specific to API risk groups.

Depression, alcohol use, and stigma in younger versus older HIV-infected pregnant women initiating antiretroviral therapy in Cape Town, South Africa.

PubMed

Wong, Marcia; Myer, Landon; Zerbe, Allison; Phillips, Tamsin; Petro, Greg; Mellins, Claude A; Remien, Robert H; Shiau, Stephanie; Brittain, Kirsty; Abrams, Elaine J

2017-02-01

HIV-infected pregnant women in sub-Saharan Africa are at risk for depression and alcohol abuse. Young women may be more vulnerable, but little is known about the psychosocial functioning of this population. We compared younger (18-24 years old) and older (≥25 years old) HIV-infected pregnant women initiating antiretroviral therapy (ART) in Cape Town, South Africa. Women were assessed on a range of psychosocial measures, including the Alcohol Use Disorders Identification Test and the Edinburgh Postnatal Depression Scale (EPDS). Among 625 women initiating ART, 16 % reported risky alcohol use and 21 % alcohol-related harm; these percentages were similar across age groups. When younger women were stratified by age, 37 % of 18-21 years old versus 20 % of 22-24 years old reported alcohol-related harm (p = 0.02). Overall, 11 % of women had EPDS scores suggesting probable depression, and 6 % reported self-harming thoughts. Younger women reported more depressive symptoms. Report of self-harming thoughts was 11 % in younger and 4 % in older women (p = 0.002). In multivariable analysis, age remained significantly associated with depressive symptoms and report of self-harming thoughts. Level of HIV-related stigma and report of intimate partner violence modified the association between age and depressive symptoms. Young HIV-infected pregnant women in South Africa were more likely to report depressive symptoms and self-harming thoughts compared to older women, and the youngest women reported the highest levels of alcohol-related harm. HIV-related stigma and intimate partner violence may be moderating factors. These findings have implications for maternal and infant health, underscoring the urgent need for effective targeted interventions in this vulnerable population.

Depression, alcohol use, and stigma in younger versus older HIV-infected pregnant women initiating antiretroviral therapy in Cape Town, South Africa

PubMed Central

Wong, Marcia; Myer, Landon; Zerbe, Allison; Phillips, Tamsin; Petro, Greg; Mellins, Claude A.; Remien, Robert H.; Shiau, Stephanie; Brittain, Kirsty; Abrams, Elaine J.

2017-01-01

Purpose HIV-infected pregnant women in sub-Saharan Africa are at risk for depression and alcohol abuse. Young women may be more vulnerable, but little is known about the psychosocial functioning of this population. Methods We compared younger (18–24 year-olds) and older (≥25 year-olds) HIV-infected pregnant women initiating antiretroviral therapy (ART) in Cape Town, South Africa. Women were assessed on a range of psychosocial measures, including the Alcohol Use Disorders Identification Test, and the Edinburgh Postnatal Depression Scale (EPDS). Results Among 625 women initiating ART, 16% reported risky alcohol use, and 21% alcohol-related harm; these percentages were similar across age groups. When younger women were stratified by age, 37% of 18–21 year-olds vs. 20% of 22–24 year-olds reported alcohol-related harm (p=0.02). Overall, 11% of women had EPDS scores suggesting probable depression, and 6% reported self-harming thoughts. Younger women reported more depressive symptoms. Report of self-harming thoughts was 11% in younger and 4% in older women (p=0.003). In multivariable analysis, age remained significantly associated with depressive symptoms and report of self-harming thoughts. Level of HIV-related stigma and report of intimate partner violence modified the association between age and depressive symptoms. Conclusions Young HIV-infected pregnant women in South Africa were more likely to report depressive symptoms and self-harming thoughts compared to older women and the youngest women reported the highest levels of alcohol-related harm. HIV-related stigma may be a moderating factor. These findings have implications for maternal and infant health, underscoring the urgent need for effective targeted interventions in this vulnerable population. PMID:27815628

Description of a Behavioral Intervention to Reduce Substance Use and Related Risk and Increase Positive Parenting among Urban Mothers with Alcohol and Other Drug Problems

ERIC Educational Resources Information Center

Leonard, Noelle R.; Gwadz, Marya V.; Arredondo, Gricel N.; Riedel, Marion; Rotko, Lauren; Hardcastle, Emily J.; Potere, Jodi C.

2007-01-01

The abuse of alcohol and other substances by mothers raising adolescent children has serious adverse effects on family functioning and youth outcomes, and on mothers' own health and adaptation. Mothers who are also HIV-infected face additional challenges. In the present report, we describe a multi-session intervention conducted in individual…

Pathological gambling, gender, and risk-taking behaviors.

PubMed

Martins, Silvia Saboia; Tavares, Hermano; da Silva Lobo, Daniela Sabbatini; Galetti, Ana Maria; Gentil, Valentim

2004-08-01

Seventy-eight female and 78 male pathological gamblers admitted to an outpatient treatment program were compared regarding a profile of risk-taking behaviors (suicide attempts, illegal activities meant to finance gambling, sexual risky behavior, and alcohol abuse). The Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Barratt Impulsiveness Scale version 11 (BIS-11), and an adaptation of the HIV Risk Behavior Scale were used. Females attempted more suicide than males. Men had more sexual risky behavior and alcohol abuse than women. Younger age and depression were risk factors for suicide attempts, younger age and impulsivity were risk factors for illegal activities. Younger age was a risk factor for sexual risky behavior, and no risk factor other than male gender was found for alcohol abuse. Future investigation of risk behaviors among gamblers must take into account the differences in gender and age. Both impulsivity and emotional distress are related to risk-taking in gamblers, and young gamblers who early in life display other potentially harmful behaviors require special attention.

Exploring Relationships Between Delinquent Peer Groups, Participation in Delinquency, Substance Abuse, and Injecting Drug Use Among the Incarcerated: Findings From a National Sample of State and Federal Inmates in the United States

PubMed Central

Marotta, Phillip

2017-01-01

The following study assesses the relationship between affiliating with delinquent peer groups, participation in delinquency, and several substance misuse and injecting drug use outcomes in a nationally representative sample of inmates in state and federal facilities in the United States. After controlling for potential confounders, affiliating with peers who engaged in deviant behaviors and participation in delinquency was associated with onset of alcohol and illicit drug use, substance dependence, alcohol dependence, types of substances used, and injecting drug use outcomes. Inmates who began engaging in delinquency at older ages reported initiating drug and alcohol use at older ages, and were less likely to meet the criteria for drug abuse or dependence, less likely to use substances daily or near daily, and less likely to report having ever injected or shared syringes. The implications of these findings for substance abuse, HIV, and crime prevention interventions are discussed. PMID:28966393

Integrating Mental Health and HIV Services in Zimbabwean Communities: A Nurse and Community-led Approach to Reach the Most Vulnerable.

PubMed

Duffy, Malia; Sharer, Melissa; Cornman, Helen; Pearson, Jennifer; Pitorak, Heather; Fullem, Andrew

Alcohol use and depression negatively impact adherence, retention in care, and HIV progression, and people living with HIV (PLWH) have disproportionately higher depression rates. In developing countries, more than 76% of people with mental health issues receive no treatment. We hypothesized that stepped-care mental health/HIV integration provided by multiple service professionals in Zimbabwe would be acceptable and feasible. A three-phase mixed-method design was used with a longitudinal cohort of 325 nurses, community health workers, and traditional medicine practitioners in nine communities. During Phase 3, 312 PLWH were screened by nurses for mental health symptoms; 28% were positive. Of 59 PLWH screened for harmful alcohol and substance use, 36% were positive. Community health workers and traditional medicine practitioners screened 123 PLWH; 54% were positive for mental health symptoms and 29% were positive for alcohol and substance abuse. Findings indicated that stepped-care was acceptable and feasible for all provider types. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Alcohol use as a marker for risky sexual behaviors and biologically-confirmed sexually transmitted infections among young adult African American women

PubMed Central

Seth, Puja; Wingood, Gina M.; DiClemente, Ralph J.; Robinson, LaShun S.

2011-01-01

Introduction Previous research has primarily focused on the relationship between illicit drug use and HIV/STI-risk behavior among African American women. Very few studies have solely reviewed the role of alcohol use on risky sexual behavior. The present study examined the relationship between alcohol use at non-abuse levels and risky sexual behaviors and sexually transmitted infections (STIs) among young adult African American women. Methods Eight hundred forty-eight African American women, 18–29, participated at baseline, with 669 and 673 women at 6- and 12-months follow-up, respectively. Participants completed an Audio Computer Assisted Survey Interview assessing sociodemographics, alcohol use, and risky sexual behaviors. Subsequently, participants provided two vaginal swab specimens for STIs. Results Multivariate logistic regression analyses were conducted for cross-sectional analyses, with illicit drug use as a covariate. Women who consumed alcohol were more likely to have multiple partners and risky partners. Binary generalized estimating equation models assessed the impact of alcohol use at baseline on risky sexual behavior and STIs over a 12-month period. Illicit drug use, intervention group, and baseline outcome measures were entered as covariates. Alcohol consumption predicted positive results for Chlamydia, positive results for any STI, and never using a condom with a casual partner over a 12-month follow-up period. Discussion Frequency of alcohol use at non-abuse levels was correlated with and predicted risky sexual behaviors and STIs. Prevention programs for African American women should incorporate education regarding the link between alcohol and HIV/STI-risk behaviors and the potential negative health consequences. PMID:21276736

Thalamic volume deficit contributes to procedural and explicit memory impairment in HIV infection with primary alcoholism comorbidity.

PubMed

Fama, Rosemary; Rosenbloom, Margaret J; Sassoon, Stephanie A; Rohlfing, Torsten; Pfefferbaum, Adolf; Sullivan, Edith V

2014-12-01

Component cognitive and motor processes contributing to diminished visuomotor procedural learning in HIV infection with comorbid chronic alcoholism (HIV+ALC) include problems with attention and explicit memory processes. The neural correlates associated with this constellation of cognitive and motor processes in HIV infection and alcoholism have yet to be delineated. Frontostriatal regions are affected in HIV infection, frontothalamocerebellar regions are affected in chronic alcoholism, and frontolimbic regions are likely affected in both; all three of these systems have the potential of contributing to both visuomotor procedural learning and explicit memory processes. Here, we examined the neural correlates of implicit memory, explicit memory, attention, and motor tests in 26 HIV+ALC (5 with comorbidity for nonalcohol drug abuse/dependence) and 19 age-range matched healthy control men. Parcellated brain volumes, including cortical, subcortical, and allocortical regions, as well as cortical sulci and ventricles, were derived using the SRI24 brain atlas. Results indicated that smaller thalamic volumes were associated with poorer performance on tests of explicit (immediate and delayed) and implicit (visuomotor procedural) memory in HIV+ALC. By contrast, smaller hippocampal volumes were associated with lower scores on explicit, but not implicit memory. Multiple regression analyses revealed that volumes of both the thalamus and the hippocampus were each unique independent predictors of explicit memory scores. This study provides evidence of a dissociation between implicit and explicit memory tasks in HIV+ALC, with selective relationships observed between hippocampal volume and explicit but not implicit memory, and highlights the relevance of the thalamus to mnemonic processes.

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial*

PubMed Central

Parcesepe, Angela M.; L'Engle, Kelly L.; Martin, Sandra L.; Green, Sherri; Sinkele, William; Suchindran, Chirayath; Speizer, Ilene S.; Mwarogo, Peter; Kingola, Nzioki

2016-01-01

Aims To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya. Design Randomized controlled trial. Setting HIV prevention drop-in centers in Mombasa, Kenya. Participants 818 women 18 or older in Mombasa who visited HIV prevention drop-in centers, were moderate-risk drinkers and engaged in transactional sex in past six months (410 and 408 in intervention and control arms, respectively). Intervention 6 session alcohol harm reduction intervention. Comparator 6 session non-alcohol related nutrition intervention. Measurements In-person interviews were conducted at enrollment, immediately post-intervention and 6-months post-intervention. General linear mixed models examined associations between intervention assignment and recent violence (physical violence, verbal abuse, and being robbed in the past 30 days) from paying and non-paying sex partners and engagement in sex work in the past 30 days. Findings The alcohol intervention was associated with statistically significant decreases in physical violence from paying partners at 6 months post-intervention and verbal abuse from paying partners immediately post-intervention and 6-months post-intervention. Those assigned to the alcohol intervention had significantly reduced odds of engaging in sex work immediately post-intervention and 6-months post-intervention. Conclusions The alcohol intervention was associated with reductions in some forms of violence and with reductions in engagement in sex work among FSWs in Mombasa, Kenya. PMID:26872880

Depression, Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History.

PubMed

Dévieux, Jessy G; Jean-Gilles, Michèle; Rosenberg, Rhonda; Beck-Sagué, Consuelo; Attonito, Jennifer M; Saxena, Anshul; Stein, Judith A

2016-02-01

Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p < 0.05) and relationship power (-0.48, p < 0.001), and greater depression (-0.16, p < 0.05) predicted more condom-use barriers. History of mental health problems predicted condom-use barriers, mediated by recent depression and relationship power (0.15, p < 0.001). These findings suggest depression and diminished relationship power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.

38 CFR 1.303 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Immunodeficiency Virus (HIV), or Sickle Cell Anemia Note: Sections 1.460 through 1.499 of this part concern the... immunodeficiency virus, or sickle cell anemia in VA records and are applicable in combination with other... immunodeficiency virus, or sickle cell anemia. The statutory authority for the drug abuse provisions and alcoholism...

38 CFR 1.303 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Immunodeficiency Virus (HIV), or Sickle Cell Anemia Note: Sections 1.460 through 1.499 of this part concern the... immunodeficiency virus, or sickle cell anemia in VA records and are applicable in combination with other... immunodeficiency virus, or sickle cell anemia. The statutory authority for the drug abuse provisions and alcoholism...

38 CFR 1.303 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Immunodeficiency Virus (HIV), or Sickle Cell Anemia Note: Sections 1.460 through 1.499 of this part concern the... immunodeficiency virus, or sickle cell anemia in VA records and are applicable in combination with other... immunodeficiency virus, or sickle cell anemia. The statutory authority for the drug abuse provisions and alcoholism...

38 CFR 1.303 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Immunodeficiency Virus (HIV), or Sickle Cell Anemia Note: Sections 1.460 through 1.499 of this part concern the... immunodeficiency virus, or sickle cell anemia in VA records and are applicable in combination with other... immunodeficiency virus, or sickle cell anemia. The statutory authority for the drug abuse provisions and alcoholism...

38 CFR 1.303 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Immunodeficiency Virus (HIV), or Sickle Cell Anemia Note: Sections 1.460 through 1.499 of this part concern the... immunodeficiency virus, or sickle cell anemia in VA records and are applicable in combination with other... immunodeficiency virus, or sickle cell anemia. The statutory authority for the drug abuse provisions and alcoholism...

Substance use and sexual risk behaviors among Peruvian MSM social media users.

PubMed

Young, Sean D; Nianogo, Roch A; Chiu, ChingChe J; Menacho, Lucho; Galea, Jerome

2016-01-01

Peru is experiencing a concentrated HIV epidemic among men who have sex with men (MSM). Substance use (alcohol and drug use) has been found to be associated with HIV-related sexual risk behaviors. A recent surge in the number of social media users in Peru has enabled these technologies to be potential tools for reaching HIV at-risk individuals. This study sought to assess the relationship between substance use and sexual risk behaviors among Peruvian MSM who use social media. A total of 556 Peruvian MSM Facebook users (ages 18-59) were recruited to complete a 92-item survey on demographics, sexual risk behaviors, and substance use. We performed a logistic regression of various sexual risk behaviors (e.g., unprotected sex, casual sex) on substance abuse, including alcohol, adjusting for potential covariates. Drinking more than five alcoholic drinks a day in the past three months was associated with an increased odds of having unprotected sex (vaginal and anal) (aOR: 1.52; 95% CL: 1.01, 2.28), casual sex (1.75; 1.17, 2.62), and sex with unknown persons (1.82; 1.23, 2.71). Drug use was not significantly associated with sexual risk behaviors. Among Peruvian MSM social media users, findings suggest that alcohol use was associated with increased HIV-related sexual risk behaviors.

Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa.

PubMed

Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Cain, Demetria; Sikkema, Kathleen J; Skinner, Donald; Watt, Melissa H; Pieterse, Desiree

2013-06-01

Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior.

Gender-based Violence, Alcohol use, and Sexual Risk Among Female Patrons of Drinking Venues in Cape Town, South Africa

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Cain, Demetria; Sikkema, Kathleen J.; Skinner, Donald; Watt, Melissa H.; Pieterse, Desiree

2013-01-01

Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior. PMID:22526526

Prevalence and correlates of psychosocial conditions among people living with HIV in southern India.

PubMed

Chan, Brian T; Pradeep, Amrose; Prasad, Lakshmi; Murugesan, Vinothini; Chandrasekaran, Ezhilarasi; Kumarasamy, Nagalingeswaran; Mayer, Kenneth H

2017-06-01

Psychosocial conditions such as depression, intimate partner violence (IPV), and history of childhood sexual abuse (CSA) have been associated with poor HIV-related outcomes. In India, which has the third largest HIV epidemic in the world, little is understood about the impact of psychosocial conditions on people living with HIV (PLHIV). We aimed to understand the prevalence and correlates of psychosocial conditions among PLHIV entering into HIV care at the Y.R. Gaitonde Centre for AIDS Research and Education in Chennai, India. Thirteen questions were added to the standard voluntary counseling and testing questionnaire, including the Patient Health Questionnaire-9 (a depression scale) and questions assessing for CSA and IPV. We fitted logistic regression models, stratified by gender, with psychosocial condition as the outcome of interest and substance use variables and socio-demographic variables as the correlates of interest. Three hundred and eighty-three persons were enrolled into the study; of these, 253 (66%) tested positive for HIV, including 149 men and 104 women, and were included in the models. More than one-quarter (28%) of the men and 19% of the women reported at least one psychosocial condition (probable depression, CSA, or IPV). In adjusted analysis, current alcohol use was associated with greater than two times higher odds of a psychosocial condition (Adjusted Odds Ratio = 2.24, 95% CI, 1.04-4.85) among men. In conclusion, we estimated the prevalence of probable depression, CSA, and IPV among PLHIV presenting for HIV care in southern India and found that, among male PLHIV, alcohol use was associated with a markedly higher odds of reporting a psychosocial condition. Further study is needed to characterize alcohol use among male PLHIV and the possible deleterious impact of psychosocial conditions and alcohol use on HIV-related outcomes in India.

HIV Sexual Risk Behavior Among Low-Income Women Experiencing Intimate Partner Violence: The Role of Posttraumatic Stress Disorder

PubMed Central

Cavanaugh, Courtenay E.; Hansen, Nathan B.; Sullivan, Tami P.

2010-01-01

Posttraumatic stress disorder resulting from intimate partner violence (IPV-related PTSD), drug problems, and alcohol problems were tested as correlates of women’s sexual risk behavior. Participants were 136 low-income women experiencing physical violence by a male partner during the past 6 months. Sexual risk behavior was assessed by whether women had unprotected sex with a risky primary partner (i.e., HIV-positive, injection drug user, and/or nonmonogamous), unprotected sex with a risky nonprimary partner (i.e. HIV-positive or unknown status), or traded sex during the past 6 months. Nearly one in five women engaged in these recent sexual risk behaviors. Simultaneous logistic regression results revealed IPV-related PTSD, but not drug or alcohol problems, was significantly associated with sexual risk behavior while controlling for childhood abuse and demographic covariates. Women with IPV-related PTSD had four times greater odds of recent sexual risk behavior compared to women without IPV-related PTSD. Implications for HIV prevention interventions are discussed. PMID:19856093

Improving adherence to ante-retroviral treatment for people with harmful alcohol use in Kariobangi, Kenya through participatory research and action

PubMed Central

2012-01-01

Background Harmful alcohol use has been linked to the spread of HIV in Kenya. It also adversely affects those on antiretroviral (ARV) treatment through poor compliance. This study using participatory research and action (PRA) methods sought to understand factors related to alcohol abuse and non-adherence and to formulate appropriate interventions in a sample of people living with HIV and AIDS (PLWHA) who were also abusing alcohol, at Kariobangi in Nairobi, Kenya. Methods Entry into the community was gained through previous PRA work in that community and PLWHA were recruited through snowballing. Working together with the community members, the researchers explored the participants’ understanding of alcohol use problem, its effects on compliance to ARV treatment and discussed possible action areas through PRA techniques that included focus group and market place discussions; visual aids such as spider diagrams, community mapping and ranking. Follow-up meetings were held to discuss the progress. Results By the final meeting, 67 PLWHA and 19 community members had been recruited. Through discussions, misconceptions regarding alcohol use were identified. It emerged that alcohol abuse was poorly recognised among both the community and health workers. Screening for alcohol use was not routinely done and protocols for managing alcohol related disorders were not available at the local health centres providing ARVs. The study participants identified improving communication, psychoeducation and screening for alcohol use as possible action areas. Poverty was identified as a major problem but the interventions to mitigate this were not easy to implement. Conclusion We propose that PRA could be useful in improving communication between the health workers and the clients attending primary health care (PHC) facilities and can be applied to strengthen involvement of support groups and community health workers in follow up and counselling. Integrating these features into primary health care (PHC) would be important not only to PLWHA but also to other diseases in the PHC setting . Longer term follow up is needed to determine the sustained impact of the interventions. Problems encountered in the PRA work included great expectations at all levels fostered by handouts from other donors and cognitive impairment that interfered with constructive engagement in some of the PLWHA. PMID:22905910

Alcohol intoxication and sexual risk behaviors among rural-to-urban migrants in China

PubMed Central

Lin, Danhua; Li, Xiaoming; Yang, Hongmei; Fang, Xiaoyi; Stanton, Bonita; Chen, Xinguang; Abbey, Antonia; Liu, Hongjie

2007-01-01

Background The migrant population in China is at high risk for sexual risk behavior and alcohol intoxication. Information about the prevalence of alcohol intoxication and its association with sexual risk behavior among migrants is needed for designing effective intervention prevention programs for reduction in alcohol abuse and HIV infection. Methods Cross-sectional data were collected from 2153 sexually experienced young rural-to-urban migrants in Beijing and Nanjing, China, in 2002. Results Approximately one-third of the participants had been intoxicated with alcohol at least once during the previous month, with more males than females reporting intoxication (40.2% versus 23.7%, p < 0.001). Compared to non-intoxicated participants, respondents with alcohol intoxication in previous 30 days reported more psychological problems, including higher depression scores, lower levels of satisfaction with life and work, and higher perception of peer involvement in risk behavior. Intoxicated respondents were more likely to engage in premarital sex than non-intoxicated respondents (76% versus 60.2%, p < 0.001), have multiple sexual partners (13.4% versus 5.2%, p < 0.001), purchase sex (12.6% versus 4.9%, p < 0.001), and sell sex (10.1% versus 3.7%, p < 0.001). However, there was no association between alcohol intoxication and inconsistent/non-use of condoms. Multivariate analysis controlling for depression, peer risk involvement, age, gender, and other socio-demographic variables indicated that alcohol intoxication was independently correlated with premarital sex, multiple sexual partners, and buying and selling sex. Conclusions Compared to the general Chinese population, levels of intoxication were elevated among Chinese rural-to-urban migrants. Alcohol intoxication was associated with sexual risk behaviors. HIV/AIDS prevention and intervention efforts should include components of alcohol use/abuse prevention for an effective reduction of sexual risk among young rural-to-urban migrants in China. PMID:15943949

HIV-associated anal dysplasia: experience from a multiethnic-HIV clinic in Hawaii.

PubMed

Payam, Ahoora; Shiramizu, Bruce; Shikuma, Cecilia; Milne, Cris; Terada, Kevin; Kajioka, Eric; Ka'opua, Lana Sue; Cassel, Kevin; Chow, Dominic

2011-01-01

To assess the proportion as well as predictors of anal dysplasia in HIV-infected Asian/Pacific Islanders. This was a retrospective chart review evaluating the proportion of anal dysplasia among a multiethnic population from an ambulatory university-based HIV clinic in Hawaii. Demographic, clinical, and virologic parameters were examined with respect to abnormal anal Pap smear. Variables included: Pap smear results (outcome variable), cytology results, age, self-reported ethnicity, CD4/ nadir CD4 counts, HIV viral load, antiretroviral therapy use, Hepatitis B and C co-infections, history of sexually transmitted diseases, personal history of cancer, tobacco use, alcohol use, intravenous drug abuse, family history of cancer, and history of genital/anal warts. There were no significant differences in rates of abnormal Pap smear among the ethnic groups. Abnormal Pap smears were associated with history of genital warts (7% normal vs. 18% abnormal, p=.01) and alcohol consumption (16% vs. 27%, p=.05). Hepatitis B infection and current anti-retroviral therapy (ART) were associated with normal Pap cytology (9.7% vs. 0%, p=.03) and (96.8% vs. 86.5%, p=.05) respectively. No differences in the proportion of abnormal Pap smears were seen among ethnic groups followed within an ambulatory HIV clinic.

Psychiatric morbidity in asymptomatic human immunodeficiency virus patients.

PubMed

Chauhan, V S; Chaudhury, Suprakash; Sudarsanan, S; Srivastava, Kalpana

2013-07-01

Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically. Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.

Examining the Impact of Historical/Developmental, Sociodemographic, and Psychological Factors on Passive Suicide among African-American Men

ERIC Educational Resources Information Center

Tucker, Tameka M.

2009-01-01

Nationally published reports on death rates for substance abuse (drug-alcohol related), violence (homicide), and risky sexual behaviors (HIV/AIDS) among African-American men are deeply concerning. The goal of this study was to examine the relationship between historical/developmental factors (masculine identity, racial identity, racism),…

What girls won't do for love: human immunodeficiency virus/sexually transmitted infections risk among young African-American women driven by a relationship imperative.

PubMed

Raiford, Jerris L; Seth, Puja; DiClemente, Ralph J

2013-05-01

Rates of Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) continue to increase among African-American youth. Adolescents who have a stronger identity in relation to others (relational identity) rather than to themselves (self-identity) may view intimate relationships as imperative to a positive self-concept, which may lead to risky sexual behavior and abuse. Therefore, the present study assessed the associations among a relationship imperative and HIV/STI-related risk factors and behaviors. Participants were 715 African-American adolescent females, aged 15 to 21 years. They completed measures that assessed how important a relationship was to them and HIV-related risk factors and behaviors. Participants also provided vaginal swab specimens for STI testing. Multivariate logistic regression analyses, controlling for covariates, were conducted. Females who endorsed a relationship imperative (29%), compared to those who did not, were more likely to report: unprotected sex, less power in their relationships, perceived inability to refuse sex, anal sex, sex while their partner was high on alcohol/drugs, and partner abuse. Furthermore, participants with less power, recent partner abuse, and a perceived ability to refuse sex were more likely to test STI positive. These results indicate that if African-American adolescent females believe a relationship is imperative, they are more likely to engage in riskier sexual behaviors. Additionally, less perceived power and partner abuse increases their risk for STIs. HIV/STI prevention programs should target males and females and address healthy relationships, sense of self-worth, self-esteem and the gender power imbalance that may persist in the community along with HIV/STI risk. Published by Elsevier Inc.

Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood.

PubMed

Wilson, Helen W; Widom, Cathy Spatz

2011-04-01

This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0-11) processed during 1967-1971 were matched with nonmaltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003-2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling was used to test mediator models. Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood, odds ratio = 2.84, 95% CI [1.74, 4.64], p ≤ .001, and this relationship was mediated by risky romantic relationships in young adulthood. Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, in particular sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts. (c) 2011 APA, all rights reserved.

Arrest history as an indicator of adolescent/young adult substance use and HIV risk.

PubMed

Tolou-Shams, Marina; Brown, Larry K; Gordon, Glenn; Fernandez, Isabel

2007-04-17

Juvenile offenders are particularly at risk for HIV because of their substantially high rates of risk behaviors, high rates of substance use disorders and psychopathology. Most studies have focused on risk behaviors among incarcerated youth. This study sought to determine if an arrest history could serve as a marker for HIV risk and substance abuse among a community-based sample of high-risk adolescents and young adults. Adolescents (N=1400; mean age=18 years) who participated in a larger multi-site HIV prevention program in three states (GA, FL and RI) provided baseline data on sexual risk, substance use, attitudes and mental health history. Participants were grouped as arrestees (N=404) and non-arrestees (N=996) based on self-reported arrest history. Juvenile arrestees reported more alcohol and drug use, substance use during sex, unprotected sex acts, STI diagnoses, suicide attempts and psychiatric hospitalizations than non-arrestees. Having an arrest history may serve as a marker for adolescent HIV risk and substance abuse. Effectively screening adolescents for legal history and responding to the psychosocial and health needs of these high-risk adolescents could increase necessary engagement in substance use and mental health treatment, reduce HIV risk in the community, and reduce costs to the legal, medical and mental health systems.

Unhealthy Substance Use Behaviors as Symptom-Related Self-Care in HIV/AIDS

PubMed Central

Brion, John M.; Rose, Carol Dawson; Nicholas, Patrice K.; Sloane, Rick; Voss, Joachim G.; Corless, Inge B.; Lindgren, Teri G.; Wantland, Dean J.; Kemppainen, Jeanne K.; Sefcik, Elizabeth F.; Nokes, Kathleen M.; Kirksey, Kenn M.; Eller, Lucille Sanzero; Hamilton, Mary Jane; Holzemer, William L.; Portillo, Carmen J.; Mendez, Marta Rivero; Robinson, Linda M.; Moezzi, Shanaz; Rosa, Maria; Human, Sarie; Maryland, Mary; Arudo, John; Ros, Ana Viamonte; Nicholas, Thomas P.; Cuca, Yvette; Huang, Emily; Bain, Catherine; Tyer-Viola, Lynda; Zang, Sheryl M.; Shannon, Maureen; Peters-Lewis, Angelleen

2014-01-01

The prevalence of symptoms in HIV disease can be associated with HIV disease itself, comorbid illness, and/or antiretroviral therapy. Unhealthy substance use behaviors, particularly substance-use behaviors including heavy alcohol intake, marijuana use, other illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage disease-related symptoms. This study is a secondary data analysis of baseline data from a larger randomized-controlled trial of an HIV/AIDS Symptom Management Manual. In the present study, the prevalence and characteristics of unhealthy substance use behaviors in relation to HIV/AIDS symptoms are examined. Subjects were recruited from a variety of settings which provide HIV/AIDS care and treatment. The mean age of the sample (n=775) was 42.8 years (SD=9.6) and nearly thirty-nine percent (38.5%) of the sample was female. The racial demographics of the sample were: 28% African American, 28% Hispanic, 21% White/Caucasian, 16% African from Kenya or South Africa, 1% Asian, and 5% self-described as “Other.” The mean number of years living with HIV was reported to be 9.1 years (SD=6.6).Specific self-reported unhealthy substance-use behaviors were use of marijuana (n= 111; 14.3%), cigarette smoking (n=355; 45.8%), heavy alcohol use (n= 66; 8.5%), and illicit drugs (n= 98; 12.6%). A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance use behaviors including amphetamine and injection drug use in addition to heavy alcohol use, cigarette smoking, and marijuana use. Implications for clinical practice include assessment of self-care behaviors, screening for substance abuse, and education of persons related to self-management across the trajectory of HIV disease. PMID:21352430

Incomplete adherence among treatment-experienced adults on antiretroviral therapy in Tanzania, Uganda and Zambia

PubMed Central

Denison, Julie A.; Koole, Olivier; Tsui, Sharon; Menten, Joris; Torpey, Kwasi; van Praag, Eric; Mukadi, Ya Diul; Colebunders, Robert; Auld, Andrew F.; Agolory, Simon; Kaplan, Jonathan E.; Mulenga, Modest; Kwesigabo, Gideon P.; Wabwire-Mangen, Fred; Bangsberg, David R.

2016-01-01

Objectives To characterize antiretroviral therapy (ART) adherence across different programmes and examine the relationship between individual and programme characteristics and incomplete adherence among ART clients in sub-Saharan Africa. Design A cross-sectional study. Methods Systematically selected ART clients (≥18 years; on ART ≥6 months) attending 18 facilities in three countries (250 clients/facility) were interviewed. Client self-reports (3-day, 30-day, Case Index ≥48 consecutive hours of missed ART), healthcare provider estimates and the pharmacy medication possession ratio (MPR) were used to estimate ART adherence. Participants from two facilities per country underwent HIV RNA testing. Optimal adherence measures were selected on the basis of degree of association with concurrent HIV RNA dichotomized at less than or greater/equal to 1000 copies/ml. Multivariate regression analysis, adjusted for site-level clustering, assessed associations between incomplete adherence and individual and programme factors. Results A total of 4489 participants were included, of whom 1498 underwent HIV RNA testing. Nonadherence ranged from 3.2% missing at least 48 consecutive hours to 40.1% having an MPR of less than 90%. The percentage with HIV RNA at least 1000 copies/ml ranged from 7.2 to 17.2% across study sites (mean = 9.9%). Having at least 48 consecutive hours of missed ART was the adherence measure most strongly related to virologic failure. Factors significantly related to incomplete adherence included visiting a traditional healer, screening positive for alcohol abuse, experiencing more HIV symptoms, having an ART regimen without nevirapine and greater levels of internalized stigma. Conclusion Results support more in-depth investigations of the role of traditional healers, and the development of interventions to address alcohol abuse and internalized stigma among treatment-experienced adult ART patients. PMID:25686684

The social context of gender-based violence, alcohol use and HIV risk among women involved in high-risk sexual behaviour and their intimate partners in Kampala, Uganda.

PubMed

Schulkind, Jasmine; Mbonye, Martin; Watts, Charlotte; Seeley, Janet

2016-07-01

This paper explores the interaction between gender-based violence and alcohol use and their links to vulnerability to HIV-infection in a population of women and their regular male partners in Kampala, Uganda. Data derive from 20 life history interviews (10 women and 10 men). Participants were drawn from a cohort of women at high risk of sexually transmitted infection (including HIV). Six of the women were current or former sex workers. Findings reveal that life histories are characterised by recurrent patterns of gender inequity related to violence, limited livelihood options and socioeconomic disadvantage. Overall, findings suggest women are able to negotiate safer sex and protect themselves better against abuse and violence from clients than from their intimate partners, although the status of men as 'client' or 'partner' is transitory and fluid. Among male respondents, alcohol led to intimate partner violence and high levels of sexual-risk taking, such as engagement with sex workers and reduced condom use. However, male partners are a heterogeneous group, with distinct and contrasting attitudes towards alcohol, condom use and violence. Actions to address gender-based violence need to be multi-pronged in order to respond to different needs and circumstances, of both women and men.

Adaptation of an Alcohol and HIV School-Based Prevention Program for Teens

PubMed Central

Springer, Carolyn; Leu, Cheng-Shiun; Ghosh, Shivnath; Sharma, Sunil Kumar; Rapkin, Bruce

2010-01-01

Given the current status of HIV infection in youth in India, developing and implementing HIV education and prevention interventions is critical. The goal for School-based Teenage Education Program (STEP) was to demonstrate that a HIV/AIDS and alcohol abuse educational program built with specific cultural, linguistic, and community-specific characteristics could be effective. Utilizing the Train-the-Trainer model, the instructors (17–21 years) were trained to present the 10 session manualized program to primarily rural and tribal youth aged 13–16 years in 23 schools (N = 1,421) in the northern state of Himachal Pradesh in India. The intervention had a greater impact on girls; girls evidenced greater communication skills and a trend towards greater self efficacy and reduced risk taking behavior. The STEP has been successfully adapted by the community organizations that were involved in coordinating the program at the local level. Their intention to continue STEP beyond extra funding shows that utilizing the local community in designing, implementing and evaluating programs promotes ownership and sustainability. PMID:20589528

Characteristics and knowledge about HIV/AIDS and drug abuse associated with inmates education level within prison populations in Singkawang, West Borneo in 2006.

PubMed

Sigarlaki, Herke G

2008-07-01

to identify the characteristics and knowledge of inmates within prison population in Singkawang city about HIV/AIDS and drugs associated with their education level. a cross-sectional study with 240 respondents was conducted in Singkawang City, West Borneo. The subjects were inmates of prison population. They were interviewed by co-assistant doctors who completed the questionnaire forms about various aspects of knowledge about HIV/AIDS and drugs, including the application of standardized scales on subject characteristics. Data was prepared by using Microsoft Excel 2000 and all data were evaluated by univariate and bivariate analyses. The presentation will be shown in table. at the end of 2006, 91.25% respondents were male and mostly were Malay ethnic group. Moreover, 32.08% of them had formal educational background of Senior High School. Approximately 83.33% of respondents had discovered their status of HIV/AIDS by voluntary counseling and testing (VCT). Their level of knowledge about HIV/AIDS issue particularly that AIDS is caused by HIV was 90.42%. Approximately 48.33% respondents agreed that the risk factor for drug abuse was living with a family member who had taken up smoking and alcoholic consumption. our data indicate that higher education level has better contribution to the better knowledge about HIV/AIDS and drugs.

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia.

PubMed

Wickersham, Jeffrey A; Loeliger, Kelsey B; Marcus, Ruthanne; Pillai, Veena; Kamarulzaman, Adeeba; Altice, Frederick L

2016-01-01

While drug use is associated with HIV risk in Southeast Asia, little is known about substance use behaviors among women, including drug injection. To describe patterns of substance use among women using alcohol and drugs in Malaysia and identify correlates of lifetime and active drug injection, a risk factor for HIV transmission. A survey of 103 women who used drugs in the last 12 months assessed drug use history and frequency, including drug injection and drug use during pregnancy, self-reported HIV-status, childhood and adulthood physical and sexual abuse, and access to and utilization of harm reduction services, including needle-syringe exchange programs (NSEP) and opioid agonist maintenance therapy (OAT). Principal component analyses (PCA) were conducted to assess drug use grouping. Amphetamine-type substances (ATS; 82.5%), alcohol (75.7%) and heroin (71.8%) were the most commonly used drugs across the lifetime. Drug injection was reported by 32.0% (n = 33) of participants with 21.4% (n = 22) having injected in the last 30 days. PCA identified two groups of drug users: opioids/benzodiazepines and club drugs. Lifetime drug injection was significantly associated with lower education, homelessness, prior criminal justice involvement, opioid use, polysubstance use, childhood physical and sexual abuse, and being HIV-infected, but not with prior OAT. Women who use drugs in Malaysia report high levels of polysubstance use and injection-related risk behaviors, including sharing of injection equipment and being injected by others. Low OAT utilization suggests the need for improved access to OAT services and other harm reduction measures that prioritize women.

Assessing Life Styles, Stressors and Health Status among a Predominantly African American On-Campus and Off-Campus Student Population

ERIC Educational Resources Information Center

Hicks, Terence; Herndon, Michael; Hilton, Adriel; Attoh, Prince; Armstrong, Vikki

2013-01-01

Students who attend college and reside on campus often have to contend with social problems such as alcohol and drug abuse, HIV/AIDS infection, courtship, sex and marriage, home and family and other social-psychological issues while trying to maintain academically and matriculate to graduation. Earlier research from the 1995 National College…

Evaluating the Relationship-Oriented Information, Motivation, and Behavioral Skills model of HIV preventive behaviors in young men who have sex with men

PubMed Central

Macapagal, Kathryn; Greene, George J; Andrews, Katie; Mustanski, Brian

2016-01-01

Most HIV infections among young men who have sex with men (YMSM) occur within primary partnerships. Research on YMSM’s knowledge, motivation, and behavioral skills regarding relationship-related HIV prevention, and how these correspond to HIV risk and partnership characteristics, is limited. We examined links among the Relationship-Oriented Information-Motivation-Behavioral Skills (RELO-IMB) model, relationship characteristics, and HIV risk in 96 YMSM. Condomless sex with a primary partner was associated with low relationship-related HIV preventive information, motivation, and behavioral skills. Lack of HIV testing and alcohol use before sex were associated with low behavioral skills. In multivariate analyses, behavioral skills were the only consistent predictor of these outcomes. Regarding relationship characteristics, feeling trapped in the relationship or being physically abused by a partner was associated with low motivation and behavioral skills. The RELO-IMB model can be used to understand HIV risk in relationships and points to targets for relationship-specific HIV prevention education for YMSM. PMID:27459167

Correlates of engaging in survival sex among homeless youth and young adults.

PubMed

Walls, N Eugene; Bell, Stephanie

2011-09-01

Using a sample of 1,625 homeless youth and young adults aged 10 to 25 from 28 different states in the United States, this study examines the correlates of having engaged in survival sex. Findings suggest that differences exist based on demographic variables (gender, age, race, and sexual orientation), lifetime drug use (inhalants, Valium™, crack cocaine, alcohol, Coricidin™, and morphine), recent drug use (alcohol, ecstasy, heroin, and methamphetamine), mental health variables (suicide attempts, familial history of substance use, and having been in substance abuse treatment), and health variables (sharing needles and having been tested for HIV). In addition to replicating previous findings, this study's findings suggest that African American youth; gay, lesbian, or bisexual youth; and youth who had been tested for HIV were significantly more likely to have engaged in survival sex than White, heterosexual youth, and youth who had not been tested for HIV, respectively. Implications for interventions with youth and suggestions for future research are discussed.

Alcohol use disorders and antiretroviral therapy among prisoners in Argentina

PubMed Central

Alpert, Michael; Wickersham, Jeffrey A.; Vázquez, Mariana; Altice, Frederick L.

2013-01-01

Purpose While Argentina has significantly improved access to HIV care and antiretroviral therapy (ART) for both the general population and prisoners, the prevalence of alcohol use disorders (AUDs) among HIV-infected prisoners and their relationship to accessing ART in Argentina is currently unknown. This study aims to characterize the substance abuse patterns of HIV-infected prisoners in Argentina and to assess the independent correlates of receipt of pre-incarceration ART. Design/methodology/approach An anonymous, cross-sectional survey of 100 HIV-infected federal prisoners was conducted in the Buenos Aires municipality from July–December 2010. AUDs were assessed using the AUDIT scale. Findings A majority (63 per cent) of participants met criteria for AUDs, 45 per cent of subjects were diagnosed with HIV in prison and one-quarter had initiated ART during the current incarceration. In addition, over one-third (35 per cent) of participants did not receive ART during the pre-incarceration period despite receiving it upon incarceration. This correlated significantly with the presence of having an AUD (AOR 0.20, 95 per cent CI 0.06–0.74, p = 0.016). Practical implications AUDs are prevalent among HIV-infected prisoners in Argentina and are significantly related to negative secondary HIV prevention and treatment outcomes. While Argentina has provided an exemplary model of HIV-related health care reform within its prisons, future efforts to provide screening and treatment for AUDs are needed to improve the health of the nation’s incarcerated population. Originality/value This paper is the first to describe pre-incarceration drug and alcohol use disorders and issues related to access to ART among prisoners in Argentina. PMID:24772187

A Population-Based Study on Alcohol and High-Risk Sexual Behaviors in Botswana

PubMed Central

Weiser, Sheri D; Leiter, Karen; Heisler, Michele; McFarland, Willi; Korte, Fiona Percy-de; DeMonner, Sonya M; Tlou, Sheila; Phaladze, Nthabiseng; Iacopino, Vincent; Bangsberg, David R

2006-01-01

Background In Botswana, an estimated 24% of adults ages 15–49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors. Methods and Findings We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men) as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking) and several risky sex outcomes including: (a) having unprotected sex with a nonmonogamous partner; (b) having multiple sexual partners; and (c) paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap ≥10 y), higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32), multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87), and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37). Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28), multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07), and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18). A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers. Conclusions Alcohol use is associated with multiple risks for HIV transmission among both men and women. The findings of this study underscore the need to integrate alcohol abuse and HIV prevention efforts in Botswana and elsewhere. PMID:17032060

Addressing the intersection between alcohol consumption and antiretroviral treatment: needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa.

PubMed

Schneider, M; Chersich, M; Temmerman, M; Parry, C D

2016-10-26

At the points where an infectious disease and risk factors for poor health intersect, while health problems may be compounded, there is also an opportunity to provide health services. Where human immunodeficiency virus (HIV) infection and alcohol consumption intersect include infection with HIV, onward transmission of HIV, impact on HIV and acquired immunodeficiency syndrome (AIDS) disease progression, and premature death. The levels of knowledge and attitudes relating to the health and treatment outcomes of HIV and AIDS and the concurrent consumption of alcohol need to be determined. This study aimed to ascertain the knowledge, attitudes and practices of primary healthcare workers concerning the concurrent consumption of alcohol of clinic attendees who are prescribed antiretroviral drugs. An assessment of the exchange of information on the subject between clinic attendees and primary healthcare providers forms an important aspect of the research. A further objective of this study is an assessment of the level of alcohol consumption of people living with HIV and AIDS attending public health facilities in the Western Cape Province in South Africa, to which end, the study reviewed health workers' perceptions of the problem's extent. A final objective is to contribute to the development of evidence-based guidelines for AIDS patients who consume alcohol when on ARVs. The overall study purpose is to optimise antiretroviral health outcomes for all people living with HIV and AIDS, but with specific reference to the clinic attendees studied in this research. Overall the research study utilised mixed methods. Three group-specific questionnaires were administered between September 2013 and May 2014. The resulting qualitative data presented here supplements the results of the quantitative data questionnaires for HIV and AIDS clinic attendees, which have been analysed and written up separately. This arm of the research study comprised two, separate, semi-structured sets of interviews: one face-to-face with healthcare workers at the same primary healthcare clinics from which the clinic attendees were sampled, and the other with administrators from the local government health service via email. The qualitative analysis from the primary healthcare worker interviews has been analysed using thematic content analysis. The key capacity gaps for nurses include the definition of different patterns and volumes of alcohol consumption, resultant health outcomes and how to answer patient questions on alcohol consumption while on antiretroviral treatment. Not only did the counsellors lack knowledge regarding alcohol abuse and its treatment, but they were also they were unclear on their role and rights in relation to their patients. Doctors highlighted the need for additional training for clinicians in diagnosing alcohol use disorders and information on the pharmacological interventions to treat alcoholism. Pertinent knowledge regarding patient alcohol consumption while taking ARVs needs to be disseminated to primary healthcare workers.

Drug use and HIV risk in Trinidad and Tobago: qualitative study.

PubMed

Djumalieva, D; Imamshah, W; Wagner, U; Razum, O

2002-09-01

Crack use is an important risk factor for HIV infection because of its association with unsafe sexual practices. We investigated factors promoting the initiation of crack cocaine use; the sexual behaviour of crack users; and their rehabilitation care seeking behaviour in Trinidad and Tobago. We conducted 40 in-depth interviews with drug users. Respondents frequently reported a history of parental desertion, alcohol abuse, and physical abuse within the family. They perceived peer pressure and drug use in the family as important factors promoting first drug use. Exchanging sex for drugs was common, and practising oral sex was considered safe. Female drug users rarely seek rehabilitative care because of stigmatization and lack of care for their children. In Trinidad, attitudes towards drugs in society and families need to be changed. Campaigns promoting safer sex should emphasize the risk of oral sex. Rehabilitation facilities caring for female drug users should offer child care.

76 FR 14980 - National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Notice of Meeting Pursuant to section 10(a... meeting of the National Advisory Council on Alcohol Abuse and Alcoholism and the National Advisory Council.... Name of Committees: National Advisory Council on Alcohol Abuse and Alcoholism and National Advisory...

The Usability and Acceptability of an Adolescent mHealth HIV/STI and Drug Abuse Preventive Intervention in Primary Care.

PubMed

Cordova, David; Alers-Rojas, Francheska; Lua, Frania Mendoza; Bauermeister, Jose; Nurenberg, Rachel; Ovadje, Lauretta; Fessler, Kathryn; Delva, Jorge; Salas-Wright, Christopher P; Council, Youth Leadership

2018-01-01

Human Immunodeficiency Virus (HIV)/sexually transmitted infection (STI) risk behaviors among adolescents remain significant public health concerns. Shifts in policy and advances in technology provide opportunities for researchers and clinicians to deliver and evaluate mobile-health (mHealth) prevention programs in primary care, however, research is limited. This study assessed the usability and acceptability of Storytelling 4 Empowerment-a mHealth HIV/STI and drug abuse preventive intervention app-among adolescents in primary care. Informed by principles of community-based participatory research, we recruited a purposive sample of 30 adolescents from a youth-centered community health care clinic in Southeast Michigan. The study sample is primarily African American and female. Adolescents who participated in the Storytelling 4 Empowerment intervention assessed its usability and acceptability, and self-reported their HIV/STI risk behaviors. We used a multiple-methods approach. Adolescents reported high acceptability of the content, process, and format of Storytelling 4 Empowerment, as evidenced by qualitative data and mean scores from the Session Evaluation Form for the HIV/STI and Alcohol/Drug content, overall Storytelling 4 Empowerment intervention, and Client Satisfaction Questionnaire-8. Findings indicate that Storytelling 4 Empowerment is acceptable among adolescents in primary care. A next step is to examine the effect of Storytelling 4 Empowerment on adolescent sexual risk and drug use behaviors and HIV/STI testing.

Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior.

PubMed

Meade, Christina S; Kershaw, Trace S; Hansen, Nathan B; Sikkema, Kathleen J

2009-04-01

The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.

Alcohol use and subsequent sex among HIV-infected patients in an ethnic minority area of Yunnan Province, China.

PubMed

Luo, Xiaofeng; Duan, Song; Duan, Qixiang; Pu, Yongcheng; Yang, Yuecheng; Ding, Yingying; Gao, Meiyang; He, Na

2013-01-01

To examine alcohol use and subsequent HIV risky behaviors among a sample of predominately ethnic minority people living with HIV/AIDS (PLWHA) in a rural community in Yunnan Province, China. A cross-sectional study with a face-to-face questionnaire interview was conducted among eligible participants. In total, 455 (94.4%) out of 482 eligible HIV patients participated in the study. Of them, 82.6% were ethnic minorities; 15.4% were never married; 96.5% were sexually experienced; 55.4% had used drugs, 67% were receiving antiretroviral therapy (ART). Over 65% were ever drinkers; of whom 61.5% were current drinkers. Among current drinkers, 32.4% drank daily and 41.2% were hazardous drinkers. Chinese white wine was the preferred choice. Higher level of alcohol use among drinkers in the preceding month was positively associated with being males (OR = 2.76, 95%CI: 1.03-7.43), ethnic minorities (OR Jingpo = 2.21, 95%CI: 1.06-4.59; OR other minorities = 3.20, 95%CI: 1.34-7.62), higher education (OR1-6 = 1.98, 95%CI: 0.99-3.96; OR≥7 = 2.35, 95%CI: 1.09-5.06) and being ART-naive (OR = 2.69, 95%CI: 1.67-4.32). About 39% of ever drinkers reported having engaged in sex after drinking since HIV diagnosis. Those who were younger than 46 years (OR16-25 = 7.77, 95%CI: 1.22-49.60, OR26-35 = 2.79, 95%CI: 1.06-7.35, OR36-45 = 2.96, 95%CI: 1.57-7.58), hazardous drinkers (OR = 1.99, 95%CI: 1.00-3.97) and drug users (OR = 3.01, 95%CI: 1.19-7.58) were more likely to have had sex after drinking. Approximately 56% of drug users had used drugs after drinking. High prevalence of alcohol use and subsequent risky behaviors including sexual engagement and drug use among HIV patients in rural Yunnan require tremendous and integrated efforts for prevention and control of alcohol and drug abuse and HIV spreading.

Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach.

PubMed

Stein, Judith A; Nyamathi, Adeline; Ullman, Jodie B; Bentler, Peter M

2007-01-01

Studies among normative samples generally demonstrate a positive impact of marriage on health behaviors and other related attitudes. In this study, we examine the impact of marriage on HIV/AIDS risk behaviors and attitudes among impoverished, highly stressed, homeless couples, many with severe substance abuse problems. A multilevel analysis of 368 high-risk sexually intimate married and unmarried heterosexual couples assessed individual and couple-level effects on social support, substance use problems, HIV/AIDS knowledge, perceived HIV/AIDS risk, needle-sharing, condom use, multiple sex partners, and HIV/AIDS testing. More variance was explained in the protective and risk variables by couple-level latent variable predictors than by individual latent variable predictors, although some gender effects were found (e.g., more alcohol problems among men). The couple-level variable of marriage predicted lower perceived risk, less deviant social support, and fewer sex partners but predicted more needle-sharing.

Liver Disease in the HIV-Infected Individual

PubMed Central

Price, Jennifer C.; Thio, Chloe L.

2010-01-01

Since the advent of effective antiretroviral therapy (ART) for human immunodeficiency virus-1 (HIV), there has been a substantial decrease in deaths related to acquired immunodeficiency syndrome (AIDS). However, in the ART-era liver disease is now the most common non-AIDS related cause of death among HIV-infected patients, accounting for 14-18% of all deaths in this population and almost half of deaths among hospitalized HIV-infected patients. Just as the burden of non-AIDS morbidity and mortality has changed in the ART-era, the types of liver disease the clinician is likely to encounter among these patients have changed as well. This review will discuss the causes of liver disease in the HIV-infected population in the ART-era, including chronic hepatitis C virus, chronic hepatitis B virus, medication-related hepatotoxicity, alcohol abuse, nonalcoholic fatty liver disease, and AIDS-related liver diseases. PMID:20851211

Crack-cocaine use accelerates HIV disease progression in a cohort of HIV-positive drug users.

PubMed

Baum, Marianna K; Rafie, Carlin; Lai, Shenghan; Sales, Sabrina; Page, Bryan; Campa, Adriana

2009-01-01

HIV infection is prevalent among substance abusers. The effects of specific illicit drugs on HIV disease progression have not been established. We evaluated the relationship between substances of abuse and HIV disease progression in a cohort of HIV-1-positive active drug users. A prospective, 30-month, longitudinal study was conducted on 222 HIV-1 seropositive drug users in Miami, FL. History of illicit drug, alcohol, and medication use, CD4+ cell count, and viral load were performed every 6 months. Crack-cocaine users were 2.14 times [95% confidence interval (CI): 1.08 to 4.25, P = 0.029] more likely to present a decline of CD4 to

Quantification of Liver Fat with Magnetic Resonance Imaging

PubMed Central

Reeder, Scott B.; Sirlin, Claude

2010-01-01

Intracellular fat accumulation is common feature of liver disease. Intracellular fat (steatosis) is the histological hallmark of non-alcoholic fatty liver disease (NAFLD) but also may occur with alcohol abuse, viral hepatitis, HIV and genetic lipodystrophies, and chemotherapy. This article reviews emerging magnetic resonance imaging techniques that attempt to quantify liver fat. The content provides an overview of fatty liver disease and diseases where fat is an important disease feature. Also discussed is the current use and limitation of non-targeted biopsy in diffuse liver disease, and why quantitative non-invasive biomarkers of liver fat would be beneficial. PMID:21094444

Analytic strategies to evaluate the association of time-varying exposures to HIV-related outcomes: Alcohol consumption as an example.

PubMed

Cook, Robert L; Kelso, Natalie E; Brumback, Babette A; Chen, Xinguang

2016-01-01

As persons with HIV are living longer, there is a growing need to investigate factors associated with chronic disease, rate of disease progression and survivorship. Many risk factors for this high-risk population change over time, such as participation in treatment, alcohol consumption and drug abuse. Longitudinal datasets are increasingly available, particularly clinical data that contain multiple observations of health exposures and outcomes over time. Several analytic options are available for assessment of longitudinal data; however, it can be challenging to choose the appropriate analytic method for specific combinations of research questions and types of data. The purpose of this review is to help researchers choose the appropriate methods to analyze longitudinal data, using alcohol consumption as an example of a time-varying exposure variable. When selecting the optimal analytic method, one must consider aspects of exposure (e.g. timing, pattern, and amount) and outcome (fixed or time-varying), while also addressing minimizing bias. In this article, we will describe several analytic approaches for longitudinal data, including developmental trajectory analysis, generalized estimating equations, and mixed effect models. For each analytic strategy, we describe appropriate situations to use the method and provide an example that demonstrates the use of the method. Clinical data related to alcohol consumption and HIV are used to illustrate these methods.

The social context of gender-based violence, alcohol use and HIV risk among women involved in high-risk sexual behaviour and their intimate partners in Kampala, Uganda

PubMed Central

Schulkind, Jasmine; Mbonye, Martin; Watts, Charlotte; Seeley, Janet

2016-01-01

Abstract This paper explores the interaction between gender-based violence and alcohol use and their links to vulnerability to HIV-infection in a population of women and their regular male partners in Kampala, Uganda. Data derive from 20 life history interviews (10 women and 10 men). Participants were drawn from a cohort of women at high risk of sexually transmitted infection (including HIV). Six of the women were current or former sex workers. Findings reveal that life histories are characterised by recurrent patterns of gender inequity related to violence, limited livelihood options and socioeconomic disadvantage. Overall, findings suggest women are able to negotiate safer sex and protect themselves better against abuse and violence from clients than from their intimate partners, although the status of men as ‘client’ or ‘partner’ is transitory and fluid. Among male respondents, alcohol led to intimate partner violence and high levels of sexual-risk taking, such as engagement with sex workers and reduced condom use. However, male partners are a heterogeneous group, with distinct and contrasting attitudes towards alcohol, condom use and violence. Actions to address gender-based violence need to be multi-pronged in order to respond to different needs and circumstances, of both women and men. PMID:26786739

Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV.

PubMed Central

Cohen, M; Deamant, C; Barkan, S; Richardson, J; Young, M; Holman, S; Anastos, K; Cohen, J; Melnick, S

2000-01-01

OBJECTIVES: The purpose of this study was to determine the prevalence and effect of domestic violence and childhood sexual abuse in women with HIV or at risk for HIV infection. METHODS: Participants with HIV or at risk for HIV infection enrolled in the Women's Interagency HIV Study. Childhood sexual abuse; all physical, sexual, and coercive violence by a partner; HIV serostatus; demographic data; and substance use and sexual habits were assessed. RESULTS: The lifetime prevalence of domestic violence was 66% and 67%, respectively, in 1288 women with HIV and 357 uninfected women. One quarter of the women reported recent abuse, and 31% of the HIV-seropositive women and 27% of the HIV-seronegative women reported childhood sexual abuse. Childhood sexual abuse was strongly associated with a lifetime history of domestic violence and high-risk behaviors, including using drugs, having more than 10 male sexual partners and having male partners at risk for HIV infection, and exchanging sex for drugs, money, or shelter. CONCLUSIONS: Our data support the hypothesis of a continuum of risk, with early childhood abuse leading to later domestic violence, which may increase the risk of behaviors leading to HIV infection. PMID:10754970

Patterns of Substance Use and Correlates of Lifetime and Active Injection Drug Use Among Women in Malaysia

PubMed Central

Wickersham, Jeffrey A.; Loeliger, Kelsey B.; Marcus, Ruthanne; Pillai, Veena; Kamarulzaman, Adeeba; Altice, Frederick L.

2016-01-01

Background While drug use is associated with HIV risk in Southeast Asia, little is known about substance use behaviors among women, including drug injection. Objectives To describe patterns of substance use among women using alcohol and drugs in Malaysia and identify correlates of lifetime and active drug injection, a risk factor for HIV transmission. Methods A survey of 103 women who used drugs in the last 12 months assessed drug use history and frequency, including drug injection and drug use during pregnancy, self-reported HIV-status, childhood and adulthood physical and sexual abuse, and access to and utilization of harm reduction services, including needle-syringe exchange programs (NSEP) and opioid agonist maintenance therapy (OAT). Principal component analyses (PCA) were conducted to assess drug use grouping. Results Amphetamine-type substances (ATS; 82.5%), alcohol (75.7%) and heroin (71.8%) were the most commonly used drugs across the lifetime. Drug injection was reported by 32.0% (n=33) of participants with 21.4% (n=22) having injected in the last 30 days. PCA identified two groups of drug users: opioids/benzodiazepines and club drugs. Lifetime drug injection was significantly associated with lower education, homelessness, prior criminal justice involvement, opioid use, polysubstance use, childhood physical and sexual abuse, and being HIV-infected, but not with prior OAT. Conclusion Women who use drugs in Malaysia report high levels of polysubstance use and injection-related risk behaviors, including sharing of injection equipment and being injected by others. Low OAT utilization suggests the need for improved access to OAT services and other harm reduction measures that prioritize women. PMID:26636885

Modeling the Relationship between Trauma and Psychological Distress among HIV-Positive and HIV-Negative Women.

PubMed

Brumsey, Ayesha Delany; Joseph, Nataria T; Myers, Hector F; Ullman, Jodie B; Wyatt, Gail E

2013-01-01

This study investigated the association between cumulative exposure to multiple traumatic events and psychological distress, as mediated by problematic substance use and impaired psychosocial resources. A sample of HIV-positive and HIV-negative women were assessed for a history of childhood and adult sexual abuse and non-sexual trauma as predictors of psychological distress (i.e., depression, non-specific anxiety, and posttraumatic stress), as mediated by problematic alcohol and drug use and psychosocial resources (i.e., social support, self-esteem and optimism). Structural equation modeling confirmed that cumulative trauma exposure is positively associated with greater psychological distress, and that this association is partially mediated through impaired psychosocial resources. However, although cumulative trauma was associated with greater problematic substance use, substance use did not mediate the relationship between trauma and psychological distress.

Disrespect and abuse during childbirth in Tanzania: are women living with HIV more vulnerable?

PubMed

Sando, David; Kendall, Tamil; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

2014-12-01

HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on ensuring respectful maternity care for all women.

Pathways from Childhood Abuse and Neglect to HIV-Risk Sexual Behavior in Middle Adulthood

PubMed Central

Wilson, Helen W.; Widom, Cathy Spatz

2011-01-01

Objective This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Methods Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) processed during 1967–1971 were matched with non-maltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003–2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling (SEM) was used to test mediator models. Results Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood (OR = 2.84, 95% CI = 1.74 - 4.64, p ≤ .001), and this relationship was mediated by criminal behavior and risky romantic relationships in young adulthood. When both factors were included in SEM, only risky relationships remained a significant mediator (indirect β = .07, p < .05). Conclusions Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, particularly sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts. PMID:21355638

[Beyond depression: assessing personality disorders, alexithymia and socio-emotional alienation in patients with HIV infection].

PubMed

Masiello, Addolorata; De Guglielmo, Carmen; Giglio, Sergio; Acone, Nicola

2014-09-01

HIV infection is commonly associated with emotional and cognitive disorders that recognize both causes of an organic nature (related to the virus itself) and non-organic factors (emotional stress resulting from HIV diagnosis, social stigma and continued risk behaviour such as alcohol or drug abuse). Most of the literature has focused attention on depressive disorder, the most common mental disorder in the HIV population. In our analysis we evaluated the presence of personality disorders and alexithymia in a group of patients seropositive for HIV through appropriate psychological tests. Our data revealed a close relationship between socio-emotional alienation, distorted body perception and the difficulty in relating with each other, which is perceived as threatening and judgmental; this concept takes us back to the social stigma that modifies the emotional communication of HIV patients. The illness is experienced as an outsider that modifies the body, imprisons the emotionalism and cannot be controlled. Such personality alterations stop the emotional communication, thereby developing alexithymia.

TB epidemiology: where are the young women? Know your tuberculosis epidemic, know your response.

PubMed

Perumal, Rubeshan; Naidoo, Kogieleum; Padayatchi, Nesri

2018-03-27

The global predominance of tuberculosis in men has received significant attention. However, epidemiological studies now demonstrate that there is an increased representation of young women with tuberculosis, especially in high HIV burden settings where young women bear a disproportionate burden of HIV. The role of the HIV epidemic, as well as changes in behavioural, biological, and structural risk factors are explored as potential explanations for the increasing burden of tuberculosis in young women. As young women are particularly vulnerable to HIV infection in sub-Saharan Africa, it is unsurprising that the TB epidemic in this setting has become increasingly feminised. This age-sex trend of TB in South Africa is similar to WHO estimates for other countries with a high HIV prevalence where there are more female than male cases notified up to the age of 25 years. The high prevalence of anaemia of chronic disease in young women with HIV is an additional potential reason for their increased TB risk. The widespread use of injectable medroxyprogesterone acetate contraception, which has been shown to possess selective glucocorticoid effect and oestrogen suppression, in young women may be an important emerging biological risk factor for tuberculosis in young women. Behavioural factors such as alcohol use and tobacco smoking patterns are further factors which may be responsible for the narrowing of the sex gap in TB epidemiology. In comparison to the significantly higher alcohol consumption rates in men globally, there is a narrowing gap in alcohol consumption between the sexes in South Africa with alarming rates of alcohol abuse in young women. There is a similar narrowing of the tobacco smoking gap between the sexes in South Africa, with increasing smoking prevalence in young women. With nearly 70% of all TB patients being co-infected with HIV in our setting, it is not surprising that the age and sex distribution of TB is increasingly resembling the distribution of HIV in this region of dual hyperendemicity. New TB service design must begin to reflect the presence of young women as a significant group burdened by the disease.

76 FR 17140 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcohol Abuse and Alcoholism Special Emphasis Panel; RFA-AA-11-02 Alcohol Induced Metabolic and Hepatic...: Philippe Marmillot, PhD, Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism...

Feasibility of Using Soccer and Job Training to Prevent Drug Abuse and HIV

PubMed Central

Rotheram-Borus, Mary Jane; Tomlinson, Mark; Durkin, Andrew; Baird, Kelly; DeCelles, Jeff; Swendeman, Dallas

2016-01-01

Background Many young, South African men use alcohol and drugs and have multiple partners, but avoid health care settings – the primary site for delivery of HIV intervention activities. Objectives To identify the feasibility of engaging men in HIV testing and reducing substance use with soccer and vocational training programs. Methods In two Cape Town neighborhoods, all unemployed men aged 18–25 years were recruited and randomized by neighborhood to: 1) an immediate intervention condition with access to a soccer program, random rapid diagnostic tests (RDT) for alcohol and drug use, and an opportunity to enter a vocational training program (n=72); or 2) a delayed control condition (n=70). Young men were assessed at baseline and six months later by an independent team. Results Almost all young men in the two neighborhoods participated (98%); 85% attended at least one practice (M = 42.3, SD= 34.4); 71% typically attended practice. Access to job training was provided to the 35 young men with the most on-time arrivals at practice, drug-free RDT, and no red cards for violence. The percentage of young men agreeing to complete RDT at soccer increased significantly over time; RDTs with evidence of alcohol and drug use decreased over time. At the pre-post assessments, the frequency of substance use decreased; and employment and income increased in the immediate condition compared to the delayed condition. HIV testing rates, health care contacts, sexual behaviors, HIV knowledge, condom use and attitudes towards women were similar over time. Discussion Alternative engagement strategies are critical pathways to prevent HIV among young men. This feasibility study shows that soccer and job training offer such an alternative, and suggest that a more robust evaluation of this intervention strategy be pursued. PMID:26837624

FIB-4 index is associated with hepatocellular carcinoma risk in HIV-infected patients.

PubMed

Park, Lesley S; Tate, Janet P; Justice, Amy C; Lo Re, Vincent; Lim, Joseph K; Bräu, Norbert; Brown, Sheldon T; Butt, Adeel A; Gibert, Cynthia; Goetz, Matthew Bidwell; Rimland, David; Rodriguez-Barradas, Maria C; Dubrow, Robert

2011-12-01

Chronic inflammation caused by hepatitis B virus infection, hepatitis C virus infection, and/or heavy alcohol use can lead to fibrosis, cirrhosis, and eventually hepatocellular carcinoma (HCC). FIB-4 is an index score calculated from platelet count, alanine transaminase, aspartate transaminase, and age that predicts fibrosis and cirrhosis. We hypothesized that high FIB-4 would be associated with development of HCC in HIV-infected persons, who are at high risk due to high prevalence of viral hepatitis and alcohol consumption, and possibly due to HIV infection itself. Using proportional hazards models, we tested this hypothesis among 22,980 HIV-infected men from the Veterans Aging Cohort Study. We identified incident HCC cases from the Veterans Affairs Central Cancer Registry. During follow-up, there were 112 incident HCC diagnoses. The age- and race/ethnic group-adjusted HR was 4.2 [95% confidence interval (CI), 2.4-7.4] for intermediate FIB-4 and 13.0 (95% CI, 7.2-23.4) for high FIB-4, compared with low FIB-4. After further adjustment for enrollment year, CD4 count, HIV-1 RNA level, antiretroviral therapy use, hepatitis B and C virus infection, alcohol abuse/dependency, and diabetes, FIB-4 remained a strong, significant, independent risk factor for HCC. The multivariate-adjusted HR was 3.6 (95% CI, 2.1-6.4) for intermediate FIB-4 and 9.6 (95% CI, 5.2-17.4) for high FIB-4. Calculated from routine, noninvasive laboratory tests, FIB-4 is a strong, independent HCC risk factor in HIV-infected patients. FIB-4 might prove valuable as an easily measured index to identify those at highest risk for HCC, even prior to development of clinical cirrhosis.

Feasibility of Using Soccer and Job Training to Prevent Drug Abuse and HIV.

PubMed

Rotheram-Borus, Mary Jane; Tomlinson, Mark; Durkin, Andrew; Baird, Kelly; DeCelles, Jeff; Swendeman, Dallas

2016-09-01

Many young, South African men use alcohol and drugs and have multiple partners, but avoid health care settings-the primary site for delivery of HIV intervention activities. To identify the feasibility of engaging men in HIV testing and reducing substance use with soccer and vocational training programs. In two Cape Town neighborhoods, all unemployed men aged 18-25 years were recruited and randomized by neighborhood to: (1) an immediate intervention condition with access to a soccer program, random rapid diagnostic tests (RDT) for alcohol and drug use, and an opportunity to enter a vocational training program (n = 72); or (2) a delayed control condition (n = 70). Young men were assessed at baseline and 6 months later by an independent team. Almost all young men in the two neighborhoods participated (98 %); 85 % attended at least one practice (M = 42.3, SD = 34.4); 71 % typically attended practice. Access to job training was provided to the 35 young men with the most on-time arrivals at practice, drug-free RDT, and no red cards for violence. The percentage of young men agreeing to complete RDT at soccer increased significantly over time; RDTs with evidence of alcohol and drug use decreased over time. At the pre-post assessments, the frequency of substance use decreased; and employment and income increased in the immediate condition compared to the delayed condition. HIV testing rates, health care contacts, sexual behaviors, HIV knowledge, condom use and attitudes towards women were similar over time. Alternative engagement strategies are critical pathways to prevent HIV among young men. This feasibility study shows that soccer and job training offer such an alternative, and suggest that a more robust evaluation of this intervention strategy be pursued.

HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

PubMed

Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

2014-01-01

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

78 FR 66015 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcohol Abuse and Alcoholism Special Emphasis Panel; AA-2 Deferred Grant Application Review. Date...: National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane (Teleconference), Rockville, MD 20852...

75 FR 46949 - National Institute on Alcohol Abuse and Alcoholism; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... Alcohol Abuse and Alcoholism; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... intramural programs and projects conducted by the National Institute on Alcohol Abuse and Alcoholism... Branch, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers...

Psychological characteristics in high-risk MSM in China

PubMed Central

2012-01-01

Background Men who have sex with men (MSM) have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26%) had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P < 0.05). In contrast, the two groups did not differ significantly the sexual orientation, level of education, types of profession, drug use, condom use and experience of social stigma and discrimination (P > 0.05). A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China. PMID:22264355

The Provider Perception Inventory: Psychometrics of a Scale Designed to Measure Provider Stigma about HIV, Substance Abuse, and MSM Behavior

PubMed Central

Windsor, Liliane Cambraia; Benoit, Ellen; Ream, Geoffrey; Forenza, Brad

2012-01-01

Non-gay identified men who have sex with men and women (NGI MSMW) and who use alcohol and other drugs are a vulnerable, understudied, and undertreated population. Little is known about the stigma faced by this population or about the way that health service providers view and serve these stigmatized clients. The Provider Perception Inventory (PPI) is a 39-item scale that measures health services providers’ stigma about HIV/AIDS, substance use, and MSM behavior. The PPI is unique in that it was developed to include service provider stigma targeted at NGI MSMW individuals. PPI was developed through a mixed methods approach. Items were developed based on existing measures and findings from focus groups with 18 HIV and substance abuse treatment providers. Exploratory factor analysis using data from 212 health service providers yielded a two dimensional scale: 1) Individual Attitudes (19 items), and 2) Agency Environment (11 items). Structural equation model analysis supported the scale’s predictive validity (N=190 sufficiently complete cases). Overall findings indicate initial support for the psychometrics of the PPI as a measure of service provider stigma pertaining to the intersection of HIV/AIDS, substance use, and MSM behavior. Limitations and implications to future research are discussed. PMID:23082899

The provider perception inventory: psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior.

PubMed

Windsor, Liliane C; Benoit, Ellen; Ream, Geoffrey L; Forenza, Brad

2013-01-01

Nongay identified men who have sex with men and women (NGI MSMW) and who use alcohol and other drugs are a vulnerable, understudied, and undertreated population. Little is known about the stigma faced by this population or about the way that health service providers view and serve these stigmatized clients. The provider perception inventory (PPI) is a 39-item scale that measures health services providers' stigma about HIV/AIDS, substance use, and MSM behavior. The PPI is unique in that it was developed to include service provider stigma targeted at NGI MSMW individuals. PPI was developed through a mixed methods approach. Items were developed based on existing measures and findings from focus groups with 18 HIV and substance abuse treatment providers. Exploratory factor analysis using data from 212 health service providers yielded a two dimensional scale: (1) individual attitudes (19 items) and (2) agency environment (11 items). Structural equation modeling analysis supported the scale's predictive validity (N=190 sufficiently complete cases). Overall findings indicate initial support for the psychometrics of the PPI as a measure of service provider stigma pertaining to the intersection of HIV/AIDS, substance use, and MSM behavior. Limitations and implications to future research are discussed.

HIV Risk, Substance Use, and Personality Characteristics among Adults with History of Serious Mental Illness.

PubMed

Mainville, Cathryn H; Richardson, Mark A; Brady, Stephen M; Berger-Greenstein, Jori; Bacic, Janine

2017-01-01

The present study examined the relationship between characteristics associated with personality disorders, substance use, and HIV risk among adults with a history of serious mental illness. Participants included 103 adults with antisocial or borderline personality disorder, serious mental illness, and recent HIV risk behavior. The sample was predominately male (64%), diverse (42% African American and 13% Hispanic), and homeless/marginally housed (76%). In order to examine the relationship between personality characteristics and risk we constructed a risk index comprising key symptoms of antisocial and borderline personality disorders, namely; impulsivity, affective instability, and disregard for safety of self/others. Contrary to our primary hypotheses, risk index scores did not predict HIV risk behavior and substance abuse did not mediate this risk. Exploratory analyses did reveal that women engaged in significantly more risk behaviors than their male counterparts and that risk scores were a significant predictor of total sex acts for women but not men. In addition, increased emotional dysregulation was a significant predictor of condomless sex acts for women but not men. Finally, recent alcohol use and increased impulsivity was associated with more condomless oral sex for men and women. These results suggest the relationship among serious mental illness, personality disorder, substance abuse, and gender is complex and merits further study.

Verbal and spatial working memory among drug-using HIV-infected men and women.

PubMed

Martin, Eileen; Keutmann, M K; Fogel, J S; Maki, P M; Gonzalez, R; Vassileva, J; Rubin, L H; Hardy, D

2018-04-23

Working memory (WM) is a critical component of many neurocognitive functions. The literature has demonstrated consistently that WM impairment is more frequent and severe among substance-dependent individuals (SDIs) infected with HIV compared with uninfected SDIs; however, the SDIs who participated in these previous studies were primarily male. There are few published data on WM performance among HIV+ women with or without substance use disorders, and essentially no direct comparisons of WM performance between HIV+ men and women, regardless of substance use. We investigated potential sex and serostatus effects on WM among a sample of 360 SDIs (114 with HIV; 66% female) verified abstinent from alcohol and drugs of abuse at testing and generally comparable on substance use and comorbid characteristics. Participants were tested with the n-back task, a well-established WM measure that is sensitive to HIV-associated cognitive impairment. HIV+ men and women performed spatial and verbal versions of the n-back significantly less accurately compared with HIV- participants. Women showed slower response times compared with men on both versions, regardless of HIV serostatus. Individuals dependent on cocaine showed faster RTs compared with non-dependent users, but this effect was not apparent among opioid- or alcohol-dependent groups. Findings on n-back accuracy are consistent with our previous proposal that WM impairment represents a signature deficit among HIV+ SDIs; however, WM impairment appears less common among HIV+ women without a substance use history. The pattern of sex differences in response speed but serostatus effects on response accuracy is comparable to a recent report by our group of sex differences in learning speed but serostatus effects on delayed recall.

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Latent Classes and Cumulative Impacts of Adverse Childhood Experiences.

PubMed

Barboza, Gia Elise

2018-05-01

Studies of adverse childhood experiences (ACEs) have gauged severity using a cumulative risk (CR) index. Few studies have focused on the nature of the context of adversity and their association with psychosocial outcomes. The objective of this study was to examine the patterning of ACEs and to explore the resultant patterns' association with HIV risk-taking, problem drinking, and depressive symptoms in adulthood. Latent class analysis (LCA) was used to identify homogeneous, mutually exclusive "classes" of 11 of the most commonly used ACEs. The LCA resulted in four high-risk profiles and one low-risk profile, which were labeled: (1) highly abusive and dysfunctional (3.3%; n = 1,983), (2) emotionally abusive alcoholic with parental conflict (6%, n = 3,303), (3) sexual abuse only (4.3%, n = 2,260), (4) emotionally abusive and alcoholic (30.3%, n = 17,460), and (5) normative, low risk (56.3%, n = 32,950). Compared to the low-risk class, each high-risk profile was differentially associated with adult psychosocial outcomes even when the conditional CR within that class was similar. The results further our understanding about the pattern of ACEs and the unique pathways to poor health. Implications for child welfare systems when dealing with individuals who have experienced multiple forms of early childhood maltreatment and/or household dysfunction are discussed.

Psychiatric symptoms and disorders in HIV infected mine workers in South Africa. A retrospective descriptive study of acute first admissions.

PubMed

Säll, L; Salamon, E; Allgulander, C; Owe-Larsson, B

2009-08-01

The social and living conditions of mine workers in South Africa contribute to a rapid transmission of human immunodeficiency virus (HIV) and other sexually transmitted infections. HIV-associated dementia is a serious condition during HIV disease. Several other psychiatric symptoms and disorders, such as psychosis, secondary mania and depression, have also been associated with clinical HIV infection. We describe the onset of psychiatric symptoms and signs in a group of untreated, HIV infected male mine workers first admitted for psychiatric treatment at the Rand Mutual Hospital in Johannesburg. Between 1987 and 1997, 38 consecutive cases were admitted, and their files were retrieved for study in 2006. The subjects were 38 black male mine workers admitted acutely for psychiatric care due to psychiatric symptoms, and subsequently diagnosed with HIV infection. The presenting psychiatric symptoms on admission and diagnoses at discharge were compiled for all patients, not to infer causality but to establish the range of symptoms that the clinician has to deal with. The 38 patients presented with a wide range of psychiatric symptoms. The dominating symptoms were those of cognitive deficits, and different psychotic manifestations. 12 of the patients, almost one third of the individuals, were diagnosed with dementia. The patients with dementia exhibited cognitive deficits, and in addition often abnormal behaviour and psychotic symptoms, and several also had symptoms of secondary mania. 5 of the patients presented with delirium. Psychosis, without concurrent dementia, was diagnosed in 5 patients. Bipolar disorder with mania, without concurrent dementia, and major depression was present in 2 patients, respectively. Screening for substance abuse showed that 9 of the patients had ongoing cannabis abuse and 10 had alcohol abuse. Cannabis-induced psychotic disorder was present in 5 patients. The findings confirm that patients with a new diagnosis of HIV may present with disorders of thought and/or cognition as well as gross behavioural disturbance, and that psychotic symptoms and secondary mania could be manifestations of the clinical onset of HIV/acquired immune deficiency syndrome (AIDS) infection.

The mental health impact of AIDS-related mortality in South Africa: a national study

PubMed Central

Myer, L; Seedat, S; Stein, D J; Moomal, H; Williams, D R

2011-01-01

Background Few data exist on how the HIV/AIDS epidemic may influence population mental health. The associations were examined between knowing someone who died of HIV/AIDS and common mental disorders among South African adults. Methods Between 2002 and 2004, a nationally representative sample of 4351 adults were interviewed about personally knowing someone who died of HIV/AIDS, and the World Health Organization Composite International Diagnostic Interview was used to generate psychiatric diagnoses for depression, anxiety and substance abuse disorders during the preceding 12 months based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). Results Overall, 42.2% of the sample knew someone who died of HIV/AIDS, and 16.5% met the criteria for at least one DSM-IV diagnosis. Individuals who knew someone who died of HIV/AIDS were significantly more likely to have any DSM-IV defined disorder, including any depressive, anxiety or substance-related disorder (p<0.001 for all associations). In multivariate models adjusted for participant demographic characteristics, life events and socioeconomic status, individual disorders significantly associated with knowing someone who died of HIV/AIDS included generalised anxiety disorder, social phobia and alcohol/drug dependence or abuse. Based on these results, it is estimated that up to 15% of 12-month DSM-IV disorders in the South African adult population may be related to knowing someone who died of HIV/AIDS. Conclusion These novel data suggest that AIDS-related mortality may contribute substantially to the burden of mental disorders in settings of high HIV prevalence. While this finding requires further investigation, these data suggest the need to strengthen mental health services in communities where HIV/AIDS is prevalent. PMID:19074926

National Institute on Drug Abuse symposium report: drugs of abuse, dopamine, and HIV-associated neurocognitive disorders/HIV-associated dementia.

PubMed

Purohit, Vishnudutt; Rapaka, Rao; Frankenheim, Jerry; Avila, Albert; Sorensen, Roger; Rutter, Joni

2013-04-01

The National Institute on Drug Abuse organized a symposium on drugs of abuse, dopamine, and HIV-associated neurocognitive disorders (HAND)/HIV-associated dementia (HAD) in Rockville, Maryland, October 4, 2011. The purpose of this symposium was to evaluate the potential role of dopamine in the potentiation of HAND/HAD by drugs of abuse. A summary of the symposium has been presented in this report.

Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey.

PubMed

Lown, E Anne; Nayak, Madhabika B; Korcha, Rachael A; Greenfield, Thomas K

2011-02-01

Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR(adj) = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR(adj) = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR(adj) = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR(adj) = 3.5; 95% CI 2.6 to 4.8) and dependence (OR(adj) = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting. Copyright © 2010 by the Research Society on Alcoholism.

78 FR 65347 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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78 FR 41940 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-03-05

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2012-04-17

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2011-07-26

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Characteristics of U.S. Substance Abuse Treatment Facilities Offering HIV Services: Results From a National Survey.

PubMed

Cohn, Amy; Stanton, Cassandra; Elmasry, Hoda; Ehlke, Sarah; Niaura, Ray

2016-06-01

Substance use disorders are common among persons with HIV/AIDS. This study examined the prevalence and correlates of the provision of four HIV services in a national sample of substance abuse treatment facilities. Data were from the 2011 National Survey of Substance Abuse Treatment Services. Prevalence estimates indicated that 28% of facilities offered HIV testing, 26% early intervention, 58% HIV/AIDS education, and 8% special programs for HIV/AIDS. Facilities offering inpatient substance abuse care were more than six times as likely to offer HIV testing but not more likely to offer any other type of HIV service. Facilities offering methadone treatment were 2.5 times more likely to offer HIV services. Given the high rates of substance use among persons with HIV, the prevalence of facilities offering HIV services was low in most domains, with different barriers identified in multivariable models. Integrating comprehensive HIV prevention, testing, and support services into programs that address substance abuse is needed.

Psychopathological Dimensions in Substance Abusers with and without HIV/AIDS and Healthy Matched Group.

PubMed

Rezaei, Sajjad; Taramian, Sonbol; Kafie, Seyed Mousa

2013-01-01

Inattention to symptoms of mental disorders and substance abuse in patients with HIV/AIDS and other at-risk groups, may lead to irreversible damages. The purpose of this study was to compare the psychopathological dimensions in substance abusers with and without HIV/AIDS and healthy matched groups. In a cross-sectional and analytical study, selected samples (by available, consecutive, and objective methods) were 43 HIV-positive substance abusers, 49 HIV negative substance abusers under methadone maintenance therapy (MMT) in the counseling clinic of Behavioral Diseases and Addiction Abandonment, and 45 ordinary individuals. All of them were evaluated by matched confounding variables via Symptom Checklist-90-Revised (SCL-90-R). Results indicated a significant difference between these groups in the Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), and Positive Symptom Total (PST) (P < 0.001). Two by two the comparison of the three groups from psychopathological dimensions revealed that substance abusers with HIV/AIDS persistently suffer more mental problems in all dimensions compared with healthy individuals (P < 0.05). In addition, in comparison with HIV negative substance abusers, they also suffer more mental problems in other dimensions, including somatization, interpersonal sensitivity, depression, anxiety, phobia, and psychoticism (P < 0.05). Yet, the difference in paranoid ideation, hostility, and obsessive-compulsive cases was insignificant. Two by two, the comparison between healthy individuals and substance abusers without HIV/AIDS showed higher levels of depression and psychoticism in substance abusers (P < 0.05), but no difference in other dimensions. Comorbidity of substance abuse and HIV diagnosis intensify mental disorder symptoms. Moreover, lack of prevention and implementation of appropriate psychological and psychiatric interventions after substance abuse and HIV lead to extended establishment of mental disorder symptoms.

Psychopathological Dimensions in Substance Abusers with and without HIV/AIDS and Healthy Matched Group

PubMed Central

Rezaei, Sajjad; Taramian, Sonbol; Kafie, Seyed Mousa

2013-01-01

Background Inattention to symptoms of mental disorders and substance abuse in patients with HIV/AIDS and other at-risk groups, may lead to irreversible damages. The purpose of this study was to compare the psychopathological dimensions in substance abusers with and without HIV/AIDS and healthy matched groups. Methods In a cross-sectional and analytical study, selected samples (by available, consecutive, and objective methods) were 43 HIV-positive substance abusers, 49 HIV negative substance abusers under methadone maintenance therapy (MMT) in the counseling clinic of Behavioral Diseases and Addiction Abandonment, and 45 ordinary individuals. All of them were evaluated by matched confounding variables via Symptom Checklist-90-Revised (SCL-90-R). Findings Results indicated a significant difference between these groups in the Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), and Positive Symptom Total (PST) (P < 0.001). Two by two the comparison of the three groups from psychopathological dimensions revealed that substance abusers with HIV/AIDS persistently suffer more mental problems in all dimensions compared with healthy individuals (P < 0.05). In addition, in comparison with HIV negative substance abusers, they also suffer more mental problems in other dimensions, including somatization, interpersonal sensitivity, depression, anxiety, phobia, and psychoticism (P < 0.05). Yet, the difference in paranoid ideation, hostility, and obsessive-compulsive cases was insignificant. Two by two, the comparison between healthy individuals and substance abusers without HIV/AIDS showed higher levels of depression and psychoticism in substance abusers (P < 0.05), but no difference in other dimensions. Conclusion Comorbidity of substance abuse and HIV diagnosis intensify mental disorder symptoms. Moreover, lack of prevention and implementation of appropriate psychological and psychiatric interventions after substance abuse and HIV lead to extended establishment of mental disorder symptoms. PMID:24494168

Genetic moderators and psychiatric mediators of the link between sexual abuse and alcohol dependence.

PubMed

Copeland, William E; Magnusson, Asa; Göransson, Mona; Heilig, Markus A

2011-06-01

This study used a case-control female sample to test psychiatric mediators and genetic moderators of the effect of sexual abuse on later alcohol dependence. The study also tested differences between alcohol dependent women with or without a history of sexual abuse on variables that might affect treatment planning. A case-control design compared 192 treatment-seeking alcohol dependent women with 177 healthy population controls. All participants were assessed for alcohol-related behaviors, sexual abuse history, psychiatric problems, and personality functioning. Markers were genotyped in the CRHR1, MAO-A and OPRM1 genes. The association of sexual abuse with alcohol dependence was limited to the most severe category of sexual abuse involving anal or vaginal penetration. Of the five psychiatric disorders tested, anxiety, anorexia nervosa, and bulimia met criteria as potential mediators of the abuse-alcohol dependence association. Severe sexual abuse continued to have an independent effect on alcohol dependence status even after accounting for these potential mediators. None of the candidate genetic markers moderated the association between sexual abuse and alcohol dependence. Of alcohol dependent participants, those with a history of severe abuse rated higher on alcoholism severity, and psychiatric comorbidities. Sexual abuse is associated with later alcohol problems directly as well as through its effect on psychiatric problems. Treatment-seeking alcohol dependent women with a history of abuse have distinct features as compared to other alcohol dependent women. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Genetic Moderators and Psychiatric Mediators of the link between Sexual Abuse and Alcohol Dependence

PubMed Central

Copeland, William E.; Magnusson, Åsa; Göransson, Mona; Heilig, Markus A.

2011-01-01

Background/Objective This study used a case-control female sample to test psychiatric mediators and genetic moderators of the effect of sexual abuse on later alcohol dependence. The study also tested differences between alcohol dependent women with or without a history of sexual abuse on variables that that might affect treatment planning. Methods A case-control design compared 192 treatment-seeking alcohol dependent women with 177 healthy population controls. All participants were assessed for alcohol-related behaviors, sexual abuse history, psychiatric problems, and personality functioning. Markers were genotyped in the CRHR1, MAO-A and OPRM1 genes. Results The association of sexual abuse with alcohol dependence was limited to the most severe category of sexual abuse involving anal or vaginal penetration. Of the five psychiatric disorders tested, anxiety, anorexia nervosa, and bulimia met criteria as potential mediators of the abuse-alcohol dependence association. Severe sexual abuse continued to have an independent effect on alcohol dependence status even after accounting for these potential mediators. None of the candidate genetic markers moderated the association between sexual abuse and alcohol dependence. Of alcohol dependent participants, those with a history of severe abuse rated higher on alcoholism severity, and psychiatric comorbidities. Conclusion Sexual abuse is associated with later alcohol problems directly as well as through its effect on psychiatric problems. Treatment-seeking alcohol dependent women with a history of abuse have distinct features as compared to other alcohol dependent women. PMID:21193270

Cognitive impairment associated with cocaine use: The role of co-existent alcohol abuse/dependence.

PubMed

Blanco-Presas, Laura; Moreno-Alcázar, Ana; Alonso-Lana, Silvia; Salvador, Raymond; Pomarol-Clotet, Edith; McKenna, Peter

2018-05-29

Cocaine abuse has been reported as leading to impaired cognitive function. However, cocaine abusers commonly also abuse alcohol, which can itself produce cognitive impairment. This study, therefore, aimed to examine the potential confounding effect of alcohol abuse on neuropsychological test performance in cocaine and alcohol abusing individuals, comparing them with individuals who abused alcohol alone and non-abusing controls. Nineteen cocaine abusers who also met DSM-IV criteria for alcohol abuse/dependence (14 m, 5f; mean age 38.65 ± 3.83) and 20 matched individuals who met criteria for alcohol abuse/dependence alone (12 m, 8f; mean age 38.19 ± 4.82) were administered a battery of neuropsychological tests covering executive function, memory, language and visual/visuospatial function after two to four weeks of abstinence. Nineteen matched healthy controls (8 m, 11f; mean age 37.01 ± 5.98) were also tested. Both the cocaine + alcohol group and the alcohol group performed significantly more poorly than the healthy controls on the executive (ESs 2.13 and 2.57) and memory tests (ESs 0.58 and 1.06). The findings were similar for language (ESs 0.92 and 1.69), where the cocaine + alcohol abusers additionally performed significantly better than the alcohol abusers. Both patient groups were impaired on two of the five tests of visual/visuospatial function, with better performance by the cocaine + alcohol group on one of them. Chronic cocaine abuse does not appear from this study to be associated with cognitive impairment over and above that which can be attributed to co-existent alcohol abuse. Copyright © 2018 Elsevier B.V. All rights reserved.

78 FR 41938 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2013-07-12

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2013-12-13

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76 FR 44597 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-07-26

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76 FR 44596 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-07-26

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75 FR 24961 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meetings

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2010-05-06

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77 FR 70171 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-11-23

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, RM 2081...

76 FR 44600 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... Person: Richard A. Rippe, PhD, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane...

75 FR 69090 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Room 2019, Bethesda, MD 20892, 301-443-2861, marmillotp...

Preventing the Consequences of Alcohol Abuse: Identification of Soldiers at High Risk for Fatal and Serious Injuries

DTIC Science & Technology

2005-07-01

Drug/Alcohol Combo: 1980-1985 1986-1988 303.1 - Alcohol dependence with drug abuse 303.07 - Alcohol dependence syndrome - acute alcohol intoxication...with single drug use 303.10 - Alcohol dependence with drug abuse, unspecified 303.08 - Alcohol dependence syndrome - acute alcohol intoxication, with...multiple drug use 303.11 - Alcohol dependence with drug abuse, 303.97 - Alcohol dependence syndrome - other and continuous/habitual unspecified alcohol

Disrespect and Abuse During Childbirth in Tanzania: Are Women Living With HIV More Vulnerable?

PubMed Central

Sando, David; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

2014-01-01

Introduction: HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Methods: Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Results: Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. Conclusions: In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on ensuring respectful maternity care for all women. PMID:25436822

NIDA’s Clinical Trials Network: An Opportunity for HIV Research in Community Substance Abuse Treatment Programs

PubMed Central

Tross, Susan; Campbell, Aimee N. C.; Calsyn, Donald A.; Metsch, Lisa R.; Sorensen, James L.; Shoptaw, Steven; Haynes, Louise; Woody, George E.; Malow, Robert M.; Brown, Lawrence S.; Feaster, Daniel J.; Booth, Robert E.; Mandler, Raul N.; Masson, Carmen; Holmes, Beverly W.; Colfax, Grant; Brooks, Audrey J.; Hien, Denise A.; Schackman, Bruce R.; Korthuis, P. Todd; Miele, Gloria M.

2012-01-01

Background/Objectives HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV activities of the CTN during its first 10 years. Results While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs. Conclusion/Significance While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed. PMID:21854270

NIDA's Clinical Trials Network: an opportunity for HIV research in community substance abuse treatment programs.

PubMed

Tross, Susan; Campbell, Aimee N C; Calsyn, Donald A; Metsch, Lisa R; Sorensen, James L; Shoptaw, Steven; Haynes, Louise; Woody, George E; Malow, Robert M; Brown, Lawrence S; Feaster, Daniel J; Booth, Robert E; Mandler, Raul N; Masson, Carmen; Holmes, Beverly W; Colfax, Grant; Brooks, Audrey J; Hien, Denise A; Schackman, Bruce R; Korthuis, P Todd; Miele, Gloria M

2011-09-01

HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV activities of the CTN during its first 10 years. While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs. While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed.

77 FR 22794 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-17

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... Person: Katrina L Foster, Ph.D., Scientific Review Administrator, National Institutes on Alcohol Abuse...

76 FR 36930 - National Advisory Council on Alcohol Abuse and Alcoholism and National Advisory Council on Drug...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-23

... National Institute on Drug Abuse. The meeting will be open to the public as indicated below, with... Alcohol Abuse and Alcoholism and National Advisory Council on Drug Abuse; Notice of Joint Meeting Pursuant... Alcoholism and National Advisory Council on Drug Abuse. Date: September 12, 2011. Open: September 12, 2011...

Intimate partner violence among pregnant women in Rwanda

PubMed Central

Ntaganira, Joseph; Muula, Adamson S; Masaisa, Florence; Dusabeyezu, Fidens; Siziya, Seter; Rudatsikira, Emmanuel

2008-01-01

Background Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV) against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women. Methods A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis. Results Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%), slapping (32.0% vs. 15.3%), kicking with fists (36.3% vs. 19.7%), throwing to the ground and kicking with feet (23.3% vs. 12.7%), and burning with hot liquid (4.1% vs. 3.5%). HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]). Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29]), having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers), and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV. Conclusion We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be made available. PMID:18847476

Identifying community risk factors for HIV among South African adolescents with mental health problems: a qualitative study of parental perceptions.

PubMed

Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky

2014-01-01

High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.

78 FR 42529 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... Abuse & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 3037, Rockville, MD 20852, 301...

75 FR 63494 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse...: Ranga Srinivas, PhD, Chief, Extramural Project Review Branch, EPRB, National Institute on Alcohol Abuse...

77 FR 22794 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-04-17

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse.... Contact Person: Katrina L Foster, Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse...

76 FR 44599 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-07-26

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse.... Contact Person: Katrina L. Foster, PhD, Scientific Review officer, National Institute on Alcohol Abuse...

Alcohol Myopia and Sexual Abdication among Women: Examining the Moderating Effect of Child Sexual Abuse

PubMed Central

Staples, Jennifer M.; George, William H.; Stappenbeck, Cynthia A.; Davis, Kelly Cue; Norris, Jeanette; Heiman, Julia

2014-01-01

HIV and other STIs are major public health concerns for women, and risky sexual behaviors increase the risk of transmission. Risky sexual behaviors include sexual abdication, that is, willingness to let a partner decide how far to go sexually. Alcohol intoxication is a risk factor for risky sexual behavior, and the Inhibition Conflict Model of Alcohol Myopia may help explain this relationship (Steele et al., 1985). This model suggests that in order for intoxication to influence behavior there must be high conflict, meaning the strength of the instigatory cues and inhibitory cues are both high. Recent research indicates that the degree to which cues are experienced as high in instigation or inhibition is subject to individual difference factors. One individual difference factor associated with alcohol-related sexual risk taking is child sexual abuse (CSA) history. The current study examined the influence of acute alcohol intoxication, CSA, and inhibition conflict on sexual abdication with 131 women (mean age 25) randomized into a 2 (alcohol, control) x 2 (high conflict, low conflict) experimental design. Regression analyses yielded a significant 3-way interaction, F (1,122) = 8.15, R2 = .14, p <.01. When there was high conflict, intoxicated CSA women were more likely to abdicate than sober CSA women, however, sober CSA women were less likely to abdicate than sober NSA women. When there was low conflict, CSA history and alcohol intoxication had no influence on abdication. These results may help explain the association between alcohol and risky sexual decision making among women with CSA. PMID:25310825

Alcohol myopia and sexual abdication among women: examining the moderating effect of child sexual abuse.

PubMed

Staples, Jennifer M; George, William H; Stappenbeck, Cynthia A; Davis, Kelly Cue; Norris, Jeanette; Heiman, Julia R

2015-02-01

HIV and other STIs are major public health concerns for women, and risky sexual behaviors increase the risk of transmission. Risky sexual behaviors include sexual abdication, that is, willingness to let a partner decide how far to go sexually. Alcohol intoxication is a risk factor for risky sexual behavior, and the Inhibition Conflict Model of Alcohol Myopia may help explain this relationship. This model suggests that in order for intoxication to influence behavior there must be high conflict, meaning the strength of the instigatory cues and inhibitory cues are both high. Recent research indicates that the degree to which cues are experienced as high in instigation or inhibition is subject to individual difference factors. One individual difference factor associated with alcohol-related sexual risk taking is child sexual abuse (CSA) history. The current study examined the influence of acute alcohol intoxication, CSA, and inhibition conflict on sexual abdication with 131 women (mean age 25) randomized into a 2 (alcohol, control)×2 (high conflict, low conflict) experimental design. Regression analyses yielded a significant 3-way interaction, F (1,122)=8.15, R(2)=.14, p<.01. When there was high conflict, intoxicated CSA women were more likely to abdicate than sober CSA women, however, sober CSA women were less likely to abdicate than sober NSA women, when there was low conflict, CSA history and alcohol intoxication had no influence on abdication. These results may help explain the association between alcohol and risky sexual decision making among women with CSA. Copyright © 2014 Elsevier Ltd. All rights reserved.

A miRNA Signature for Cognitive Deficits and Alcohol Use Disorder in Persons Living with HIV/AIDS

PubMed Central

Wyczechowska, Dorota; Lin, Hui-Yi; LaPlante, Andrea; Jeansonne, Duane; Lassak, Adam; Parsons, Christopher H.; Molina, Patricia E.; Peruzzi, Francesca

2017-01-01

HIV-associated neurocognitive disorders (HAND) affects more than half of persons living with HIV-1/AIDS (PLWHA). Identification of biomarkers representing the cognitive status of PLWHA is a critical step for implementation of successful cognitive, behavioral and pharmacological strategies to prevent onset and progression of HAND. However, the presence of co-morbidity factors in PLWHA, the most common being substance abuse, can prevent the identification of such biomarkers. We have optimized a protocol to profile plasma miRNAs using quantitative RT-qPCR and found a miRNA signature with very good discriminatory ability to distinguish PLWHA with cognitive impairment from those without cognitive impairment. Here, we have evaluated this miRNA signature in PLWHA with alcohol use disorder (AUD) at LSU Health Sciences Center (LSUHSC). The results show that AUD is a potential confounding factor for the miRNAs associated with cognitive impairment in PLWHA. Furthermore, we have investigated the miRNA signature associated with cognitive impairment in an independent cohort of PLWHA using plasma samples from the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) program. Despite differences between the two cohorts in socioeconomic status, AUD, and likely misuse of illicit or prescription drugs, we validated a miRNA signature for cognitive deficits found at LSUHSC in the CHARTER samples. PMID:29187813

Growing up with Parental Alcohol Abuse: Exposure to Childhood Abuse, Neglect, and Household Dysfunction.

ERIC Educational Resources Information Center

Dube, Shanta R.; Anda, Robert F.; Felitti, Vincent J.; Croft, Janet B.; Edwards, Valerie J.; Giles, Wayne H.

2001-01-01

A study involving 8,629 adults examined the association between parental alcohol abuse and child abuse, neglect, and other household dysfunction. Compared to households without alcohol abuse, the adjusted odds ratio for each category of adverse childhood experience was 2 to 13 times higher if parents abused alcohol. (Contains references.) (CR)

In their own voices: a qualitative study of women's risk for intimate partner violence and HIV in South Africa.

PubMed

Fox, Ashley M; Jackson, Sharon S; Hansen, Nathan B; Gasa, Nolwazi; Crewe, Mary; Sikkema, Kathleen J

2007-06-01

This study qualitatively examines the intersections of risk for intimate partner violence (IPV) and HIV infection in South Africa. Eighteen women seeking services for relationship violence were asked semistructured questions regarding their abusive experiences and HIV risk. Participants had experienced myriad forms of abuse, which reinforced each other to create a climate that sustained abuse and multiplied HIV risk. Male partners having multiple concurrent sexual relationships, and poor relationship communication compounded female vulnerability to HIV and abuse. A social environment of silence, male power, and economic constraints enabled abuse to continue. "Breaking the silence" and women's empowerment were suggested solutions.

Predictors of HIV-risk sexual behavior: examining lifetime sexual and physical abuse histories in relation to substance use and psychiatric problem severity among ex-offenders.

PubMed

Majer, John M; Rodriguez, Jaclyn; Bloomer, Craig; Jason, Leonard A

2014-01-01

Lifetime histories of sexual and physical abuse have been associated with increased HIV-risk sexual behavior, and some studies have identified other variables associated with these relationships. However, there is a dearth of literature that has critically examined abuse histories and HIV-risk sexual behavior in relation to these other variables. Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient substance dependence treatment to identify factors related to increases in HIV-risk sexual behavior beyond that of abuse histories. Hierarchical linear regression was conducted to examine sociodemographic characteristics, recent substance use, and current psychiatric problem severity in addition to lifetime histories of sexual/physical abuse in a cross-sectional design. Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behavior beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in these practices based on lifetime abuse histories and gender were not significant. Findings suggest recent substance use and current psychiatric problem severity are greater risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have substance use disorders.

32 CFR 634.13 - Alcohol and drug abuse programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Alcohol and drug abuse programs. 634.13 Section... and drug abuse programs. (a) Commanders will refer military personnel suspected of drug or alcohol abuse for evaluation in the following circumstances: (1) Behavior indicative of alcohol or drug abuse...

32 CFR 634.13 - Alcohol and drug abuse programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Alcohol and drug abuse programs. 634.13 Section... and drug abuse programs. (a) Commanders will refer military personnel suspected of drug or alcohol abuse for evaluation in the following circumstances: (1) Behavior indicative of alcohol or drug abuse...

32 CFR 634.13 - Alcohol and drug abuse programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Alcohol and drug abuse programs. 634.13 Section... and drug abuse programs. (a) Commanders will refer military personnel suspected of drug or alcohol abuse for evaluation in the following circumstances: (1) Behavior indicative of alcohol or drug abuse...

32 CFR 634.13 - Alcohol and drug abuse programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Alcohol and drug abuse programs. 634.13 Section... and drug abuse programs. (a) Commanders will refer military personnel suspected of drug or alcohol abuse for evaluation in the following circumstances: (1) Behavior indicative of alcohol or drug abuse...

32 CFR 634.13 - Alcohol and drug abuse programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Alcohol and drug abuse programs. 634.13 Section... and drug abuse programs. (a) Commanders will refer military personnel suspected of drug or alcohol abuse for evaluation in the following circumstances: (1) Behavior indicative of alcohol or drug abuse...

Violence, abuse, alcohol and drug use, and sexual behaviors in street children of Greater Cairo and Alexandria, Egypt.

PubMed

Nada, Khaled H; Suliman, El Daw A

2010-07-01

To measure the prevalence of HIV/AIDS risk behaviors and related factors in a large, probability-based sample of boys and girls aged 12-17 years living on the streets of Egypt's largest urban centers of Greater Cairo and Alexandria. Time-location sampling (TLS) was used to recruit a cross-sectional sample of street children. Procedures entailed using key informants and field observation to create a sampling frame of locations at predetermined time intervals of the day, where street children congregate in the two cities, selecting a random sample of time-locations from the complete list, and intercepting children in the selected time-locations to assess eligibility and conduct interviews. Interviews gathered basic demographic information, life events on the street (including violence, abuse, forced sex), sexual and drug use behaviors, and HIV/AIDS knowledge. A total of 857 street children were enrolled in the two cities, with an age, sex, and time-location composition matching the sampling frame. The majority of these children had faced harassment or abuse (93%) typically by police and other street children, had used drugs (62%), and, among the older adolescents, were sexually active (67%). Among the sexually active 15-17-year-olds, most reported multiple partners (54%) and never using condoms (52%). Most girls (53% in Greater Cairo and 90% in Alexandria) had experienced sexual abuse. The majority of street children experienced more than one of these risks. Overlaps with populations at highest risk for HIV were substantial, namely men who have sex with men, commercial sex workers, and injection drug users. Our study using a randomized TLS approach produced a rigorous, diverse, probability-based sample of street children and documented very high levels of multiple concurrent risks. Our findings strongly advocate for multiple services including those addressing HIV and STI prevention and care, substance use, shelters, and sensitization of authorities to the plight of street children in Egypt.

Symptoms of substance dependence and risky sexual behavior in a probability sample of HIV-negative men who have sex with men in Chicago.

PubMed

Mackesy-Amiti, Mary Ellen; Fendrich, Michael; Johnson, Timothy P

2010-07-01

This study examines the relationship between self-reported symptoms of substance dependence and risky sexual behavior among 187 HIV-negative men who have sex with men. In a supplement to a Chicago household survey, using random probability sampling, men who reported consensual sex with other men or who identified as gay or bisexual were selected for interviews. Participants reported on sexual behavior, substance use, and symptoms of substance dependence related to past year use of alcohol, marijuana, cocaine, and sedatives, tranquilizers or pain relievers. Risky sexual behavior was defined as unprotected insertive or receptive anal intercourse plus having multiple partners, casual partners, or a partner who was HIV positive or of unknown serostatus. Risky sexual behavior in the past six months was significantly and positively associated with alcohol dependence symptoms, cocaine dependence symptoms (receptive only), and prescription drug dependence symptoms (insertive only). Confirmatory factor analyses revealed that dependence symptoms loaded on separate factors by substance, which in turn loaded on an overarching dependence symptoms factor. In structural equation models, individual substance factors were not significantly associated with sexual risk behavior, however the higher order dependence symptoms factor was significantly and positively associated with both receptive and insertive risk behavior. MSM with symptoms of multiple substance use dependencies are more likely to be engaged in sexual behavior that places them at risk for acquiring HIV and other sexually transmitted infections. Alcohol and drug abuse treatment providers should be aware of the need for HIV testing and counseling in this population. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

[Tobacco use and illicit substance use disorders: what should we have to do?].

PubMed

Karila, Laurent; Petit, Aymeric; Zarmdini, Rim; Coscas, Sarah; Lowenstein, William; Reynaud, Michel

2013-05-01

Tobacco use is a commonplace phenomenon in our society. Its use is responsible for more death and disease than any other noninfectious cause. More deaths are caused each year by tobacco use than by all deaths from HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. Tobacco remains responsible for greater morbidity than alcohol and all other drugs combined. Tobacco dependence is highly prevalent among drug-dependent patients. Substance abuse patients smoke more and are more vulnerable to the effects of smoking than general populations. Traditional substance abuse therapeutic programs too frequently focus only on treatment of alcohol or other drugs rather than including treatment for tobacco dependence. Currently, there are no official medical recommendations for the treatment of tobacco addiction in illicit polysubstance users. A comprehensive literature search from a range of electronic databases (PubMed, Embase, PsycInfo, Google Scholar) was conducted for the period from 1988 to September 2012, using the following keywords alone or in combination: tobacco, nicotine, cocaine, cannabis, amphetamines, opiates, substance abuse, substance dependence, addiction, treatment. There were no restrictions on the identification or inclusion of studies in terms of publication status, language and design type. Our literature review will focus on epidemiological, neurobiological, clinical interactions between tobacco, alcohol and other illicit drugs. It will also focus on therapeutic programs in this dual addictive disorder. The aim of this literature review is to make proposals for the treatment of tobacco addiction in polysubstance users entering in specific therapeutic programs. Copyright © 2013. Published by Elsevier Masson SAS.

Identification of alcohol abuse and transition from long-term unemployment to disability pension.

PubMed

Nurmela, Kirsti; Heikkinen, Virpi; Hokkanen, Risto; Ylinen, Aarne; Uitti, Jukka; Mattila, Aino; Joukamaa, Matti; Virtanen, Pekka

2015-07-01

The aim of the study was to reveal potential gaps and inconsistencies in the identification of alcohol abuse in health care and in employment services and to analyse the granting of disability pensions with respect to the alcohol abuse identification pattern. The material consisted of documentary information on 505 long-term unemployed subjects with low employability sent to the development project entitled 'Eligibility for a Disability Pension' in 2001-2006 in Finland. The dichotomous variables 'Alcohol abuse identified in employment services' and 'Alcohol abuse identified in health care' were cross-tabulated to obtain a four-class variable 'Alcohol abuse identification pattern'. Logistic regression analyses were conducted to ascertain the association of alcohol abuse identification pattern with the granting of disability pensions. Alcohol abuse was detected by both health care and employment services in 47% of those identified as abusers (41% of examinees). Each service systems also identified cases that the other did not. When alcohol abuse was identified in health care only, the OR for a disability pension being granted was 2.8 (95% CI 1.5-5.2) compared with applicants without identified alcohol abuse. The result remained the same and statistically significant after adjusting for confounders. Alcohol abuse identified in health care was positively associated with the granting of a disability pension. Closer co-operation between employment services and health care could help to identify those long-term unemployed individuals with impaired work ability in need of thorough medical examination. © 2015 the Nordic Societies of Public Health.

Cultural investment: providing opportunities to reduce risky behavior among gay American Indian males.

PubMed

Gilley, Brian Joseph; Co-Cké, John Hawk

2005-09-01

Many gay American Indian (GAI) men feel alienated from their tribal, ceremonial and social communities because of homophobia and heterosexism. As a result, they often turn to their local gay community for social participation and sex opportunities. It is no secret that a significant aspect of some gay communities is socializing in local bars and clubs. The gay bar scene makes healthy living difficult for Native American gay men. This is especially the case for those who are in alcohol or drug recovery. In response, gay Native men's support groups are attempting to make available a cultural alternative to the double bind of alienation from one's Native community and exposure to substance abuse by providing alcohol and substance free opportunities for ceremonial and social involvement. The hope is that the men will go to bars less frequently and instead turn to Native cultural activities in men's groups for social, spiritual and emotional support. The logic of this approach assumes that individuals who are culturally invested in a community will gain a level of self and social acceptance, making them less likely to abuse substances and put themselves at risk for HIV infection. The information presented in this article comes from over six years of ethnographic research among GAI men concerning self and social acceptance, HIV/AIDS and American Indian GLBT identity.

The economic impact of alcohol abuse and alcoholism.

PubMed

Burke, T R

1988-01-01

The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs. Alcohol abuse is a problem being given high priority within the Department in an effort to create a national agenda on the issue and to try to impart a greater sense of urgency about the problems. Ways are being explored to integrate alcoholism activities into more Departmental programs. Employee assistance programs for alcohol abuse have been established in about 90 percent of major companies, and Federal employees' access to treatment is being expanded through health insurance coverage. Collective public efforts are required to encourage prevention and treatment efforts, and to begin to reduce the economic effects of alcohol abuse that the country can no longer afford.

Strategies to prevent HIV transmission among heterosexual African-American men

PubMed Central

Essien, Ekere J; Meshack, Angela F; Peters, Ronald J; Ogungbade, Gbadebo O; Osemene, Nora I

2005-01-01

Background As part of qualitative research for developing a culturally sensitive and developmentally appropriate videotape-based HIV prevention intervention for heterosexual African- American men, six focus groups were conducted with thirty African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African Americans at risk for HIV infection, their personal high risk behaviors, and suggestions on how HIV intervention videotapes could be produced to achieve maximum levels of interest among African-American men in HIV training programs. Methods The groups took place at a low-income housing project in Houston, Texas, a major epicenter for HIV/AIDS. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The results revealed that low-income African-American men perceive HIV/AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sex practices, substance abuse, and lack of knowledge. They also cite lack of income to purchase condoms as a barrier to safe sex practice. They believe that HIV training programs should address these risk factors and that videotapes developed for prevention should offer a sensationalized look at the effects of HIV/AIDS on affected persons. They further believe that programs should be held in African-American communities and should include condoms to facilitate reduction of risk behaviors. Conclusions The results indicate that the respondents taking part in this study believe that HIV and AIDS are continued threats to the African-American community because of sexual risk taking behavior, that is, failure to use condoms. Further, African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or other mind-altering substances and they are having sex with men while incarcerated and become infected and once released resume unprotected sexual relations with women. According to the men, substance abuse is an important part of the problem of HIV in the African-American community. This is in keeping with research that shows that drug use, especially crack cocaine, is linked to sexual risk taking among African Americans and to increased likelihood of becoming infected with other sexually transmitted diseases (STDs) including HIV. Thus, interventions for men should address condom use, condom availability, skills for using condoms, eroticizing condoms and substance abuse prevention. Men in the present study also strongly recommended that HIV/AIDS videotaped messages should include footage of the sensational effects of the disease. PMID:15638937

Strategies to prevent HIV transmission among heterosexual African-American men.

PubMed

Essien, Ekere J; Meshack, Angela F; Peters, Ronald J; Ogungbade, Gbadebo O; Osemene, Nora I

2005-01-07

As part of qualitative research for developing a culturally sensitive and developmentally appropriate videotape-based HIV prevention intervention for heterosexual African- American men, six focus groups were conducted with thirty African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African Americans at risk for HIV infection, their personal high risk behaviors, and suggestions on how HIV intervention videotapes could be produced to achieve maximum levels of interest among African-American men in HIV training programs. The groups took place at a low-income housing project in Houston, Texas, a major epicenter for HIV/AIDS. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. The results revealed that low-income African-American men perceive HIV/AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sex practices, substance abuse, and lack of knowledge. They also cite lack of income to purchase condoms as a barrier to safe sex practice. They believe that HIV training programs should address these risk factors and that videotapes developed for prevention should offer a sensationalized look at the effects of HIV/AIDS on affected persons. They further believe that programs should be held in African-American communities and should include condoms to facilitate reduction of risk behaviors. The results indicate that the respondents taking part in this study believe that HIV and AIDS are continued threats to the African-American community because of sexual risk taking behavior, that is, failure to use condoms. Further, African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or other mind-altering substances and they are having sex with men while incarcerated and become infected and once released resume unprotected sexual relations with women. According to the men, substance abuse is an important part of the problem of HIV in the African-American community. This is in keeping with research that shows that drug use, especially crack cocaine, is linked to sexual risk taking among African Americans and to increased likelihood of becoming infected with other sexually transmitted diseases (STDs) including HIV. Thus, interventions for men should address condom use, condom availability, skills for using condoms, eroticizing condoms and substance abuse prevention. Men in the present study also strongly recommended that HIV/AIDS videotaped messages should include footage of the sensational effects of the disease.

Alcoholism and Familial Abuse: Enhancement of Quality Force Programs Using a Companion-Problem Approach

DTIC Science & Technology

1986-04-01

physical auc] sexual abuse and spouse abuse) hurt Air Force readiness and mission accomiplishmnent. The Air Force needs better means of problem identi- A...Abuse and Domestic Violence ................... 7 Alcohol Abuse and Child Physical Abuse ............... 9 i Alcohol Abuse and Child Sexual Abuse...abuse (spouse abuse, child phyzical abuse, and child sexual abuse) are serious problems in today’s Air Force. Beyond the moral considerations, they

Child-abusers face mob justice.

PubMed

Sebunya, C

1996-06-01

In Uganda, before the acquired immunodeficiency syndrome (AIDS) epidemic, rape or sexual abuse of children was not considered a serious offense by the public, although the maximum criminal offense for rape was death. Because so many young girls are testing positive for human immunodeficiency virus (HIV), and due to the efforts of women's groups, public opinion is changing. According to the United Nations International Children's Fund (UNICEF), girls aged 9-15 years are five times more likely to be infected with HIV than boys of the same age. Adults, who fear their peers may be infected with HIV, turn to children; some AIDS patients believe sleeping with a virgin girl will cure their illness. Uganda is targeting a $15 million project to protect children 5-15 years of age. A study commissioned by the Uganda National Council for Women and Children in 1994 found that in Kabale district 31% of girls and 15% of boys had been abused, many by teachers. In Masaka district, the Council found that 30% of women had been coerced into sex; bosses abuse their maids, and customers abuse alcohol sellers. According to police, rape is the second most common crime in Uganda. Victims are reluctant to come forward to testify; rape victims can be shunned in their communities and may be considered ineligible for marriage. Cases which make it to court rarely get a fair hearing, according to the Council of Women, because the men handling the cases often favor the culprits. FIDA, an association of women lawyers, Action for Development (ACFODE), and the National Association of Women's Organisations in Uganda (NAWOU) are lobbying for tougher laws on rape and closed courts. They are pressuring newspapers to not disclose the names of victims. Although many expect the Ministry of Women to take the lead in this area, it has been unable to do so, because of a lack of funds; it received two-thirds of its budget for 1994-95, an indication, perhaps, of the Ugandan government's intentions. Two figures are shown; one concerns the relation of abuser to child, while the other concerns the action taken on abuse cases.

Early life traumatic stressors and the mediating role of PTSD in incident HIV infection among US men, comparisons by sexual orientation and race/ethnicity: results from the NESARC, 2004-2005.

PubMed

Reisner, Sari L; Falb, Kathryn L; Mimiaga, Matthew J

2011-08-01

Stressful life events in childhood during critical periods of development have long-term psychological and neurobiological sequelae, which may affect risk for HIV infection across the life course. Data were from a nationally representative sample of 13,274 US men (National Epidemiologic Survey on Alcohol and Related Conditions, 2004-2005). Weighted multivariable logistic regression models examined (1) the association of childhood violent events before age 18 on 12-month incident HIV infection and (2) whether posttraumatic stress disorder (PTSD) diagnosis (clinical interview) mediated the association between early life events and HIV. Overall, the 12-month HIV incidence was <1% (0.35%); 44% of new infections were among racial/ethnic minorities and 31% among men who have sex with men). One-third of the sample (33.5%) reported one or more early life stressors (physical abuse, sexual abuse, neglect, verbal violence, or witnessed violence). In a weighted multivariable logistic regression model adjusted for age, education, family's socioeconomic position, and sexual behaviors, each additional early life violent event was associated with an elevated odds of HIV infection [adjusted odds ratio (aOR) = 1.32; 95% confidence interval (CI): 1.16 to 1.50]. Adding PTSD to this adjusted model, PTSD was highly associated with incident HIV infection (aOR = 5.75; 95% CI: 4.76 to 6.95). There was evidence that PTSD partially mediated the relationship between early life events and HIV (aOR = 1.14; 95% CI: 1.02 to 1.28). Experiencing early life violent family stressors was associated with HIV infection among men. Early life events and HIV infection were mediated by PTSD, which has implications for understanding disparities in HIV infection. Interventions are urgently needed that address the long-term sequelae of childhood violence.

Adolescent Depression, Alcohol and Drug Abuse.

ERIC Educational Resources Information Center

Deykin, Eva Y.; And Others

1987-01-01

Interviews of 434 college students revealed that prevalence of major depressive disorder (MDD) was 6.8 percent; of alcohol abuse, 8.2 percent; and of substance abuse, 9.4 percent. Alcohol and substance abuse were associated with MDD. Substance abuse was associated with other psychiatric diagnoses as well. MDD usually preceded alcohol or substance…

76 FR 2129 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-01-12

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism, Special Emphasis Panel, ``Review of the Prenatal Alcohol in Sudden Infant Death... Officer, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers...

75 FR 10808 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-03-09

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Special Emphasis Panel; Review of Alcohol Resource Grant Applications. Date: April 6...: Richard A Rippe, Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism...

75 FR 42451 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-07-21

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism, Special Emphasis Panel, Review of Alcohol Research Centers' Applications. Date: August...: Richard Rippe, PhD, Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism...

Signs of Alcohol Abuse and Addiction

MedlinePlus

... Used Drugs in the Past Drug Use Prevention Phone Numbers and Websites Search Share You are here Home » Drugs That People Abuse » Alcohol Facts » Signs of Alcohol Abuse and Addiction Signs of Alcohol Abuse and Addiction Listen ©istock. ...

Mujeres que Consumen Sustancias y su Vulnerabilidad frente al VIH en Santiago de Chile (Women Who Consume Substances and Their Vulnerability to HIV in Santiago of Chile).

PubMed

Irarrázabal, Lisette P; Ferrer, Lilian; Villegas, Natalia; Sanhueza, Sebastián; Molina, Yerko; Cianelli, Rosina

2016-06-01

Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation (p < 0.05) between substance abuse and HIV risk behaviors. It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community. © The Author(s) 2016.

Sexual Behavior, Sexual Identity, and Substance Abuse Among Low-Income Bisexual and Non-Gay-Identifying African American Men Who Have Sex with Men

PubMed Central

Harawa, Nina T.; Williams, John K.; Ramamurthi, Hema C.; Manago, Cleo; Avina, Sergio; Jones, Marvin

2008-01-01

We examined the role of drug use and addiction in same-sex sexuality among non-gay-identifying African American men who have sex with men or with both men and women (MSM/MSMW). Between July 2005 and February 2006, we conducted seven focus groups with 46 predominately low socioeconomic status African American MSM/MSMW. A total of 29 men self-identified as HIV-infected and 17 self-identified as uninfected. Focus group transcripts were analyzed using consensual qualitative research techniques. Alcohol, crack cocaine, and crystal methamphetamine were the primary drugs mentioned by participants. Drug use was identified as playing a central role in same-sex sexuality for many African American MSM/MSMW. Participants described alcohol use and drug transactions, use, and addiction as motivating sex with men, allowing and rationalizing same-sex activity and unprotected sex, and facilitating access to male sex partners. Some of those in treatment for substance abuse indicated that a readiness to admit their same-sex activity and come to terms with their homosexuality/bisexuality was necessary for recovery. Because successful engagement of non-gay-identifying African American MSM/MSMW is essential to the reduction of HIV transmission and substance abuse in Black communities, findings call for drug treatment approaches that acknowledge and accept diverse sexuality in clients. Service providers and policy-makers may be guided by these findings toward building cultural competency among direct service staff. Future research should examine interrelated dynamics of sexual activity, identity, and drug use as they evolve within individual African American MSM/MSMW and compare the frequency with which sex, condom use, and substance use co-occur with male versus female partners. PMID:18546069

75 FR 42450 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-07-21

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The economic impact of alcohol abuse and alcoholism.

PubMed Central

Burke, T R

1988-01-01

The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3141948

DOES ALCOHOL OUTLET DENSITY MODERATE THE RELATIONSHIP BETWEEN LEVELS OF ALCOHOL USE AND CHILD PHYSICAL ABUSE?

PubMed Central

Freisthler, Bridget; Wolf, Jennifer Price

2016-01-01

Objectives Parental alcohol use and alcohol outlet density are both associated with child abuse. Guided by alcohol availability theory, this paper examines whether alcohol outlet density moderates the relationship between parental alcohol use and child physical abuse. Methods A general population telephone survey of 3,023 parents or legal guardians 18 years or older was conducted across 50 California cities, while densities of alcohol outlets were measured for by zip code. Data were analyzed via overdispersed multilevel Poisson models. Results Ex-drinkers, light drinkers, and heavy drinkers use physical abuse more often than lifetime abstainers. Moderate drinking was not related to child physical abuse. Proportion of bars was negatively related to frequency of physical abuse. Moderating relationships between alcohol outlet density and drinking categories were found for all drinking patterns. Conclusion Different types of alcohol outlets may be differentially related to drinking patterns, indicating that the interaction of drinking patterns and the drinking environment may place children at greater risk for being physically abused. PMID:27642071

Testing a Social Mechanism: Does Alcohol Outlet Density Moderate the Relationship Between Levels of Alcohol Use and Child Physical Abuse?

PubMed

Freisthler, Bridget; Wolf, Jennifer Price

2016-12-01

Parental alcohol use and alcohol outlet density are both associated with child abuse. Guided by alcohol availability theory, this article examines whether alcohol outlet density moderates the relationship between parental alcohol use and child physical abuse. A general population telephone survey of 3,023 parents or legal guardians 18 years or older was conducted across 50 California cities, whereas densities of alcohol outlets were measured for by zip code. Data were analyzed via overdispersed multilevel Poisson models. Ex-drinkers, light drinkers, and heavy drinkers use physical abuse more often than lifetime abstainers. Moderate drinking was not related to child physical abuse. Proportion of bars was negatively related to frequency of physical abuse. Moderating relationships between alcohol outlet density and drinking categories were found for all drinking patterns. Different types of alcohol outlets may be differentially related to drinking patterns, indicating that the interaction of drinking patterns and the drinking environment may place children at greater risk for being physically abused.

The Impact of Shame on Health-Related Quality of Life Among HIV-Positive Adults with a History of Childhood Sexual Abuse

PubMed Central

Persons, Elizabeth; Kershaw, Trace; Sikkema, Kathleen J.

2010-01-01

Abstract Childhood sexual abuse is prevalent among people living with HIV, and the experience of shame is a common consequence of childhood sexual abuse and HIV infection. This study examined the role of shame in health-related quality of life among HIV-positive adults who have experienced childhood sexual abuse. Data from 247 HIV-infected adults with a history of childhood sexual abuse were analyzed. Hierarchical linear regression was conducted to assess the impact of shame regarding both sexual abuse and HIV infection, while controlling for demographic, clinical, and psychosocial factors. In bivariate analyses, shame regarding sexual abuse and HIV infection were each negatively associated with health-related quality of life and its components (physical well-being, function and global well-being, emotional and social well-being, and cognitive functioning). After controlling for demographic, clinical, and psychosocial factors, HIV-related, but not sexual abuse-related, shame remained a significant predictor of reduced health-related quality of life, explaining up to 10% of the variance in multivariable models for overall health-related quality of life, emotional, function and global, and social well-being and cognitive functioning over and above that of other variables entered into the model. Additionally, HIV symptoms, perceived stress, and perceived availability of social support were associated with health-related quality of life in multivariable models. Shame is an important and modifiable predictor of health-related quality of life in HIV-positive populations, and medical and mental health providers serving HIV-infected populations should be aware of the importance of shame and its impact on the well-being of their patients. PMID:20718687

Alcohol Dependence and Domestic Violence as Sequelae of Abuse and Conduct Disorder in Childhood.

ERIC Educational Resources Information Center

Kunitz, Stephen J.; Levy, Jerrold E.; McCloskey, Joanne; Gabriel, K. Ruben

1998-01-01

This study compared 204 Navajo men and women for alcohol dependence and domestic violence as sequelae of abuse and conduct disorders in childhood. Both physical and sexual abuse were risk factors for conduct disorder. Physical abuse and conduct disorder were risk factors for alcohol dependence. Alcohol dependence and physical abuse were…

Exploring the Impact of Childhood Abuse on HIV Social and Attitudinal Factors Among Adults With and Without this History in Sub-Saharan Africa: Findings from NIMH Project Accept (HPTN 043).

PubMed

Richter, Linda; Makusha, Tawanda; Komárek, Arnošt; Daniels, Joseph; Coates, Tom

2016-04-01

Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.

77 FR 43098 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-08-10

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76 FR 26311 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-05-06

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2013-10-24

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2013-04-11

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75 FR 42451 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-07-21

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism, Initial Review Group, Neuroscience Review Subcommittee. Date: November 2-3, 2010. Time..., Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health...

HIV and hepatitis B infection and risk behavior in young gay and bisexual men.

PubMed Central

Seage, G R; Mayer, K H; Lenderking, W R; Wold, C; Gross, M; Goldstein, R; Cai, B; Heeren, T; Hingson, R; Holmberg, S

1997-01-01

OBJECTIVES: To estimate the prevalence of and identify risk factors for human immunodeficiency virus type 1 (HIV-1) and hepatitis B virus (HBV) infections and unprotected anal intercourse among young homosexual and bisexual men. METHODS: The authors performed a cross-sectional analysis of data from a prospective cohort of 508 young gay and bisexual men ages 18-29. RESULTS: HIV-1 seroprevalence was 2.4%, with five (1.3%) of 390 college students and seven (6.0%) of 117 non-students infected. After adjusting for confounders, HIV-1 infection was associated with having a history of a sexually transmitted disease other than HIV-1 or hepatitis B. The prevalence of hepatitis B markers in unvaccinated men was 12.9%. The presence of hepatitis B markers in unvaccinated men was significantly associated with Asian ethnicity, off-campus residence, and history of a sexually transmitted disease other than HIV-1 or hepatitis B and inversely associated with recent non-intravenous drug use. Eighteen percent of the participants reported having had sex with women during the previous 12 months, and 26.4% reported a history of unprotected anal intercourse during the previous six months. Men who reported unprotected anal intercourse were more likely to have at least one steady partner, to have met their partners in anonymous settings, and to be identified as probably alcohol dependent. CONCLUSIONS: Although the prevalence of HIV-1 infection among young homosexual and bisexual men in Boston was relatively low, the high rates of unprotected anal intercourse suggest a potential for future HIV-1 and hepatitis B transmission. Interventions should focus on young men with histories of sexually transmitted diseases, alcohol abuse, and depression. PMID:9071279

Alcohol use and abuse in young adulthood: do self-control and parents' perceptions of friends during adolescence modify peer influence? The TRAILS study.

PubMed

Visser, Leenke; de Winter, Andrea F; Veenstra, René; Verhulst, Frank C; Reijneveld, Sijmen A

2013-12-01

To assess the influence of peer alcohol use during adolescence on young adults' alcohol use and abuse, and to assess to what extent parents' perception of their adolescent child's friends and adolescent's self-control modify this influence. We analyzed data from the first, third, and fourth wave of a population-based prospective cohort study of 2230 adolescents conducted between 2001 and 2010 (mean ages: 11.1, 16.3, and 19.1, respectively). Alcohol use and abuse were measured at T4 by self-report questionnaires and by the Composite International Diagnostics Interview (CIDI), respectively. Peer alcohol use, self-control, and parents' perception of their adolescent child's friends were measured at T3. We adjusted for gender, age, socioeconomic-status, parental alcohol use, and adolescent baseline alcohol use. Peer alcohol use during adolescence was related to young adults' alcohol use and abuse [odds ratio (95% confidence interval): 1.31 (1.11-1.54) and 1.50 (1.20-1.87), respectively]. Neither parents' perception of their adolescent child's friends nor self-control modified this relationship. Alcohol abusers were more likely to have low self-control than alcohol users. No differences were found between alcohol users and abusers regarding their parents' perception of their friends and peer alcohol use. Peer alcohol use during adolescence affects young adults' alcohol use and abuse. We found that self-control was only related to alcohol abuse. Peer influence was not modified by parents' perception of peers or by self-control. Peer alcohol use and self-control should thus be separate targets in the prevention of alcohol use/abuse. © 2013.

The relationship between childhood sexual abuse and alcohol abuse in women--a case-control study.

PubMed

Fleming, J; Mullen, P E; Sibthorpe, B; Attewell, R; Bammer, G

1998-12-01

The aim of this paper was to examine the association between reporting childhood sexual abuse (CSA) and alcohol abuse in a community sample of women using multivariate analysis which took into account a range of potential confounding variables (such as a family history of alcoholism) and effect modifiers (such as having an alcoholic partner). A two-stage retrospective case-control study was used to investigate the relationship between reporting CSA and alcohol abuse in women. Seven hundred and ten women randomly selected from the Australian federal electoral rolls. The Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol abuse. A series of questions based on those developed by Wyatt (1985) were used to ascertain the prevalence of CSA. The final model showed that the relationship between a history of CSA and alcohol abuse reflected a complex interaction between CSA and a range of other factors in a woman's background. CSA was not by itself a significant predictor of alcohol abuse (OR = 0.61; 95% CI = 0.31-1.20). However, a history of CSA became significant in combination with co-factors which included: having a mother who was perceived as cold and uncaring; having an alcoholic partner; and believing that alcohol is a sexual disinhibitor. This study indicates that CSA alone is not a causative factor in the development of alcohol abuse among women and highlights the importance of examining the family background of women with alcohol problems.

Childhood risk factors for alcohol abuse and psychological distress among adult lesbians.

PubMed

Hughes, Tonda L; Johnson, Timothy P; Wilsnack, Sharon C; Szalacha, Laura A

2007-07-01

This study examined the relationships between childhood and family background variables, including sexual and physical abuse, and subsequent alcohol abuse and psychological distress in adult lesbians. Structural equation modeling was used to evaluate relationships between childhood sexual and physical abuse and parenting variables and latent measures of lifetime alcohol abuse and psychological distress in a large community-based sample of lesbians. Childhood sexual abuse (CSA) directly predicted lifetime alcohol abuse, and childhood physical abuse (CPA) directly predicted lifetime psychological distress. In addition, CSA indirectly increased the risk of lifetime alcohol abuse through its negative effect on age at first heterosexual intercourse. Childhood physical abuse had only indirect effects on lifetime alcohol abuse through its strong relationship to lifetime psychological distress. Parental drinking problems and parental strictness directly predicted lifetime psychological distress; parental drinking problems indirectly predicted lifetime alcohol abuse through the mediators of age of drinking onset and lifetime psychological distress. White lesbians, younger lesbians, and those with lower levels of education were at greatest risk of psychological distress. While the cross-sectional design precludes causal conclusions, study findings--especially those related to CSA--are consistent with previous research on predominantly heterosexual women in the general population. Lesbians who experienced CSA were at heightened risk of lifetime alcohol abuse and those who experienced CPA were at heightened risk of lifetime psychological distress relative to lesbians without abuse histories. Given the dearth of research on childhood abuse and sexual orientation, studies are needed that examine the similarities and differences between lesbians' and heterosexual women's experiences of, and responses to, childhood abuse.

Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010.

PubMed

Jones, Christopher M; Paulozzi, Leonard J; Mack, Karin A

2014-10-10

The abuse of prescription drugs has led to a significant increase in emergency department (ED) visits and drug-related deaths over the past decade. Opioid pain relievers (OPRs) and benzodiazepines are the prescription drugs most commonly involved in these events. Excessive alcohol consumption also accounts for a significant health burden and is common among groups that report high rates of prescription drug abuse. When taken with OPRs or benzodiazepines, alcohol increases central nervous system depression and the risk for overdose. Data describing alcohol involvement in OPR or benzodiazepine abuse are limited. To quantify alcohol involvement in OPR and benzodiazepine abuse and drug-related deaths and to inform prevention efforts, the Food and Drug Administration (FDA) and CDC analyzed 2010 data for drug abuse-related ED visits in the United States and drug-related deaths that involved OPRs and alcohol or benzodiazepines and alcohol in 13 states. The analyses showed alcohol was involved in 18.5% of OPR and 27.2% of benzodiazepine drug abuse-related ED visits and 22.1% of OPR and 21.4% of benzodiazepine drug-related deaths. These findings indicate that alcohol plays a significant role in OPR and benzodiazepine abuse. Interventions to reduce the abuse of alcohol and these drugs alone and in combination are needed.

75 FR 42756 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-03-25

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcoholism Initial Review Group; Neuroscience Review Subcommittee. Date: June 9-10, 2011. Time: 8:30 a.m. to..., Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health...

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2011-03-22

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2010-07-21

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2010-10-20

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76 FR 59709 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-09-27

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Special Emphasis Panel, NIAAA Member Conflict Application Review. Date: October 26...: Richard A Rippe, PhD, Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism, 5635...

75 FR 10807 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-03-09

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism, Special Emphasis Panel, Member Conflicts SEP. Date: April 22, 2010. Time: 12 p.m. to 2... Alcohol Abuse and Alcoholism, Office of Extramural Activities, Extramural Project Review Branch, 5635...

Morphine affects HIV-induced inflammatory response without influencing viral replication in human monocyte-derived macrophages

PubMed Central

Dave, Rajnish S.

2011-01-01

Opiate-abusing individuals are in the top three risk-factor groups for HIV infection. In fact, almost 30% of HIV-infected individuals in the USA are reported to abuse opiates, highlighting the intersection of drugs of abuse with HIV/AIDS. Opiate-abusers are cognitively impaired and suffer from neurological dysfunctions that may lead to high-risk sexual behavior, poor adherence to antiretroviral regimens, and hepatitis-C virus infection. Collectively, these factors may contribute to accelerated HIV CNS disease progression. To understand the role of morphine in disease progression, we sought to determine whether morphine influences HIV-induced inflammation or viral replication in human monocyte-derived macrophages (h-mdms) and MAGI cells infected with HIV and exposed to morphine. Chronic morphine exposure of HIV-infected h-mdms led to significant alterations in secretion of IL-6 and MCP-2. Morphine enhanced IL-6 secretion and blunted MCP-2 secretion from HIV-infected h-mdms. However, exposure of HIV-infected h-mdms to morphine had no effect on TNF-α secretion. Morphine had no effect on later-stages of viral replication in HIV-infected h-mdms. Morphine had a potentially additive effect on the HIV-induced production of IL-6 and delayed HIV-induced MCP-2 production. These results suggest that in HIV-infected opiate abusers enhanced CNS inflammation might result even when HIV disease is controlled. PMID:22066570

Geriatric Alcoholism and Drug Abuse

ERIC Educational Resources Information Center

Schuckit, Marc A.

1977-01-01

This paper reviews the literature and presents new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates, inadvertent misusers, and deliberate abusers of nonopiates. Two to 10 percent of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. (Author)

42 CFR 2.22 - Notice to patients of Federal confidentiality requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.22... alcohol and drug abuse patient records. (d) Sample notice. Confidentiality of Alcohol and Drug Abuse Patient Records The confidentiality of alcohol and drug abuse patient records maintained by this program...

42 CFR 2.22 - Notice to patients of Federal confidentiality requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.22... alcohol and drug abuse patient records. (d) Sample notice. Confidentiality of Alcohol and Drug Abuse Patient Records The confidentiality of alcohol and drug abuse patient records maintained by this program...

42 CFR 2.22 - Notice to patients of Federal confidentiality requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.22... alcohol and drug abuse patient records. (d) Sample notice. Confidentiality of Alcohol and Drug Abuse Patient Records The confidentiality of alcohol and drug abuse patient records maintained by this program...

42 CFR 2.22 - Notice to patients of Federal confidentiality requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.22... alcohol and drug abuse patient records. (d) Sample notice. Confidentiality of Alcohol and Drug Abuse Patient Records The confidentiality of alcohol and drug abuse patient records maintained by this program...

42 CFR 2.22 - Notice to patients of Federal confidentiality requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.22... alcohol and drug abuse patient records. (d) Sample notice. Confidentiality of Alcohol and Drug Abuse Patient Records The confidentiality of alcohol and drug abuse patient records maintained by this program...

The cost-effectiveness of rapid HIV testing in substance abuse treatment: results of a randomized trial.

PubMed

Schackman, Bruce R; Metsch, Lisa R; Colfax, Grant N; Leff, Jared A; Wong, Angela; Scott, Callie A; Feaster, Daniel J; Gooden, Lauren; Matheson, Tim; Haynes, Louise F; Paltiel, A David; Walensky, Rochelle P

2013-02-01

The President's National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk-reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost-Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Cost-effectiveness of Rapid HIV Testing in Substance Abuse Treatment: Results of a Randomized Trial*

PubMed Central

Schackman, Bruce R.; Metsch, Lisa R.; Colfax, Grant N.; Leff, Jared A.; Wong, Angela; Scott, Callie A.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Haynes, Louise F.; Paltiel, A. David; Walensky, Rochelle P.

2012-01-01

BACKGROUND The President’s National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. METHODS We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. RESULTS Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. CONCLUSIONS A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. PMID:22971593

77 FR 72873 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-12-06

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77 FR 22795 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-04-17

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78 FR 10185 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2013-02-13

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78 FR 17680 - National Institute on Alcohol Abuse and Alcoholism; Closed Meeting

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2013-03-22

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75 FR 10291 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-03-05

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77 FR 52337 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meetings

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2012-08-29

... Alcohol Abuse and Alcoholism; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group Clinical, Treatment and Health Services Research Review... Abuse & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 2019, Rockville, MD 20852, 301...

76 FR 78014 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-12-15

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group, Epidemiology, Prevention and Behavior Research Review... Abuse & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 3037, Rockville, MD 20852...

75 FR 36660 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-06-28

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77 FR 61769 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-10-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcohol Abuse and Alcoholism Special Emphasis Panel; NIIAAA Member Conflict Applications: Epidemiology...

Alcohol and condom use among HIV-positive and HIV-negative female sex workers in Nagaland, India.

PubMed

Nuken, Amenla; Kermode, Michelle; Saggurti, Niranjan; Armstrong, Greg; Medhi, Gajendra Kumar

2013-09-01

This study examines the relationship between alcohol use, HIV status, and condom use among female sex workers in Nagaland, India. We analyzed data from a cross-sectional survey undertaken in 2009, using descriptive and multivariate statistics. Out of 417 female sex workers, one-fifth used alcohol daily and one-tenth were HIV-positive. HIV-positive female sex workers were more likely than HIV-negative female sex workers to consume alcohol daily (30.2% vs. 18.0%). HIV-positive daily alcohol users reported lower condom use at last sex with regular clients compared to HIV-positive non-daily alcohol users (46.2% vs. 79.3%), a relationship not evident among HIV-negative female sex workers. There is a need to promote awareness of synergies between alcohol use and HIV, and to screen for problematic alcohol use among female sex workers in order to reduce the spread of HIV.

75 FR 8726 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-02-25

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcohol Abuse and Alcoholism Special Emphasis Panel, Review of Applications on Case Ascertainment to Estimate the U.S. Prevalence of Fetal Alcohol Spectrum Disorders in Young Children (U01), RFA AA-10-005...

75 FR 38533 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-07-02

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Special Emphasis Panel ZAA1 HH01--AA3 Member Conflicts. Date: July 30, 2010. Time: 11 a... Review Officer, National Institute on Alcohol Abuse and Alcoholism, Office of Extramural Activities...

77 FR 43603 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-07-25

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Special Emphasis Panel. Date: September 25, 2012. Time: 8:00 a.m. to 6:00 p.m. Agenda... Officer, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers...

76 FR 50743 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-08-16

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Special Emphasis Panel, P01 Application Reviews. Date: October 5, 2011. Time: 1 p.m. to..., Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Room 2109...

75 FR 71711 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2010-11-24

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcoholism Special Emphasis Panel NIAAA--R34 & T32 Reviews. Date: December 17, 2010. Time: 11 a.m. to 1 p.m..., Extramural Project Review Branch, EPRB, National Institute on Alcohol Abuse and Alcoholism, National...

Health risks of alcohol use

MedlinePlus

Alcoholism - risks; Alcohol abuse - risks; Alcohol dependence - risks; Risky drinking ... pubmed/23698791 . National Institute on Alcohol Abuse and Alcoholism website. Alcohol use disorder. www.niaaa.nih.gov/ ...

Assessing the relationship between child sexual abuse and marginal living conditions on HIV/AIDS-related risk behavior among women prisoners.

PubMed

Mullings, J L; Marquart, J W; Brewer, V E

2000-05-01

There were two aims in this research. First, to examine the relationships between childhood sexual abuse and HIV drug and sexual risk taking behaviors among female prisoners, and second, to examine the relationship between a marginal adult living context and HIV drug and sexual risk taking behavior among female prisoners. The data were collected through face-to-face interviews with a random sample of 500 women at admission to prison in 1994. Differences between women who were sexually abused while growing up (n = 130) were compared to women who reported no sexual abuse (n = 370) along various demographic, and HIV drug and sexual risk taking dimensions. A history of sexual abuse while growing up was associated with increased sexual risk taking behaviors in adulthood. A marginal adult living situation also emerged as an important factor increasing the risk for HIV infection. Examining the co-occurrence of both childhood sexual abuse and adult marginal living context revealed a strong relationship between these two factors and HIV risk taking activities. The findings indicate that childhood sexual abuse may be a predictor for HIV sexual risk taking behaviors among incarcerated women. The marginal and chaotic adult living style of these women was also associated the extent of their HIV drug and sexual risk taking behaviors. Our research suggests that the co-occurrence of sexual victimization and marginality is a stronger predictor of HIV risk than each variable alone.

Mobile outreach strategies for screening hepatitis and HIV in high-risk populations.

PubMed

Zucker, Donna M; Choi, Jeungok; Gallagher, Emily R

2012-01-01

To screen, counsel and offer hepatitis A and B vaccination for subjects at high risk for hepatitis C virus (HCV) and HIV, and determine any relationship between risk factors and HCV positivity. A descriptive correlational design. We correlated risk factors and HCV positivity and measured vaccination completion rates. Two hundred and two unduplicated subjects in 4 locations in Western Massachusetts: a walk in substance abuse clinic, a homeless shelter, a county jail, and a community corrections facility. Demographic data and a standard HCV risk- screening survey were used. Significantly higher rates of HCV were found in subjects who were currently using injection drugs (83.3% HCV positive, χ2(1) = 20.85, p<.001), who had a history of sharing needles for drug use (75% HCV positive χ(2) (1)=83.20, p<.001), or a history of receiving treatment for drug abuse/alcoholism (38.4% HCV positive χ2(1) = 12.14, p<.001). Vaccination completion ranged by setting between 18% and 38%. Targeted outreach to hard to reach groups is effective in providing access for those at high risk for HIV and HCV infection. A mobile outreach strategy can focus needed resources for a variety of groups in a community. © 2011 Wiley Periodicals, Inc.

Racial and Ethnic Differences in Substance Use Diagnoses, Comorbid Psychiatric Disorders, and Treatment Initiation among HIV-Positive and HIV-Negative Women in an Integrated Health Plan.

PubMed

Storholm, Erik David; Silverberg, Michael J; Satre, Derek D

2016-01-01

Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a diverse sample of HIV-positive women (n = 228) and a demographically similar cohort of HIV-negative women (n = 693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northern California. HIV-positive women were less likely to initiate SUD treatment. Significant racial/ethnic differences were found among both HIV-positive and HIV-negative women with respect to SUD diagnosis type and diagnosis of comorbid psychiatric disorders. Among the HIV-negative women, rates of SUD treatment initiation were lower for black women than for white or Latina women. Multivariable logistic regression models showed that alcohol, cannabis, and opiate diagnoses were predictive of SUD treatment initiation for both cohorts, while amphetamine diagnoses, comorbid depressive disorder, and being white or Latina were predictive of SUD treatment initiation for HIV-negative, but not HIV-positive, women. Findings suggest that clinicians need to be aware of differences in substances of abuse, comorbid psychiatric disorders, and to consider the demographic and social factors that may contribute to differences in SUD treatment initiation among HIV-positive and HIV-negative women.

Examining the Role of Psychological Distress in Linking Childhood Maltreatment and Alcohol Use in Young Adulthood

PubMed Central

Shin, Sunny H.; Hassamal, Sameer; Groves, Lauren Peasley

2017-01-01

Background and Objectives Childhood maltreatment is related to alcohol use as well as psychological distress in young adulthood. Few studies have examined whether psychological distress mediates the relationship between child maltreatment and alcohol use. We examined the role of psychological distress in linking child maltreatment subtypes (ie, emotional abuse, physical abuse, sexual abuse, neglect) to four patterns of alcohol use, including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol dependence. Methods We used a community sample of young adults (N=337), who completed an interview assessing exposure to childhood maltreatment, current psychological distress, and drinking behaviors. Results Emotional abuse was associated with psychological distress, whereas psychological distress was related to more pathological drinking behaviors such as alcohol-related problems and alcohol dependence. Subsequent analyses indicated significant mediated effects between emotional abuse and alcohol-related problems and alcohol dependence via psychological distress, even after controlling for demographic factors, other maltreatment subtypes, parental alcoholism, and peer alcohol use. Conclusions and Scientific Significance Findings suggest that among four types of childhood maltreatment, emotional abuse might be the major driver of pathological drinking among child maltreatment victims. Interventions aimed at negative emotionality may be useful in preventing and treating problematic drinking among the victims of childhood emotional abuse. PMID:26346173

Commentary: Ethical Considerations in Testing Victims of Sexual Abuse for HIV Infection.

ERIC Educational Resources Information Center

Fost, Norman

1990-01-01

Ethical issues in screening of victims of sexual abuse for infection with the human immunodeficiency virus (HIV) are raised in response to Gellert (EC 222 881). It is concluded that widescale HIV testing of child victims of sexual abuse is not justified by the available information. (DB)

Paternal and maternal alcohol abuse and offspring mental distress in the general population: the Nord-Trøndelag health study

PubMed Central

2012-01-01

Background The degree to which parental alcohol abuse is a risk factor for offspring mental distress is unclear, due to conflicting results of previous research. The inconsistencies in previous findings may be related to sample characteristics and lack of control of confounding or moderating factors. One such factor may be the gender of the abusing parent. Also, other factors, such as parental mental health, divorce, adolescent social network, school functioning or self-esteem, may impact the outcome. This study examines the impact of maternal and paternal alcohol abuse on adolescent mental distress, including potentially confounding, mediating or moderating effects of various variables. Methods Data from the Nord-Trøndelag Health Study (HUNT), a Norwegian population based health survey, from 4012 offspring and their parents were analyzed. Parental alcohol abuse was measured by numerical consumption indicators and CAGE, whereas offspring mental distress was measured by SCL-5, an abbreviated instrument tapping symptoms of anxiety and depression. Statistical method was analysis of variance. Results Maternal alcohol abuse was related to offspring mental distress, whereas no effect could be shown of paternal alcohol abuse. Effects of maternal alcohol abuse was partly mediated by parental mental distress, offspring social network and school functioning. However, all effects were relatively small. Conclusions The results indicate graver consequences for offspring of alcohol abusing mothers compared to offspring of alcohol abusing fathers. However, small effect sizes suggest that adolescent offspring of alcohol abusing parents in general manage quite well. PMID:22708789

76 FR 44597 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-07-26

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... the review and funding cycle. (Catalogue of Federal Domestic Assistance Program Nos. 93.271, Alcohol...

77 FR 39713 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meetings

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2012-07-05

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75 FR 62553 - National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting

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2010-10-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Institute on Alcohol Abuse and Alcoholism Special Emphasis Panel, November 3, 2010, 2...

77 FR 39716 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2012-07-05

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse... Assistance Program Nos. 93.271, Alcohol Research Career Development Awards for Scientists and Clinicians; 93...

78 FR 63484 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2013-10-24

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76 FR 22715 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

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2011-04-22

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group; Biomedical Research Review Subcommittee. Date: June 14-15, 2011... Abuse and Alcoholism, 5635 Fishers Lane, RM 2019, Bethesda, MD 20892, 301-443-2861, [email protected

77 FR 14023 - National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting

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2012-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Institute on Alcohol Abuse and Alcoholism Special Emphasis Panel, March 28, 2012, 4 p...

76 FR 69746 - National Institute On Alcohol Abuse And Alcoholism; Notice of Closed Meeting

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2011-11-09

... Alcohol Abuse And Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group, Biomedical Research Review Subcommittee. Date: March 13, 2012... Abuse And Alcoholism, 5635 Fishers Lane, Rm 2019, Bethesda, MD 20892, (301) 443-2861, [email protected

Alcohol dependence and domestic violence as sequelae of abuse and conduct disorder in childhood.

PubMed

Kunitz, S J; Levy, J E; McCloskey, J; Gabriel, K R

1998-11-01

To examine in the Navajo population: (1) the importance of childhood abuse as a risk factor for conduct disorder; (2) the importance of each form of abuse and conduct disorder as risk factors for alcohol dependence; and (3) the relative importance of each form of abuse, conduct disorder, and alcohol dependence as risk factors for being a perpetrator and/or victim of domestic violence. The study is based on a case-control design. Cases (204 men and 148 women) between the ages of 21 and 65 were interviewed in alcohol treatment program and matched to community controls. There were two groups of controls: alcohol dependent (374 men, 60 women) and nonalcohol dependent (157 men, 143 women). When adjusted for stratification by age, community of residence, and sex, the combined control groups comprise a representative sample of the Navajo male and female population 21-65 years of age. The prevalence of physical and sexual abuse before age 15 is within limits observed in other populations. Each form of abuse is a risk factor for conduct disorder. Along with conduct disorder, physical abuse is a risk factor for alcohol dependence. Physical abuse and alcohol dependence are independent risk factors for being involved in domestic violence as both perpetrator and victim. There appears to have been no secular trend in the incidence of childhood abuse over the past several generations, but there is suggestive evidence that domestic violence has become more common. Physical abuse is a significant risk factor for alcohol dependence as well as for domestic violence independent of the effects of alcohol abuse. The effects of sexual abuse with regard to both domestic violence and alcohol dependence do not appear to be significant.

Addiction research centres and the nurturing of creativity: The Alcohol & Drug Abuse Research Unit at the South African Medical Research Council - strengthening substance abuse research and policy in South Africa.

PubMed

Parry, Charles; Morojele, Neo; Myers, Bronwyn; Plüddemann, Andreas

2013-01-01

The Alcohol and Drug Abuse Research Unit (ADARU) was established at the South African Medical Research Council (MRC) at the beginning of 2001, although its origins lie in the activities of the Centre for Epidemiological Research in Southern Africa and other MRC entities. Initial challenges included attracting external funding, recruiting new staff, developing the skills of junior staff, publishing in international journals and building national and international collaborative networks. ADARU currently comprises a core staff of 33 members who work on 22 projects spanning substance use epidemiology and associated consequences, intervention studies with at-risk populations and services research. A large component of this portfolio focuses on the link between alcohol and other drug use and human immunodeficiency virus (HIV) risk behaviour, with funding from the US Centers for Disease Control and Prevention. Junior staff members are encouraged to develop independent research interests and pursue PhD studies. Research outputs, such as the 20 papers that were published in 2010 and the 35 conference presentations from that year, form an important part of the unit's research translation activities. We engage actively with policy processes at the local, provincial, national and international levels, and have given particular attention to alcohol policy in recent years. The paper includes an analysis of major challenges currently facing the unit and how we are attempting to address them. It ends with some thoughts on what the unit intends doing to enhance the quality of its research, the capacity of its staff and its international standing. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Experience of sexual violence among women in HIV discordant unions after voluntary HIV counselling and testing

PubMed Central

Emusu, Donath; Ivankova, Nataliya; Jolly, Pauline; Kirby, Russell; Foushee, Herman; Wabwire-Mangen, Fred; Katongole, Drake; Ehiri, John

2009-01-01

HIV-serodiscordant relationships are those in which one partner is infected with HIV while the other is not. We investigated experiences of sexual violence among women in HIV discordant unions attending HIV post-test club services in Uganda. A volunteer sample of 26 women from three AIDS Information Centres in Uganda who reported having experienced sexual violence in a larger epidemiological study were interviewed, using the qualitative critical incident technique. Data were analysed using TEXTPACK, a software application for computer-assisted content analysis. Incidents of sexual violence narrated by the women included use of physical force and verbal threats. Overall, four themes that characterise the women’s experience of sexual violence emerged from the analysis: knowledge of HIV test results, prevalence of sexual violence, vulnerability and proprietary views and reactions to sexual violence. Alcohol abuse by the male partners was an important factor in the experience of sexual violence among the women. Their experiences evoked different reactions and feelings, including concern over the need to have children, fear of infection, desire to separate from their spouses/partners, helplessness, anger and suicidal tendencies. HIV counselling and testing centres should be supported with the capacity to address issues related to sexual violence for couples who are HIV discordant. PMID:20024712

Recent and Past Intimate Partner Abuse and HIV Risk Among Young Women

PubMed Central

Teitelman, Anne M.; Ratcliffe, Sarah J.; Dichter, Melissa E.; Sullivan, Cris M.

2011-01-01

Objective To examine the associations between past intimate partner abuse experienced during adolescence (verbal and physical), recent intimate partner abuse (verbal, physical, and sexual), and HIV risk (as indicated by lack of condom use) for sexually active young adult women in relationships with male partners. Design Secondary data analysis of waves II and III of the National Longitudinal Study of Adolescent Health (Add Health). Setting The Add Health Study is a longitudinal, in-home survey of a nationally representative sample of adolescents. Sample Analyses involved 2,058 sexually active young adult women. Main Outcome Measures HIV risk was measured by consistent condom use over the past 12 months. Results Physical and verbal abuse experienced in adolescence were associated with physical/verbal abuse experienced in young adulthood. Young, sexually active women experiencing no abuse in their relationships were more likely to consistently use condoms in the past 12 months than were their abused counterparts. Conclusion A causal pathway may exist between prior abuse, current abuse, and HIV risk. PMID:18336447

Tooth Decay in Alcohol Abusers Compared to Alcohol and Drug Abusers

PubMed Central

Dasanayake, Ananda P.; Warnakulasuriya, Saman; Harris, Colin K.; Cooper, Derek J.; Peters, Timothy J.; Gelbier, Stanley

2010-01-01

Alcohol and drug abuse are detrimental to general and oral health. Though we know the effects of these harmful habits on oral mucosa, their independent and combined effect on the dental caries experience is unknown and worthy of investigation. We compared 363 “alcohol only” abusers to 300 “alcohol and drug” abusers to test the hypothesis that various components of their dental caries experience are significantly different due to plausible sociobiological explanations. After controlling for the potential confounders, we observe that the “alcohol and drug” group had a 38% higher risk of having decayed teeth compared to the “alcohol only” group (P < .05). As expected, those who belonged to a higher social class (OR = 1.98; 95%  CI = 1.43–2.75) and drank wine (OR = 1.85; 95%  CI = 1.16–2.96) had a higher risk of having more filled teeth. We conclude that the risk of tooth decay among “alcohol only” abusers is significantly lower compared to “alcohol and drug” abusers. PMID:20379366

Alcohol abuse as a risk factor for and consequence of child abuse.

PubMed

Widom, C S; Hiller-Sturmhöfel, S

2001-01-01

The relationship between child abuse and the use or abuse of alcohol has two aspects. First, some findings have indicated that parental alcohol abuse may be associated with the physical or sexual abuse of children. Research findings in this area remain inconsistent, however. Second, the experience of being abused as a child may increase a person's risk for alcohol-related problems as an adult. This relationship has best been demonstrated in women who had been victims of childhood abuse. Several factors most likely contribute to or influence this relationship, including coping skills; antisocial behavior; and psychological problems, such as posttraumatic stress disorder.

Mujeres que Consumen Sustancias y su Vulnerabilidad frente al VIH en Santiago de Chile

PubMed Central

Irarrázabal, Lisette P.; Ferrer, Lilian; Villegas, Natalia; Sanhueza, Sebastián; Molina, Yerko; Cianelli, Rosina

2017-01-01

Introduction Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. Methodology A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. Results The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation (p < 0.05) between substance abuse and HIV risk behaviors. Conclusion It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community. PMID:27257222

Correlates of Sex Trading among Drug-Involved Women in Committed Intimate Relationships: A Risk Profile.

PubMed

Jiwatram-Negrón, Tina; El-Bassel, Nabila

2015-01-01

Despite a slight decline in new human immunodeficiency virus (HIV) infections in New York, marked increases and concentrated epidemics continue among subsets of the population, including women engaged in sex trading. We examined the prevalence and correlates of sex trading among 346 low-income, HIV-negative women in HIV-concordant intimate relationships. Women and their long-term main partners were recruited to participate in an HIV prevention intervention. Baseline data were used in this article. Of the 346 women in the study, 28% reported sex trading during the prior 90 days. Multivariate analyses showed increased relative risk of sex trading by lifetime experience of severe intimate partner violence (IPV), drug, and alcohol use, and marginal significance for mental health hospitalization, partner drug dependency, and homelessness. These findings suggest an urgent need for HIV prevention and intervention efforts targeted toward women in intimate relationships who trade sex for money or drugs, with an emphasis on IPV, mental health, history of incarceration, and substance abuse. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Harm reduction for drug abusing ex-offenders: outcome of the California prevention and education project MORE project.

PubMed

Bowser, Benjamin P; Jenkins-Barnes, Tazima; Dillard-Smith, Carla; Lockett, Gloria

2010-01-01

MORE was a mobile outreach drug abuse prevention and HIV harm reduction program primarily for ex-offenders who are active drug users. Through case management, clients were provided substance abuse education, counseling, and referral. Long term goals of these services were to reduce their drug use and re-incarceration for drug related crimes. From January 2002 to May 2006, 487 unduplicated clients were recruited in year long cohorts and offered services. The program evaluation tool was the Federal Office of Budget and Management Government Performance and Results Act questionnaire. Government Performance and Results Act interviews were conducted at in-take into the program, approximately six months later and again approximately 12 months after their initial in-take. By the six and 12 month follow-up interviews, active drug using clients reported significant reductions in their use of alcohol, cocaine/crack, heroin, and fewer sex partners and crimes. Program completers reported significantly reduced cocaine/crack and heroin use as well as fewer days in jail and crimes than non-completers (p < .01 to .001). Six program components account for these reductions: case management, day-treatment, outpatient services, outreach, HIV/AIDS, and substance abuse education. The differences in program service intensity, income, and employment for program completers and non-completers were analyzed using logistic regression. The intensity of case management and all services received along with having higher income by month six were the most significant predictors of program completion.

Abuse and Resilience in Relation to HAART Medication Adherence and HIV Viral Load Among Women with HIV in the United States

PubMed Central

Cohen, Mardge; Weber, Kathleen; Cruise, Ruth; Kelso, Gwendolyn

2014-01-01

Abstract Abuse is highly prevalent among HIV+ women, leading to behaviors, including lower adherence to highly active antiretroviral therapy (HAART) that result in poor health outcomes. Resilience (functioning competently despite adversity) may buffer the negative effects of abuse. This study investigated how resilience interacted with abuse history in relation to HAART adherence, HIV viral load (VL), and CD4+ cell count among a convenience sample of 138 HIV+ women from the Ruth M. Rothstein CORE Center/Cook County Health and Hospital Systems site of the Women's Interagency HIV Study (WIHS). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HAART adherence (≥95% vs. <95% self reported usage of prescribed medication) and current or prior sexual, physical, or emotional/domestic abuse, were reported during structured interviews. HIV viral load (≥20 vs. <20 copies/mL) and CD4+ count (200 vs. <200 cells/mm) were measured with blood specimens. Multiple logistic regressions, controlling for age, race, income, enrollment wave, substance use, and depressive symptoms, indicated that each unit increase in resilience was significantly associated with an increase in the odds of having ≥95% HAART adherence and a decrease in the odds of having a detectable viral load. Resilience-Abuse interactions showed that only among HIV+ women with sexual abuse or multiple abuses did resilience significantly relate to an increase in the odds of ≥95% HAART adherence. Interventions to improve coping strategies that promote resilience among HIV+ women may be beneficial for achieving higher HAART adherence and viral suppression. PMID:24568654

Preventing Alcohol Abuse in the Greek System on a Commuter Campus: Prevention Contracts.

ERIC Educational Resources Information Center

Hunnicutt, David M.; And Others

1991-01-01

Provides an overview of alcohol use and abuse on the college campus. Discusses theory behind alcohol abuse prevention contracts. Presents an example of how to use contracts to address alcohol abuse in a commuter university Greek system. Concludes solving the problems associated with college students' drinking is now more critical than ever.…

HIV Stigma and Unhealthy Alcohol Use Among People Living with HIV in Russia

PubMed Central

Lioznov, Dmitry; Cheng, Debbie M.; Nikitin, Ruslan V.; Coleman, Sharon M.; Bridden, Carly; Blokhina, Elena; Krupitsky, Evgeny; Samet, Jeffrey H.

2017-01-01

Unhealthy alcohol use, highly prevalent in the Russian Federation (Russia), is associated with HIV risk behaviors among people living with HIV (PLWH). HIV stigma contributes to the HIV risk environment in Russia. To examine HIV stigma among Russian PLWH and to explore its association with unhealthy alcohol use, we conducted a longitudinal analysis of 700 PLWH in St. Petersburg, Russia. We assessed the association between alcohol dependence and HIV stigma measured at baseline and 12 months follow-up. Participants with alcohol dependence (n = 446) reported significantly higher HIV stigma scores over time than those without dependence (n = 254) (adjusted mean difference 0.60, 95% CI 0.03–1.17; p = 0.04). In secondary analyses, we examined recent risky alcohol use and did not detect an association with HIV stigma. Alcohol dependence is associated with high HIV stigma among Russian PLWH but the nature of the association is conjectural. HIV prevention efforts in Russia that address alcohol use disorders hold potential to mitigate HIV-related stigma and its possible adverse effects among PLWH. PMID:28600603

HIV Stigma and Unhealthy Alcohol Use Among People Living with HIV in Russia.

PubMed

Lunze, Karsten; Lioznov, Dmitry; Cheng, Debbie M; Nikitin, Ruslan V; Coleman, Sharon M; Bridden, Carly; Blokhina, Elena; Krupitsky, Evgeny; Samet, Jeffrey H

2017-09-01

Unhealthy alcohol use, highly prevalent in the Russian Federation (Russia), is associated with HIV risk behaviors among people living with HIV (PLWH). HIV stigma contributes to the HIV risk environment in Russia. To examine HIV stigma among Russian PLWH and to explore its association with unhealthy alcohol use, we conducted a longitudinal analysis of 700 PLWH in St. Petersburg, Russia. We assessed the association between alcohol dependence and HIV stigma measured at baseline and 12 months follow-up. Participants with alcohol dependence (n = 446) reported significantly higher HIV stigma scores over time than those without dependence (n = 254) (adjusted mean difference 0.60, 95% CI 0.03-1.17; p = 0.04). In secondary analyses, we examined recent risky alcohol use and did not detect an association with HIV stigma. Alcohol dependence is associated with high HIV stigma among Russian PLWH but the nature of the association is conjectural. HIV prevention efforts in Russia that address alcohol use disorders hold potential to mitigate HIV-related stigma and its possible adverse effects among PLWH.

76 FR 51378 - National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting Notice is hereby given of a meeting of the National Advisory Council on Alcohol Abuse and Alcoholism, September 12, 2011, 3:30 p.m. to 5:30 p.m...

Facts on Mentally Ill Chemical Abusers. Clearinghouse Fact Sheet.

ERIC Educational Resources Information Center

Fiorentino, Nancy; Reilly, Phyllis

Individuals are considered mentally ill chemical abusers (MICAs) when they exhibit psychotic behaviors and are actively abusing alcohol and/or drugs; are actively psychotic with a history of alcohol or drug abuse; and/or are actively abusing alcohol or other drugs and have a history of severe psychiatric diagnoses. Although some practitioners use…

77 FR 70171 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute on Alcohol Abuse...: Katrina L Foster, Ph.D., Scientific Review Officer, National Institute [[Page 70172

Gender and HIV infection in the context of alcoholism in Kenya.

PubMed

Muturi, Nancy

2015-01-01

Women in sub-Saharan Africa account for more than half (58%) of people living with the HIV and it is the only continent where HIV prevalence is higher for women than for men. Studies have attributed alcoholism with the high rates of HIV infection due to its impact on sexual behaviour and arousal. African countries with high rates of alcoholism also reportedly have higher rates of HIV infection. This study explores rural communities' perspectives on the risk factors for HIV infection among women who are in alcohol discordant relationships where the man drinks alcohol excessively. Data were gathered through focus group discussions in rural central Kenya where alcoholism has reached epidemic levels. Key findings indicate the perceived severity of alcoholism, the perceived impact of alcoholism on men's reproductive health and the unmet sexual and reproductive needs of women in alcohol discordant relationships. Women engage in risky sexual behaviours in an attempt to meet these needs. Such risky behaviour in addition to alcohol-related sexual violence and low response-efficacy for safer sexual practices make them vulnerable to HIV infection and enhances the spread of HIV within communities. The study concludes that in preventing HIV infection among women in alcohol communities affected by alcohol, it is important to focus on their response efficacy. Intervention programmes that focus on HIV prevention among older married women and that integrate alcohol and HIV prevention are long overdue.

Socio-economic status and problem alcohol use: the positive relationship between income and the DSM-IV alcohol abuse diagnosis.

PubMed

Keyes, Katherine M; Hasin, Deborah S

2008-07-01

Epidemiological evidence indicates a positive relationship between income and the prevalence of alcohol abuse in the general population, but an inverse relationship between income and alcohol dependence. Among those with a diagnosis of alcohol abuse, the most prevalent criterion is hazardous use, which commonly requires sufficient resources to own or access a car. The present study investigated whether the association between income and the prevalence of current alcohol abuse is accounted for by the hazardous use criterion; specifically, the drinking and driving symptoms of the hazardous use criterion. Face-to-face survey conducted in the 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions, interviewed with the Alcohol Use Disorders and Associated Disabilities Interview 4th edition (AUDADIS-IV). The United States and District of Columbia, including Alaska and Hawaii. Household and group-quarters residents aged >18 years. Life-time dependence cases were excluded (n = 4781). Income was defined as past-year personal income. Outcomes were specific alcohol abuse criteria and symptom questions. Logistic regressions were performed controlling for demographics. The relationship between alcohol abuse severity indicators and income was modeled using polytomous regression. Findings Among the alcohol abuse criteria, hazardous use is the most prevalent and the only criterion to have a significant positive relationship with income (F = 20.3, df = 3, P < 0.0001). Among the hazardous use symptoms, driving after drinking (F = 13.0, df = 3, P < 0.0001) and driving while drinking (F = 9.2, df = 3, P < 0.0001) were related positively to income. Because hazardous use is the most commonly endorsed criterion of alcohol abuse, the link with income raises questions about whether the current alcohol abuse diagnosis can capture the full range of alcohol abusers in every socio-economic class. While many psychiatric disorders exhibit an inverse relationship with socio-economic status, a selection bias may cause the alcohol abuse diagnosis to have an artificially positive relationship with income due to the necessity for access to a vehicle to be diagnosed.

Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood☆

PubMed Central

Shin, Sunny H.; Lee, Sungkyu; Jeon, Sae-Mi; Wills, Thomas A.

2015-01-01

Childhood emotional abuse has been linked to problematic alcohol use in later life but there is a paucity of empirically based knowledge about the developmental pathways linking emotional abuse and alcohol use in young adulthood. Using a community sample of young individuals aged 18–25 (N = 268; female 52%), we performed structural equation modeling to investigate whether emotional abuse influences alcohol use through urgent personality trait and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD). The present study found that emotional abuse was related to urgency, which in turn influenced four types of alcohol use. Urgency may play a significant role in linking childhood maltreatment to alcohol use in young adulthood. PMID:25743371

Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood.

PubMed

Shin, Sunny H; Lee, Sungkyu; Jeon, Sae-Mi; Wills, Thomas A

2015-12-01

Childhood emotional abuse has been linked to problematic alcohol use in later life but there is a paucity of empirically based knowledge about the developmental pathways linking emotional abuse and alcohol use in young adulthood. Using a community sample of young individuals aged 18-25 (N=268; female 52%), we performed structural equation modeling to investigate whether emotional abuse influences alcohol use through urgent personality trait and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD). The present study found that emotional abuse was related to urgency, which in turn influenced four types of alcohol use. Urgency may play a significant role in linking childhood maltreatment to alcohol use in young adulthood. Copyright © 2015. Published by Elsevier Ltd.

Selective neurocognitive deficits and poor life functioning are associated with significant depressive symptoms in alcoholism-HIV infection comorbidity.

PubMed

Sassoon, Stephanie A; Rosenbloom, Margaret J; Fama, Rosemary; Sullivan, Edith V; Pfefferbaum, Adolf

2012-09-30

Alcoholism, HIV, and depressive symptoms frequently co-occur and are associated with impairment in cognition and life function. We administered the Beck Depression Inventory-II (BDI-II), measures of life function, and neurocognitive tests to 67 alcoholics, 56 HIV+ patients, 63 HIV+ alcoholics, and 64 controls to examine whether current depressive symptom level (significant, BDI-II>14 vs. minimal, BDI-II<14) was associated with poorer cognitive or psychosocial function in alcoholism-HIV comorbidity. Participants with significant depressive symptoms demonstrated slower manual motor speed and poorer visuospatial memory than those with minimal depressive symptoms. HIV patients with depressive symptoms showed impaired manual motor speed. Alcoholics with depressive symptoms showed impaired visuospatial memory. HIV+ alcoholics with depressive symptoms reported the poorest quality of life; alcoholics with depressive symptoms, irrespective of HIV status, had poorest life functioning. Thus, significant depressive symptoms were associated with poorer selective cognitive and life functioning in alcoholism and in HIV infection, even though depressive symptoms had neither synergistic nor additive effects on cognition in alcoholism-HIV comorbidity. The results suggest the relevance of assessing and treating current depressive symptoms to reduce cognitive compromise and functional disability in HIV infection, alcoholism, and their comorbidity. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Economic issues and public alcohol abuse prevention policies in France

PubMed

Spach, Miléna

2016-10-19

Objective: To analyse the impact of the alcohol market on the implementation of strong-willed public alcohol abuse prevention policies based on a critical review of the literature. Method: Documentary research and analysis of the alcohol market economic data were performed. An overview of public alcohol abuse prevention policies was conducted from a historical perspective by distinguishing drunkenness control policies, protection of vulnerable populations, and the fight against drink driving and drinking in the workplace. Results: Public alcohol abuse prevention policies are primarily designed to reduce the harmful consequences of alcohol occurring as a result of a drinking episode (motor vehicle accident, highway accidents, etc.), while neglecting the long-term consequences (cancer, cirrhosis, etc.). Moreover, while taxation is one of the major public health tools used to reduce the costs of alcohol-related damage on society, the State exercises legislative and tax protection for alcoholic beverages produced in France. In particular, wine benefits from a lower tax rate than other stronger forms of alcohol (spirits, liquors, etc.). The economic weight of the alcohol market can provide an explanation for these public alcohol abuse prevention policies. Conclusion: In view of the mortality caused by alcohol abuse, France must implement a proactive public policy. An alcohol taxation policy based on the alcohol content, a minimum unit pricing for alcohol, or higher taxes on alcohol are public policies that could be considered in order to reduce alcohol-related mortality.

Understanding a Need...Alcohol and Other Drug Abuse Prevention for People with Disabilities.

ERIC Educational Resources Information Center

VSA Educational Services, Washington, DC. Resource Center on Substance Abuse Prevention and Disability.

This booklet provides an overview of alcohol and other drug abuse prevention, disability, and the relationship between the two issues. It cites the incidence of alcohol and other drug abuse among people with disabilities. It looks at alcohol and other drug abuse risk factors that are disability related, such as medication use, chronic pain,…

Changing the Culture of Alcohol Abuse on Campus: Lessons Learned from Secondhand Smoke

ERIC Educational Resources Information Center

Misch, Donald A.

2010-01-01

Alcohol abuse is the single greatest public health hazard on American college and university campuses, but the culture of abusive alcohol consumption continues to be highly resistant to change. The author argues that secondhand smoke campaigns can be used as models to change the culture of alcohol abuse on campus. He proposes the implementation of…

Association between alcohol abuse during pregnancy and birth weight.

PubMed

Silva, Ivelissa da; Quevedo, Luciana de Avila; Silva, Ricardo Azevedo da; Oliveira, Sandro Schreiber de; Pinheiro, Ricardo Tavares

2011-10-01

To assess the association between alcohol abuse during gestation and low birth weight. Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p<0.038). The findings indicate that alcohol abuse during pregnancy is associated with low birth weight.

24 CFR 982.553 - Denial of admission and termination of assistance for criminals and alcohol abusers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... that it has reasonable cause to believe that a household member's abuse or pattern of abuse of alcohol... determines that a household member's abuse or pattern of abuse of alcohol may threaten the health, safety, or.... (e) In cases of criminal activity related to domestic violence, dating violence, or stalking, the...

Towards the Prevention of Alcohol Abuse

ERIC Educational Resources Information Center

Facy, FranCoise; Rabaud, Myriam

2006-01-01

Mortality resulting from alcohol abuse in young French people is too high in spite of prevention campaigns for road safety in particular. There are problems in identifying alcohol abuse in young people in preventive medicine or alcohol care services. This study was carried out in alcohol centres; data from patients under 25 are analysed and…

Alcohol abuse and involvement in traffic accidents in the Brazilian population, 2013.

PubMed

Damacena, Giseli Nogueira; Malta, Deborah Carvalho; Boccolini, Cristiano Siqueira; Souza, Paulo Roberto Borges de; Almeida, Wanessa da Silva de; Ribeiro, Lucas Sisinno; Szwarcwald, Célia Landmann

2016-12-01

Abstract This article aims to analyze alcohol abuse and frequent consumption according to sociodemographic characteristics and investigate the risk of greater involvement in traffic accidents, using data from the National Health Survey (PNS), 2013, Brazil. Events investigated were alcohol abuse and frequent consumption and if the individual was involved in a traffic accident and sustained an injury in the last 12 months. We investigated both events according to sociodemographic characteristics and assessed the association among them through multivariate logistic regression. The prevalence of alcohol abuse and frequent consumption was 6.1% for the population aged 18 years and over, 8.9% among men and 3.6% among women. The prevalence of involvement in traffic accidents was 3.1% in the general population and 6.1% among those who reported alcohol abuse. After controlling for sociodemographic factors, alcohol abuse and frequent consumption was significantly associated with traffic accidents. Considering a higher risk of involvement in traffic accidents among individuals who reported alcohol abuse and frequent consumption, monitoring blood alcohol concentration of drivers becomes a strategic possibility of intervention.

Non-consensual sex experienced by men who have sex with men: prevalence and association with mental health.

PubMed

Ratner, Pamela A; Johnson, Joy L; Shoveller, Jean A; Chan, Keith; Martindale, Steve L; Schilder, Arn J; Botnick, Michael R; Hogg, Robert S

2003-01-01

Little is known about the psychosocial factors associated with sexual assault experienced by males. Men (N=358), 19-35 years of age, recruited by community outreach, completed questionnaires. Eligibility criteria included: being HIV-negative and self-identifying as gay or bisexual. Lifetime prevalence rates of childhood sexual abuse, juvenile prostitution, and adult sexual assault were determined. The mental health of this population was explored including associations between sexual victimization and mental health disorders (alcohol abuse, suicidal ideation and attempts, mood disorders, and poor self-esteem). Almost 1 in 10 of the men had engaged in juvenile prostitution, 14% were forced into sexual activity before 14 years of age, and 14% were sexually victimized after the age of 14. Those exposed to non-consensual sex were 2.9 (95% CI: 1.8-4.7) times more likely to abuse alcohol than those free of victimization. Those who reported childhood sexual abuse were 3.3 (95% CI: 1.7-6.4) times more likely to have attempted suicide. Juvenile prostitution was associated with current depression (OR=6.4; 95% CI: 2.8-14.9). Health professionals have the responsibility to respond competently and sensitively to victims of sexual violence. To do this, many need to recognize the prevalence of male sexual trauma, to deconstruct their personal beliefs about same-sex sexual violence, and to learn to ask sensitive questions in their assessment interviews.

Social constructions of gender roles, gender-based violence and HIV/AIDS in two communities of the Western Cape, South Africa.

PubMed

Strebel, A; Crawford, M; Shefer, T; Cloete, A; Henda, N; Kaufman, M; Simbayi, L; Magome, K; Kalichman, S

2006-11-01

The links between gender roles, gender-based violence and HIV/AIDS risk are complex and culturally specific. In this qualitative study we investigated how women and men in two black communities in the Western Cape, South Africa, constructed their gender identities and roles, how they understood gender-based violence, and what they believed about the links between gender relations and HIV risk. First we conducted 16 key informant interviews with members of relevant stakeholder organisations. Then we held eight focus group discussions with community members in single-sex groups. Key findings included the perception that although traditional gender roles were still very much in evidence, shifts in power between men and women were occurring. Also, gender-based violence was regarded as a major problem throughout communities, and was seen to be fuelled by unemployment, poverty and alcohol abuse. HIV/AIDS was regarded as particularly a problem of African communities, with strong themes of stigma, discrimination, and especially 'othering' evident. Developing effective HIV/AIDS interventions in these communities will require tackling the overlapping as well as divergent constructions of gender, gender violence and HIV which emerged in the study.

Alcohol prevention strategies on college campuses and student alcohol abuse and related problems.

PubMed

Ringwalt, Christopher L; Paschall, Mallie J; Gitelman, Amy M

2011-01-01

This study examined the relationship between colleges' alcohol abuse prevention strategies and students' alcohol abuse and related problems. Alcohol prevention coordinators and first year students in 22 colleges reported whether their schools were implementing 48 strategies in six domains, and students (N = 2041) completed another survey concerning their use of alcohol and related consequences. Colleges were most likely to prevent alcohol use in public places on campus and the delivery and use of kegs. Four alcohol prevention domains were inversely associated with at least one of five outcomes related to student alcohol abuse or related consequences, and the alcohol policy and enforcement domain was inversely associated with all outcomes. Colleges should pay particular attention to strategies related to policy and enforcement.

Adolescent Health-Risk Sexual Behaviors: Effects of a Drug Abuse Intervention

PubMed Central

Ozechowski, Timothy J.; Waldron, Holly B.; Davis, Betsy; Turner, Charles W.; Brody, Janet L.; Barrera, Manuel

2011-01-01

Adolescents who abuse substances are more likely to engage in health-risking sexual behavior (HRSB) and are at particularly high risk for HIV/AIDS. Thus, substance abuse treatment presents a prime opportunity to target HIV-risk behaviors. The present study evaluated a one-session HIV-risk intervention embedded in a controlled clinical trial for drug-abusing adolescents. The trial was conducted in New Mexico and Oregon with Hispanic and Anglo adolescents. Youths were randomly assigned to individual cognitive behavior therapy (CBT) or to an integrated behavioral and family therapy (IBFT) condition, involving individual and family sessions. The HIV-specific intervention was not associated with change. IBFT and CBT were both efficacious in reducing HIV-risk behaviors from intake to the 18-month follow-up for high-risk adolescents. For low-risk adolescents, CBT (versus IBFT) was more efficacious in suppressing HRSB. These data suggest that drug abuse treatments can have both preventative and intervention effects for adolescents, depending on their relative HIV-risk. PMID:21833690

Alcoholism and Alcohol Abuse

MedlinePlus

... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... the liver, brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the ...

Critical care aspects of alcohol abuse.

PubMed

Al-Sanouri, Ibrahim; Dikin, Matthew; Soubani, Ayman O

2005-03-01

The authors reviewed MEDLINE and references of major articles in the published literature over the last 30 years regarding the complications of alcohol abuse and discuss the critical care aspects of alcohol abuse. This article discusses the severe medical conditions associated with alcohol abuse that lead to admission to the medical intensive care unit. The clinical manifestations, pathophysiology, diagnostic studies, and management of these conditions are discussed in detail.

78 FR 73552 - National Institute On Alcohol Abuse and Alcoholism; National Institute On Drug Abuse; and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute On Alcohol Abuse and Alcoholism; National Institute On Drug Abuse; and National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the...

Alcohol advertising, consumption and abuse: a covariance-structural modelling look at Strickland's data.

PubMed

Adlaf, E M; Kohn, P M

1989-07-01

Re-analysis employing covariance-structural models was conducted on Strickland's (1983) survey data on 772 drinking students from Grades 7, 9 and 11. These data bear on the relations among alcohol consumption, alcohol abuse, association with drinking peers and exposure to televised alcohol advertising. Whereas Strickland used a just-identified model which, therefore, could not be tested for goodness of fit, our re-analysis tested several alternative models, which could be contradicted by the data. One model did fit his data particularly well. Its major implications are as follows: (1) Symptomatic consumption, negative consequences and self-rated severity of alcohol-related problems apparently reflect a common underlying factor, namely alcohol abuse. (2) Use of alcohol to relieve distress and frequency of intoxication, however, appear not to reflect abuse, although frequent intoxication contributes substantially to it. (3). Alcohol advertising affects consumption directly and abuse indirectly, although peer association has far greater impact on both consumption and abuse. These findings are interpreted as lending little support to further restrictions on advertising.

Abuse, Nocturnal Stress Hormones, and Coronary Heart Disease Risk Among Women with HIV

PubMed Central

Dale, Sannisha K.; Weber, Kathleen M.; Cohen, Mardge H.; Brody, Leslie R.

2017-01-01

This study investigated the relationships among abuse, nocturnal levels of cortisol and norepinephrine (NE), and coronary heart disease (CHD) risk as measured by the Framingham Risk Score (FRS) among women with HIV. Participants (n=53) from the Chicago Women's Interagency HIV Study, a longitudinal prospective cohort study initiated in 1994, were enrolled in this study during 2012. At WIHS baseline and annual follow-up visits women were asked about recent experiences of abuse. Summary variables captured the proportion of visits for which women reported recent (past 12 months) physical, sexual, and domestic abuse. Cortisol and NE were assayed in overnight urine samples and adjusted for creatinine levels. Recent abuse was not significantly associated with levels of cortisol, NE, or NE/cortisol ratio. However, higher NE/cortisol ratio was significantly related to higher CHD risk score, higher cortisol was significantly related to lower CHD risk score, and NE was not associated with CHD risk score. In addition, higher proportions of visits with recent sexual abuse, physical abuse, and domestic abuse were significantly related to higher CHD risk score. The association between abuse exposure and CHD risk in the context of HIV infection is likely complex and may involve dysregulation of multiple neurobiological systems. Future research is needed to better understand these relationships and prevention and intervention efforts are needed to address abuse among women with HIV. PMID:27733045

Alcoholic pancreatitis: Lessons from the liver

PubMed Central

Clemens, Dahn L; Mahan, Katrina J

2010-01-01

The association between alcohol consumption and pancreatitis has been recognized for over 100 years. Despite the fact that this association is well recognized, the mechanisms by which alcohol abuse leads to pancreatic tissue damage are not entirely clear. Alcohol abuse is the major factor associated with pancreatitis in the Western world. Interestingly, although most cases of chronic pancreatitis and many cases of acute pancreatitis are associated with alcohol abuse, only a small percentage of individuals who abuse alcohol develop this disease. This situation is reminiscent of the association between alcohol abuse and the incidence of alcoholic liver disease. The liver and the pancreas are developmentally very closely related. Even though these two organs are quite different, they exhibit a number of general structural and functional similarities. Furthermore, the diseases mediated by alcohol abuse in these organs exhibit some striking similarities. The diseases in both organs are characterized by parenchymal cell damage, activation of stellate cells, aberrant wound healing, and fibrosis. Because of the similarities between the liver and the pancreas, and the alcohol-associated diseases of these organs, we may be able to apply much of the knowledge that we have gained regarding the effects of alcohol on the liver to the pancreas. PMID:20238397

Intergenerational Pathways Linking Childhood Sexual Abuse to HIV Risk Among Women

PubMed Central

Cavanaugh, Courtenay E.; Classen, Catherine C.

2009-01-01

Childhood sexual abuse is prevalent among women and it has been linked to a number of problems affecting women's health and functioning including women's parenting practices. Another body of literature has linked specific maternal parenting practices to daughters’ HIV risk, including mother-daughter sex communication, monitoring/knowledge about daughters’ activities, mother-daughter relationship quality, attitudes towards sex, and modeling of sexual values. This paper reviews and links these two bodies of literature to indicate how maternal histories of childhood sexual abuse may compromise mothers’ parenting practices, which may in turn impact daughters’ HIV risk. We also build upon Malow and colleagues’ model (2006) of the associations between childhood sexual abuse and HIV risk to present a model indicating potential intergenerational pathways between childhood sexual abuse and HIV risk among women. The literature supporting this model and gaps in the literature are described. PMID:19333846

Let’s talk about sex: helping substance abuse counsellors address HIV prevention with men who have sex with men

PubMed Central

Spector, Anya Y.; Pinto, Rogério M.

2012-01-01

Integrating HIV prevention into substance abuse counselling is recommended to ameliorate the health outcomes of men who have sex with men. However, culture-based countertransferences (CBCs) may hamper this effort. Using a case illustration, this paper will explain the manifestation of CBCs held among substance abuse counsellors and how they hinder counsellors’ work with men who have sex with men. The following CBCs will be explored: distancing, topic avoidance, heteronormativity, assumptions and denying client strengths. These CBCs allow counsellors to avoid discussions about sexual practices and curtail HIV prevention counselling, while undermining the counsellor-client relationship. Based on the empirical literature on HIV and substance abuse prevention with men who have sex with men, we provide recommendations to help counsellors overcome CBCs and integrate HIV prevention consistently with men who are in treatment for substance abuse. PMID:21308577

25 CFR 700.545 - Alcoholism and drug abuse.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Alcoholism and drug abuse. 700.545 Section 700.545... Employee Responsibility and Conduct § 700.545 Alcoholism and drug abuse. An employee who habitually uses... and drug abuse as serious and treatable illnesses. Excessive absence and poor work performance are two...

25 CFR 700.545 - Alcoholism and drug abuse.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false Alcoholism and drug abuse. 700.545 Section 700.545... Employee Responsibility and Conduct § 700.545 Alcoholism and drug abuse. An employee who habitually uses... and drug abuse as serious and treatable illnesses. Excessive absence and poor work performance are two...

25 CFR 700.545 - Alcoholism and drug abuse.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false Alcoholism and drug abuse. 700.545 Section 700.545... Employee Responsibility and Conduct § 700.545 Alcoholism and drug abuse. An employee who habitually uses... and drug abuse as serious and treatable illnesses. Excessive absence and poor work performance are two...

25 CFR 700.545 - Alcoholism and drug abuse.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false Alcoholism and drug abuse. 700.545 Section 700.545... Employee Responsibility and Conduct § 700.545 Alcoholism and drug abuse. An employee who habitually uses... and drug abuse as serious and treatable illnesses. Excessive absence and poor work performance are two...

25 CFR 700.545 - Alcoholism and drug abuse.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false Alcoholism and drug abuse. 700.545 Section 700.545... Employee Responsibility and Conduct § 700.545 Alcoholism and drug abuse. An employee who habitually uses... and drug abuse as serious and treatable illnesses. Excessive absence and poor work performance are two...

42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... abuse patient records. 2.2 Section 2.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.2 Statutory authority for confidentiality of alcohol abuse patient records. The restrictions of...

42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... abuse patient records. 2.2 Section 2.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.2 Statutory authority for confidentiality of alcohol abuse patient records. The restrictions of...

42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... abuse patient records. 2.2 Section 2.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.2 Statutory authority for confidentiality of alcohol abuse patient records. The restrictions of...

42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... abuse patient records. 2.2 Section 2.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.2 Statutory authority for confidentiality of alcohol abuse patient records. The restrictions of...

42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... abuse patient records. 2.2 Section 2.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.2 Statutory authority for confidentiality of alcohol abuse patient records. The restrictions of...

HIV Risk, Prevalence, and Access to Care Among Men Who Have Sex with Men in Lebanon.

PubMed

Heimer, Robert; Barbour, Russell; Khouri, Danielle; Crawford, Forrest W; Shebl, Fatma; Aaraj, Elie; Khoshnood, Kaveh

2017-11-01

Little is known about HIV prevalence and risk among men who have sex with men (MSM) in much of the Middle East, including Lebanon. Recent national-level surveillance has suggested an increase in HIV prevalence concentrated among men in Lebanon. We undertook a biobehavioral study to provide direct evidence for the spread of HIV. MSM were recruited by respondent-driven sampling, interviewed, and offered HIV testing anonymously at sites located in Beirut, Lebanon, from October 2014 through February 2015. The interview questionnaire was designed to obtain information on participants' sociodemographic situation, sexual behaviors, alcohol and drug use, health, HIV testing and care, and experiences of stigma and discrimination. Individuals not reporting an HIV diagnosis were offered optional, anonymous HIV testing. Among the 292 MSM recruited, we identified 36 cases of HIV (12.3%). A quarter of the MSM were born in Syria and recently arrived in Lebanon. Condom use was uncommon; 65% reported condomless sex with other men. Group sex encounters were reported by 22% of participants. Among the 32 individuals already aware of their infection, 30 were in treatment and receiving antiretroviral therapy. HIV prevalence was substantially increased over past estimates. Efforts to control future increases will have to focus on reducing specific risk behaviors and experience of stigma and abuse, especially among Syrian refugees.

Interactions of HIV and drugs of abuse: the importance of glia, neural progenitors, and host genetic factors.

PubMed

Hauser, Kurt F; Knapp, Pamela E

2014-01-01

Considerable insight has been gained into the comorbid, interactive effects of HIV and drug abuse in the brain using experimental models. This review, which considers opiates, methamphetamine, and cocaine, emphasizes the importance of host genetics and glial plasticity in driving the pathogenic neuron remodeling underlying neuro-acquired immunodeficiency syndrome and drug abuse comorbidity. Clinical findings are less concordant than experimental work, and the response of individuals to HIV and to drug abuse can vary tremendously. Host-genetic variability is important in determining viral tropism, neuropathogenesis, drug responses, and addictive behavior. However, genetic differences alone cannot account for individual variability in the brain "connectome." Environment and experience are critical determinants in the evolution of synaptic circuitry throughout life. Neurons and glia both exercise control over determinants of synaptic plasticity that are disrupted by HIV and drug abuse. Perivascular macrophages, microglia, and to a lesser extent astroglia can harbor the infection. Uninfected bystanders, especially astroglia, propagate and amplify inflammatory signals. Drug abuse by itself derails neuronal and glial function, and the outcome of chronic exposure is maladaptive plasticity. The negative consequences of coexposure to HIV and drug abuse are determined by numerous factors including genetics, sex, age, and multidrug exposure. Glia and some neurons are generated throughout life, and their progenitors appear to be targets of HIV and opiates/psychostimulants. The chronic nature of HIV and drug abuse appears to result in sustained alterations in the maturation and fate of neural progenitors, which may affect the balance of glial populations within multiple brain regions. © 2014 Elsevier Inc. All rights reserved.

Interactions of HIV and drugs of abuse: the importance of glia, neural progenitors, and host genetic factors

PubMed Central

Hauser, Kurt F.; Knapp, Pamela E.

2015-01-01

Considerable insight has been gained into the comorbid, interactive effects of HIV and drug abuse in the brain using experimental models. This review, which considers opiates, methamphetamine, and cocaine, emphasizes the importance of host genetics and glial plasticity in driving the pathogenic neuron remodeling underlying neuro-acquired immunodeficiency syndrome (neuroAIDS) and drug abuse comorbidity. Clinical findings are less concordant than experimental work, and the response of individuals to HIV and to drug abuse can vary tremendously. Host-genetic variability is important in determining viral tropism, neuropathogenesis, drug responses, and addictive behavior. However, genetic differences alone cannot account for individual variability in the brain “connectome”. Environment and experience are critical determinants in the evolution of synaptic circuitry throughout life. Neurons and glia both exercise control over determinants of synaptic plasticity that are disrupted by HIV and drug abuse. Perivascular macrophages, microglia, and to a lesser extent astroglia can harbor the infection. Uninfected bystanders, especially astroglia, propagate and amplify inflammatory signals. Drug abuse by itself derails neuronal and glial function, and the outcome of chronic exposure is maladaptive plasticity. The negative consequences of coexposure to HIV and drug abuse are determined by numerous factors including genetics, sex, age, and multidrug exposure. Glia and some neurons are generated throughout life and their progenitors appear to be targets of HIV and opiates/psychostimulants. The chronic nature of HIV and drug abuse appears to result in sustained alterations in the maturation and fate of neural progenitors, which may affect the balance of glial populations within multiple brain regions. PMID:25175867

Drug induced increases in CNS dopamine alter monocyte, macrophage and T cell functions: implications for HAND

PubMed Central

Gaskill, Peter J.; Calderon, Tina M.; Coley, Jacqueline S.; Berman, Joan W.

2013-01-01

Central nervous system (CNS) complications resulting from HIV infection remain a major public health problem as individuals live longer due to the success of combined antiretroviral therapy (cART). As many as 70% of HIV infected people have HIV associated neurocognitive disorders (HAND). Many HIV infected individuals abuse drugs, such as cocaine, heroin or methamphetamine, that may be important cofactors in the development of HIV CNS disease. Despite different mechanisms of action, all drugs of abuse increase extracellular dopamine in the CNS. The effects of dopamine on HIV neuropathogenesis are not well understood, and drug induced increases in CNS dopamine may be a common mechanism by which different types of drugs of abuse impact the development of HAND. Monocytes and macrophages are central to HIV infection of the CNS and to HAND. While T cells have not been shown to be a major factor in HIV-associated neuropathogenesis, studies indicate that T cells may play a larger role in the development of HAND in HIV infected drug abusers. Drug induced increases in CNS dopamine may dysregulate functions of, or increase HIV infection in, monocytes, macrophages and T cells in the brain. Thus, characterizing the effects of dopamine on these cells is important for understanding the mechanisms that mediate the development of HAND in drug abusers. PMID:23456305

Effects of Trauma Intervention on HIV Sexual Risk Behaviors among Women with Co-Occurring Disorders in Substance Abuse Treatment

ERIC Educational Resources Information Center

Amaro, Hortensia; Larson, Mary Jo; Zhang, Annie; Acevedo, Andrea; Dai, Jianyu; Matsumoto, Atsushi

2007-01-01

Women in substance abuse treatment often have co-occurring mental health disorders and a history of trauma; they are also at high risk for HIV infection and other sexually transmitted diseases via unprotected sex. A quasi-experimental study evaluated the effectiveness of trauma-enhanced substance abuse treatment combined with HIV/AIDS prevention…

When abuse primes addiction - automatic activation of alcohol concepts by child maltreatment related cues in emotionally abused alcoholics.

PubMed

Potthast, Nadine; Neuner, Frank; Catani, Claudia

2015-09-01

Recent research indicates that there is a link between emotional maltreatment and alcohol dependence (AD), but the underlying mechanisms still need to be clarified. There is reason to assume that maltreatment related cues automatically activate an associative memory network comprising cues eliciting craving as well as alcohol-related responses. The current study aimed to examine this network in AD patients who experienced emotional abuse using a priming paradigm. A specific priming effect in emotionally abused AD subjects was hypothesized for maltreatment related words that preceded alcohol related words. 49 AD subjects (n=14 with emotional abuse vs. n=35 without emotional abuse) and 34 control subjects performed a priming task with maltreatment related and neutral prime words combined with alcohol related and neutral target words. Maltreatment related words consisted of socially and physically threatening words. As hypothesized, a specific priming effect for socially threatening and physically threatening cues was found only in AD subjects with emotional abuse. The present data are the first to provide evidence that child maltreatment related cues automatically activate an associative memory network in alcoholics with emotional abuse experiences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men

PubMed Central

Semple, Shirley J.; Strathdee, Steffanie A.; Zians, Jim; McQuaid, John R.; Patterson, Thomas L.

2011-01-01

Drug assertiveness skills have been demonstrated effective in reducing substance use behaviors among patients with alcohol- or heroin-use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men (MSM) enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation-seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. PMID:21550758

Underage Drinking: MedlinePlus Health Topic

MedlinePlus

... on Alcohol Abuse and Alcoholism) Treatments and Therapies Substance Abuse Treatment for Children and Adolescents: Questions to Ask ( ... With Your College-Bound Young Adult About Alcohol (Substance Abuse and Mental Health Services Administration) - PDF Genetics Genetics ...

Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study.

PubMed

Wiener, Carolina D; Moreira, Fernanda P; Zago, Alethea; Souza, Luciano M; Branco, Jeronimo C; Oliveira, Jacqueline F de; Silva, Ricardo A da; Portela, Luis V; Lara, Diogo R; Jansen, Karen; Oses, Jean P

2018-01-01

To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI). Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

Education, Alcohol Use and Abuse among Young Adults in Britain. OECD Education Working Papers, No. 50

ERIC Educational Resources Information Center

del Carmen Huerta, Maria; Borgonovi, Francesca

2010-01-01

In this article we explore the relationship between education and alcohol consumption. We examine whether the probability of abusing alcohol differs across educational groups. We use data from the British Cohort Study, a longitudinal study of one week's birth in Britain in 1970. Measures of alcohol abuse include alcohol consumption above NHS…

Adolescent-onset alcohol abuse exacerbates the influence of childhood conduct disorder on late adolescent and early adult antisocial behaviour.

PubMed

Howard, Richard; Finn, Peter; Jose, Paul; Gallagher, Jennifer

2011-12-16

This study tested the hypothesis that adolescent-onset alcohol abuse (AOAA) would both mediate and moderate the effect of childhood conduct disorder on antisocial behaviour in late adolescence and early adulthood. A sample comprising 504 young men and women strategically recruited from the community were grouped using the criteria of the Diagnostic and Statistical Manual (DSM-IV, American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA), as follows: neither childhood conduct disorder (CCD) nor alcohol abuse/dependence; CCD but no alcohol abuse or dependence; alcohol abuse/dependence but no CCD; both CCD and alcohol abuse/dependence. The outcome measure was the sum of positive responses to 55 interview items capturing a variety of antisocial behaviours engaged in since age 15. Severity of lifetime alcohol-related and CCD problems served as predictor variables in regression analysis. Antisocial behaviour problems were greatest in individuals with a history of co-occurring conduct disorder (CD) and alcohol abuse/dependence. While CCD was strongly predictive of adult antisocial behaviour, this effect was both mediated and moderated (exacerbated) by AOAA.

Adolescent-onset alcohol abuse exacerbates the influence of childhood conduct disorder on late adolescent and early adult antisocial behaviour

PubMed Central

Howard, Richard; Finn, Peter; Jose, Paul; Gallagher, Jennifer

2012-01-01

This study tested the hypothesis that adolescent-onset alcohol abuse (AOAA) would both mediate and moderate the effect of childhood conduct disorder on antisocial behaviour in late adolescence and early adulthood. A sample comprising 504 young men and women strategically recruited from the community were grouped using the criteria of the Diagnostic and Statistical Manual (DSM-IV, American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA), as follows: neither childhood conduct disorder (CCD) nor alcohol abuse/dependence; CCD but no alcohol abuse or dependence; alcohol abuse/dependence but no CCD; both CCD and alcohol abuse/dependence. The outcome measure was the sum of positive responses to 55 interview items capturing a variety of antisocial behaviours engaged in since age 15. Severity of lifetime alcohol-related and CCD problems served as predictor variables in regression analysis. Antisocial behaviour problems were greatest in individuals with a history of co-occurring conduct disorder (CD) and alcohol abuse/dependence. While CCD was strongly predictive of adult antisocial behaviour, this effect was both mediated and moderated (exacerbated) by AOAA. PMID:23459369

Association between early sexual abuse and adult HIV-risky sexual behaviors among community-recruited women.

PubMed

Parillo, K M; Freeman, R C; Collier, K; Young, P

2001-03-01

The first purpose was to determine whether sexual abuse involving penetration that occurred in childhood only, adolescence only, or both childhood and adolescence differently impacted whether community-recruited women had ever traded sex for money or drugs, their number of recent sex partners, and the number of times they had engaged in recent unprotected sex. The second purpose was to assess the mediating effects of adulthood rape, recent drug use, and recent sex with an injection drug user on these three HIV-risky sexual behaviors. Women (n = 1,490) recruited from three US sites were questioned about their childhood and/or adolescent sexual abuse histories, adulthood rape experiences, recent drug use, and adult HIV-risky sexual behaviors via structured interviews. One-third of the women reported having experienced sexual abuse involving penetration in childhood and/or adolescence. Overall, regression analyses indicated a significant relationship between early sexual abuse and adult risky behaviors; rape in adulthood mediated this relationship for all three HIV-risky behaviors. Abuse that occurred in childhood only and abuse that occurred in both childhood and adolescence had a stronger impact on later risky behaviors than did abuse that occurred in adolescence only. Because childhood constitutes a critical period in individuals' sexual, social, and personal development, sexual abuse precipitated during this time may distort women's constructions of sex and sexuality. Women abused in childhood may therefore engage in HIV-risky sexual behaviors to a greater extent than women abused in adolescence as a result of these disruptions to their development. Rape in adulthood appears to intensify the effects of early sexual abuse,

Shortened telomeres in individuals with abuse in alcohol consumption

PubMed Central

Pavanello, Sofia; Hoxha, Mirjam; Dioni, Laura; Bertazzi, Pier Alberto; Snenghi, Rossella; Nalesso, Alessandro; Ferrara, Santo Davide; Montisci, Massimo; Baccarelli, Andrea

2011-01-01

Alcohol abuse leads to earlier onset of aging-related diseases, including cancer at multiple sites. Shorter telomere length (TL) in peripheral blood leucocytes (PBLs), a marker of biological aging, has been associated with alcohol-related cancer risks. Whether alcohol abusers exhibit accelerated biological aging, as reflected in PBL-TL, has never been examined. To investigated the effect of alcohol abuse on PBL-TL and its interaction with alcohol metabolic genotypes, we examined 200 drunk-driving traffic offenders diagnosed as alcohol abusers as per the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR] and enrolled in a probation program, and 257 social drinkers (controls). We assessed alcohol intake using self-reported drink-units/day and conventional alcohol abuse biomarkers (serum γ-glutamyltrasferase [GGT] and mean corpuscular volume of erythrocytes [MCV]). We used multivariable models to compute TL geometric means (GM) adjusted for age, smoking, BMI, diet, job at elevated risk of accident, genotoxic exposures. TL was nearly halved in alcohol abusers compared to controls (GMs 0.42 vs. 0.87 relative T/S ratio; P<0.0001) and decreased in relation with increasing drink-units/day (P-trend=0.003). Individuals drinking >4 drink-units/day had substantially shorter TL than those drinking 4 drink-units/day (GMs 0.48 vs. 0.61 T/S, P=0.002). Carriers of the common ADH1B*1/*1 (rs1229984) genotype were more likely to be abusers (P=0.008), reported higher drink-units/day (P=0.0003), and exhibited shorter TL (P<0.0001). The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with TL. The decrease in PBL-TL modulated by the alcohol metabolic genotype ADH1B*1/*1 may represent a novel mechanism potentially related to alcohol carcinogenesis in alcohol abusers. PMID:21351086

Shortened telomeres in individuals with abuse in alcohol consumption.

PubMed

Pavanello, Sofia; Hoxha, Mirjam; Dioni, Laura; Bertazzi, Pier Alberto; Snenghi, Rossella; Nalesso, Alessandro; Ferrara, Santo Davide; Montisci, Massimo; Baccarelli, Andrea

2011-08-15

Alcohol abuse leads to earlier onset of aging-related diseases, including cancer at multiple sites. Shorter telomere length (TL) in peripheral blood leucocytes (PBLs), a marker of biological aging, has been associated with alcohol-related cancer risks. Whether alcohol abusers exhibit accelerated biological aging, as reflected in PBL-TL, has never been examined. To investigated the effect of alcohol abuse on PBL-TL and its interaction with alcohol metabolic genotypes, we examined 200 drunk-driving traffic offenders diagnosed as alcohol abusers as per the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR] and enrolled in a probation program, and 257 social drinkers (controls). We assessed alcohol intake using self-reported drink-units/day and conventional alcohol abuse biomarkers (serum γ-glutamyltrasferase [GGT] and mean corpuscular volume of erythrocytes [MCV]). We used multivariable models to compute TL geometric means (GM) adjusted for age, smoking, BMI, diet, job at elevated risk of accident, genotoxic exposures. TL was nearly halved in alcohol abusers compared with controls (GMs 0.42 vs. 0.87 relative T/S ratio; p<0.0001) and decreased in relation with increasing drink-units/day (p-trend=0.003). Individuals drinking >4 drink-units/day had substantially shorter TL than those drinking ≤4 drink-units/day (GMs 0.48 vs. 0.61 T/S, p=0.002). Carriers of the common ADH1B*1/*1 (rs1229984) genotype were more likely to be abusers (p=0.008), reported higher drink-units/day (p=0.0003), and exhibited shorter TL (p<0.0001). The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with TL. The decrease in PBL-TL modulated by the alcohol metabolic genotype ADH1B*1/*1 may represent a novel mechanism potentially related to alcohol carcinogenesis in alcohol abusers. Copyright © 2011 UICC.

PREVENTION AND OUTCOMES FOR VICTIMS OF CHILDHOOD SEXUAL ABUSE

PubMed Central

Ulibarri, Monica D.; Ulloa, Emilio C.; Salazar, Marissa

2015-01-01

This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18–34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues. PMID:25635897

Associations between mental health, substance use, and sexual abuse experiences among Latinas.

PubMed

Ulibarri, Monica D; Ulloa, Emilio C; Salazar, Marissa

2015-01-01

This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18-34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues.

Traumatic brain injury and alcohol/substance abuse: A Bayesian meta-analysis comparing the outcomes of people with and without a history of abuse.

PubMed

Unsworth, David J; Mathias, Jane L

2017-08-01

Alcohol and substance (drugs and/or alcohol) abuse are major risk factors for traumatic brain injury (TBI); however, it remains unclear whether outcomes differ for those with and without a history of preinjury abuse. A meta-analysis was performed to examine this issue. The PubMed, Embase, and PsycINFO databases were searched for research that compared the neuroradiological, cognitive, or psychological outcomes of adults with and without a documented history of alcohol and/or substance abuse who sustained nonpenetrating TBIs. Data from 22 studies were analyzed using a random-effects model: Hedges's g effect sizes measured the mean difference in outcomes of individuals with/without a history of preinjury abuse, and Bayes factors assessed the probability that the outcomes differed. Patients with a history of alcohol and/or substance abuse had poorer neuroradiological outcomes, including reduced hippocampal (g = -0.82) and gray matter volumes (g = -0.46 to -0.82), and enlarged cerebral ventricles (g = -0.73 to -0.80). There were limited differences in cognitive outcomes: Executive functioning (g = -0.51) and memory (g = -0.39 to -0.43) were moderately affected, but attention and reasoning were not. The findings for fine motor ability, construction, perception, general cognition, and language were inconclusive. Postinjury substance and alcohol use (g = -0.97 to -1.07) and emotional functioning (g = -0.29 to -0.44) were worse in those with a history of alcohol and/or substance abuse (psychological outcomes). This study highlighted the type and extent of post-TBI differences between persons with and without a history of alcohol or substance abuse, many of which may hamper recovery. However, variation in the criteria for premorbid abuse, limited information regarding the history of abuse, and an absence of preinjury baseline data prevented an assessment of whether the differences predated the TBI, occurred as a result of ongoing alcohol/substance abuse, or reflected the cumulative impact of alcohol/substance abuse and TBI.

38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

Understanding Alcohol Abuse among College Students: Contributing Factors and Strategies for Intervention

ERIC Educational Resources Information Center

Iconis, Rosemary

2014-01-01

Alcohol abuse among college students has become a major public health concern. Individual, environmental, and demographic factors have each been associated with alcohol abuse in that population. In response to the enormous physical, emotional, and legal consequences that occur as a result of the abuse, colleges and universities are developing…

49 CFR 242.115 - Substance abuse disorders and alcohol drug rules compliance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Substance abuse disorders and alcohol drug rules... CONDUCTORS Program and Eligibility Requirements § 242.115 Substance abuse disorders and alcohol drug rules... evaluated as not currently affected by a substance abuse disorder or that the person has been evaluated as...

49 CFR 242.115 - Substance abuse disorders and alcohol drug rules compliance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Substance abuse disorders and alcohol drug rules... CONDUCTORS Program and Eligibility Requirements § 242.115 Substance abuse disorders and alcohol drug rules... evaluated as not currently affected by a substance abuse disorder or that the person has been evaluated as...

49 CFR 242.115 - Substance abuse disorders and alcohol drug rules compliance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Substance abuse disorders and alcohol drug rules... CONDUCTORS Program and Eligibility Requirements § 242.115 Substance abuse disorders and alcohol drug rules... evaluated as not currently affected by a substance abuse disorder or that the person has been evaluated as...

Preventing Alcohol and Drug Abuse through Programs at the Workplace. WBGH Worksite Wellness Series.

ERIC Educational Resources Information Center

Walsh, Diana Chapman; Kelleher, Susan E.

Alcohol and drug abuse have serious physical, psychological, and social consequences, and employees who abuse alcohol and/or drugs ultimately reduce their companies' profits. Employee substance abuse leads to reduced productivity as well as to increased absenteeism, health care and health insurance costs, and liability claims against employers of…

Child Abuse in Young, HIV-Positive Women: Linkages to Risk

PubMed Central

Clum, Gretchen A.; Andrinopoulos, Katherine; Muessig, Kathryn; Ellen, Jonathan M.

2010-01-01

In this article we explore the lives of young women living with HIV who experienced physical and/or sexual abuse in childhood. Using a modified version of the Life Story Interview, 40 women recruited from HIV clinics in three different states participated in a qualitative interview. Interviews covered abuse experiences, cognitive and emotional consequences of abuse, coping strategies, and sexual behavior and relationships. Overall, these young women had complex abuse histories, often experiencing more than one type of abuse in the context of other difficult life events. Avoidance and substance use were frequently utilized as coping strategies for abuse-related distress. Young women reported sexual and relationship concerns, including avoidance of sex, sexual dysfunction, sex as a trigger for abuse memories, and difficulty establishing intimacy and trust. Relationships between abuse-related reactions and sexual risk behavior, as well as recommendations for interventions, are discussed. PMID:19949224

Traumas and other adverse life events in adolescents with alcohol abuse and dependence.

PubMed

Clark, D B; Lesnick, L; Hegedus, A M

1997-12-01

Clinical observation suggests that adolescents with alcohol use disorders often have complex histories that include childhood maltreatment and other traumas. The aim of this study was to determine the relationships among adolescent alcohol use disorders and a broad range of traumas and adverse life events. The subjects were 132 adolescents with alcohol dependence, 51 adolescents with alcohol abuse, and 73 adolescents recruited from the community as a control group. Trauma history was assessed by a semistructured interview and other adverse life events by questionnaire. Traumatic events reflecting interpersonal violence had occurred in many of the adolescents with alcohol dependence and abuse and few of the control adolescents. Adolescents with alcohol abuse or dependence, compared with control subjects, were 6 to 12 times more likely to have a physical abuse history and 18 to 21 times more likely to have a sexual abuse history. Sexual abuse was more common in females, and victimization by other violent acts was more common in males. Many other adverse life events were also significantly more common in the alcohol use disorder groups than in the control group, including having a close friend die, arguments within the family, and legal difficulties. These results demonstrate that trauma and other adverse life events are strongly associated with alcohol use disorders in adolescents. Clinical screening of adolescents with alcohol use disorders for a range of traumatic events is recommended.

Modulation of the proteome of peripheral blood mononuclear cells from HIV-1 infected patients by drugs of abuse

PubMed Central

Reynolds, Jessica L.; Mahajan, Supriya D.; Aalinkeel, Ravikunar; Nair, Bindukumar; Sykes, Donald E.; Agosto-Mujica, Arnadri; Hsiao, Chiu Bin; Schwartz, Stanley A.

2010-01-01

We used proteomic analyses to assess how drug abuse modulates immunologic responses to infections with the human immunodeficiency virus type 1 (HIV-1). Two dimensional (2D) difference gel electrophoresis was utilized to determine changes in the proteome of peripheral blood mononuclear cells (PBMC) isolated from HIV-1 positive donors that occurred after treatment with cocaine or methamphetamine. Both drugs differentially regulated the expression of several functional classes of proteins. We further isolated specific subpopulations of PBMC to determine which subpopulations were selectively affected by treatment with drugs of abuse. Monocytes, B cells and T cells were positively or negatively selected from PBMC isolated from HIV-1 positive donors. Our results demonstrate that cocaine and methamphetamine modulate gene expression primarily in monocytes and T cells, the primary targets of HIV-1 infection. Proteomic data were validated with quantitative, real-time PCR. These studies elucidate the molecular mechanisms underlying the effects of drugs of abuse on HIV-1 infections. Several functionally relevant classes of proteins were identified as potential mediators of HIV-1 pathogenesis and disease progression associated with drug abuse. PMID:19543960

Guidelines for School-Based Alcohol and Drug Abuse Prevention Programs.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

This paper contains the revised drug education guidelines for the state of California, which emphasize prevention of alcohol and drug abuse. The materials define school-based alcohol and drug abuse prevention programming as a comprehensive process that not only provides students with accurate information about alcohol and drugs, but also enhances…

Children of Alcoholics: Implications for Professional School Counseling

ERIC Educational Resources Information Center

Lambie, Glenn W.; Sias, Shari M.

2005-01-01

Alcohol abuse affects the entire family, yet only recently has attention focused on the needs of children with parents or guardians who abuse alcohol and/or other drugs. Professional school counselors (PSCs) must be prepared to identify and address the needs of these students. Parental alcohol abuse presents serious academic, emotional, physical,…

Exploring the Role of Self-Esteem and Parenting Patterns on Alcohol Use and Abuse Among Adolescents

PubMed Central

Glozah, Franklin N.

2014-01-01

The type of parental child-rearing practices used by parents and guardians substantially influence children’s self-esteem and consequently their decision to engage in alcohol use, its abuse. The aim of this study was to explore the role of self-esteem and parenting patterns on alcohol use and abuse among adolescents. Three hundred and sixteen boys and girls in Senior High Schools completed self-report questionnaires assessing self-esteem, parenting patterns and alcohol use and abuse. The results showed that while girls reported lesser self-esteem than boys, boys reported higher levels of alcohol use and abuse than girls. Also, authoritative parenting pattern had a positive effect on self-esteem and a negative effect on alcohol use. On the other hand, authoritarian and permissive parenting patterns had negative effects on self-esteem and positive effects on alcohol use, with slight variations. These results provide valuable information regarding strategies aimed at fostering parent-child relationship and rapport with the ultimate aim of bolstering the self-esteem of adolescents to subsequently eschew insalubrious behaviour, particularly alcohol use and abuse. PMID:26973951

Exploring the Role of Self-Esteem and Parenting Patterns on Alcohol Use and Abuse Among Adolescents.

PubMed

Glozah, Franklin N

2014-11-06

The type of parental child-rearing practices used by parents and guardians substantially influence children's self-esteem and consequently their decision to engage in alcohol use, its abuse. The aim of this study was to explore the role of self-esteem and parenting patterns on alcohol use and abuse among adolescents. Three hundred and sixteen boys and girls in Senior High Schools completed self-report questionnaires assessing self-esteem, parenting patterns and alcohol use and abuse. The results showed that while girls reported lesser self-esteem than boys, boys reported higher levels of alcohol use and abuse than girls. Also, authoritative parenting pattern had a positive effect on self-esteem and a negative effect on alcohol use. On the other hand, authoritarian and permissive parenting patterns had negative effects on self-esteem and positive effects on alcohol use, with slight variations. These results provide valuable information regarding strategies aimed at fostering parent-child relationship and rapport with the ultimate aim of bolstering the self-esteem of adolescents to subsequently eschew insalubrious behaviour, particularly alcohol use and abuse.

Childhood and Adolescent Predictors of Alcohol Abuse and Dependence in Young Adulthood*

PubMed Central

Guo, Jie; Hawkins, J. David; Hill, Karl G.; Abbott, Robert D

2007-01-01

Objective To provide a comprehensive examination of childhood and adolescent predictors of alcohol abuse and dependence at age 21, theoretically guided by the social development model. Method Data were taken from an ethnically diverse urban sample of 808 students [51% male), surveyed at age 10 and followed prospectively to age 21 in 1996. Potential predictors of alcohol abuse and dependence at age 21 were measured at ages 10, 14 and 16. Relationships between these predictors and alcohol abuse and dependence were examined at each age, to assess changes in their patterns of prediction over time. Results Strong bonding to school, close parental monitoring of children and clearly defined family rules for behavior, appropriate parental rewards for good behaviors, high level of refusal skills and strong belief in the moral order predicted a lower risk for alcohol abuse and dependence at age 21. Of these, strong bonding to school consistently predicted lower alcohol abuse and dependence from all three ages (10, 14 and 16). By contrast, youths who had a higher risk of alcohol abuse and dependence at age 21 engaged in more problem behaviors, had more opportunities to be involved with antisocial individuals and spent more time with and were more bonded to those individuals, viewed fewer negative consequences from antisocial behaviors and held more favorable views on alcohol use. Of these, prior problem behaviors and antisocial opportunities and involvements at ages 10, 14 and 16 consistently predicted alcohol abuse and dependence at age 21. Conclusions These important malleable predictors, identifiable as early as age 10, provide potential intervention targets for the prevention of alcohol abuse and dependence in early adulthood. PMID:11838912

Color It Real: A Program to Increase Condom Use and Reduce Substance Abuse and Perceived Stress.

PubMed

Zellner, Tiffany; Trotter, Jennie; Lenoir, Shelia; Walston, Kelvin; Men-Na'a, L'dia; Henry-Akintobi, Tabia; Miller, Assia

2015-12-22

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults.

Baseline research for action: adolescent alcohol consumption in Los Palacios Municipality, Cuba.

PubMed

Díaz, Yolanda; Espinosa, Yairelis

2013-04-01

In Cuba, alcohol is an important contributor to morbidity, mortality and social problems. The foundation of Cuba's universal primary health care coverage, family doctor-and-nurse offices play a critical role in prevention, early detection and treatment of alcohol abuse. Los Palacios Municipality of the westernmost province of Pinar del Río, Cuba, is a socially complex, periurban area where alcohol abuse and alcoholism have been identified as important health problems. Adolescents constitute a population at high risk for alcohol abuse because of their receptivity to social influences, but the precise extent of the problem is unknown. This paper reports baseline findings from a survey and direct observation of alcohol consumption in the catchment area of a primary care center, conducted to inform planning for an educational intervention. KEYWORDS Alcohol, alcoholism, alcohol abuse, alcohol dependence, adolescence, primary health care, Cuba.

HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

PubMed

Meade, Christina S; Lion, Ryan R; Cordero, Daniella M; Watt, Melissa H; Joska, John A; Gouse, Hetta; Burnhams, Warren

2016-10-01

South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

75 FR 3165 - Vocational Rehabilitation and Employment Program-Periods of Eligibility

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... dependency or chronic alcohol abuse; and (ii) Have been determined to prevent the affected veteran from... alcoholism, chronic alcoholism, alcohol dependency, or chronic alcohol abuse, in and of itself, does not...

Sexual Victimization, Alcohol Intoxication, Sexual-Emotional Responding, and Sexual Risk in Heavy Episodic Drinking Women

PubMed Central

George, William H.; Davis, Kelly Cue; Masters, N. Tatiana; Jacques-Tiura, Angela J.; Heiman, Julia R.; Norris, Jeanette; Gilmore, Amanda K.; Nguyen, Hong V.; Kajumulo, Kelly F.; Otto, Jacqueline M.; Andrasik, Michele P.

2013-01-01

This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women’s sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10%) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol’s effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks. PMID:23857517

Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients

PubMed Central

2013-01-01

Background Emergency department (ED) patients comprise a high-risk population for alcohol misuse and sexual risk for HIV. In order to design future interventions to increase HIV screening uptake, we examined the interrelationship among alcohol misuse, sexual risk for HIV and HIV screening uptake among these patients. Methods A random sample of 18-64-year-old English- or Spanish-speaking patients at two EDs during July-August 2009 completed a self-administered questionnaire about their alcohol use using the Alcohol Use Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the HIV Sexual Risk Questionnaire. Study participants were offered a rapid HIV test after completing the questionnaires. Binging (≥ five drinks/occasion for men, ≥ four drinks for women) was assessed and sex-specific alcohol misuse severity levels (low-risk, harmful, hazardous, dependence) were calculated using AUDIT scores. Analyses were limited to participants who had sexual intercourse in the past 12 months. Multivariable logistic regression was used to assess the associations between HIV screening uptake and (1) alcohol misuse, (2) sexual risk for HIV, and (3) the intersection of HIV sexual risk and alcohol misuse. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated. All models were adjusted for patient demographic characteristics and separate models for men and women were constructed. Results Of 524 participants (55.0% female), 58.4% identified as white, non-Hispanic, and 72% reported previous HIV testing. Approximately 75% of participants reported drinking alcohol within the past 30 days and 74.5% of men and 59.6% of women reported binge drinking. A relationship was found between reported sexual risk for HIV and alcohol use among men (AOR 3.31 [CI 1.51-7.24]) and women (AOR 2.78 [CI 1.48-5.23]). Women who reported binge drinking were more likely to have higher reported sexual risk for HIV (AOR 2.55 [CI 1.40-4.64]) compared to women who do not report binge drinking. HIV screening uptake was not higher among those with greater alcohol misuse and sexual risk among men or women. Conclusions The apparent disconnection between HIV screening uptake and alcohol misuse and sexual risk for HIV among ED patients in this study is concerning. Brief interventions emphasizing these associations should be evaluated to reduce alcohol misuse and sexual risk and increase the uptake of ED HIV screening. PMID:23721108

Abuse and mental health concerns among HIV-infected Haitian women living in the United States.

PubMed

Glémaud, Myriam; Illa, Lourdes; Echenique, Marisa; Bustamente-Avellaneda, Victoria; Gazabon, Shirley; Villar-Loubet, Olga; Rodriguez, Alan; Potter, JoNell; Messick, Barbara; Jayaweera, Dushyantha T; Boulanger, Catherine; Kolber, Michael A

2014-01-01

This study describes the prevalence of abuse and mental health issues among a cohort of HIV-infected Haitian women living in the United States. We present data on 96 women, ages 19-73 years (M = 47.6, SD = 11.1), who were screened for mental health concerns between 2009 and 2012. Results demonstrated that 12.5% of the women reported a history of abuse. However, posttraumatic stress disorder (PTSD) secondary to HIV was reported by approximately 34% of women. Depression and anxiety were also highly reported, with rates of 49% and 43%, respectively. Women who reported a history of abuse were more likely to report anxiety, PTSD, and PTSD related to HIV symptoms than those without. Our findings suggest that Haitian HIV-infected women may underreport abuse and experience significant depression and anxiety. These preliminary results could be used to develop future studies and to design and implement culturally sensitive interventions for this underserved population. Copyright © 2014 Association of Nurses in AIDS Care. All rights reserved.

Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services.

PubMed

Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew

2014-05-01

This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neighborhood Alcohol Outlet Density and Rates of Child Abuse and Neglect: Moderating Effects of Access to Substance Abuse Services

PubMed Central

Morton, Cory M.; Simmel, Cassandra; Peterson, N. Andrew

2014-01-01

This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. PMID:24529493

Men (and women) as "sellers" of sex in alcohol-serving venues in Cape Town, South Africa.

PubMed

Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Watt, Melissa H; Sikkema, Kathleen J; Skinner, Donald; Pieterse, Desiree; Cain, Demetria

2014-06-01

The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7 vs. 5.8 %). Overall, men who traded sex were similar to their female counterparts. Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men.

Men (and Women) as “Sellers” of Sex in Alcohol-Serving Venues in Cape Town, South Africa

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Watt, Melissa H.; Sikkema, Kathleen J.; Skinner, Donald; Pieterse, Desiree; Cain, Demetria

2013-01-01

Background The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. Methods We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Results Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7% vs. 5.8%). Overall, men who traded sex were similar to their female counterparts. Conclusions Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men. PMID:23494405

Substances of abuse and movement disorders: complex interactions and comorbidities

PubMed Central

Deik, Andres; Saunders-Pullman, Rachel; Luciano, Marta San

2014-01-01

The relationship between movement disorders and substance abuse which we previously reviewed are updated. We examine these relationships bidirectionally with focus on drugs of abuse which cause movement disorders, as well as primary movement disorders that are associated with use and abuse of alcohol and dopaminergic medications. First, we review the movement disorders that may develop from the acute use or withdrawal of frequent drugs of abuse, including alcohol, cocaine, heroin, amphetamine and methcathinone. We then comment on the interaction between alcoholism and alcohol-responsive movement disorders, such as essential tremor and myoclonus-dystonia. Lastly, we discuss the potential for abuse of antiparkinsonian dopaminergic agents in patients with Parkinson’s disease (PD). PMID:23030352

HIV/AIDS Services in Private Substance Abuse Treatment Programs

PubMed Central

Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

2010-01-01

Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

Trends in Substances of Abuse among Pregnant Women and Women of Childbearing Age in Treatment

MedlinePlus

... pregnant admissions reporting alcohol abuse (with or without drug abuse) decreased from 46.6 percent in 2000 to ... 8 percent in 2010, and the percentage reporting drug abuse but not alcohol abuse increased from 51.1 ...

Correlates and prevalence of HIV and sexually transmitted infections among Hijras (male transgenders) in Pakistan.

PubMed

Khan, A A; Rehan, N; Qayyum, K; Khan, A

2008-12-01

This study explored the role of Hijras (male transgenders) as a core group in Pakistan's HIV epidemic. Four hundred and nine Hijras underwent detailed behavioural and biological assessment. Our subjects were young (median age: 24 years), debuted sex early and used alcohol and drugs. Sex with men, women and other Hijras along with co-habitation/marriage were reported. Most (84%) had sold sex. These reported a median of four times and at least one regular client weekly. Few used condoms. Most (94%) could identify a condom, but 42% reported never needing one. Over two-thirds had correct HIV and protective knowledge. Many reported experiencing physical abuse or forced sex (40%) and sexual orientation-related discrimination (45%). Most (58%) had sexually transmitted infections (STIs) and 38% had multiple infections. The commonest infections were syphilis (50%) and gonorrhoea (18%). Care-seeking was mainly (87%) from the private sector. High STI prevalence, commercial sex, bisexuality and infrequent protective behaviours are described. Their communal living and wider sexual networks suggest a more central role for Hijras in Pakistan's HIV epidemic. Effective HIV/STI control programmes must take the above factors into account to enrich their programme content.

Protocol for a Controlled Experiment to Identify the Causal Role of Acute Alcohol Consumption in Condomless Sex among HIV-Positive MSM: Study Procedures, Ethical Considerations, and Implications for HIV Prevention.

PubMed

Shuper, Paul A; Joharchi, Narges; Rehm, Jürgen

2016-01-01

Although alcohol consumption is frequently perceived as a driver of condomless sex and subsequent HIV acquisition, the causal nature of this relationship remains unclear, and little is known about alcohol's direct versus indirect impact on the sexual risk dynamics of those who are HIV-positive. To address this gap, we present the protocol for an in-progress NIAAA-funded controlled experiment, wherein a sample of HIV-positive men-who-have-sex-with-men (MSM) undergoes an alcohol consumption manipulation (alcohol/placebo/control) and sexual arousal induction (sexually aroused/non-aroused), and then reports intentions to engage in condom-protected and condomless sexual acts with hypothetical sexual partners differing in HIV serostatus (HIV+/HIV-/HIV status unknown), condom use preference (use/don't use/not stated), and physical attractiveness (attractive/unattractive). Study outcomes will identify alcohol's impact on HIV-positive MSM's condomless sex intentions in the context of experimentally-manipulated factors as well as risk-relevant personality traits and alcohol-related expectancies. Detailed experimental procedures, ethical considerations, and potential implications for HIV prevention are discussed.

Substance abuse treatment as HIV prevention: more questions than answers.

PubMed

Brown, Lawrence S; Kritz, Steven; Bini, Edmund J; Louie, Ben; Robinson, Jim; Alderson, Donald; Rotrosen, John

2010-12-01

This report examines associations between the availability of human immunodeficiency virus (HIV)-related health services in substance abuse treatment programs and characteristics of the programs and the patients they serve. In a cross-sectional, descriptive design and via a validated survey, program administrators within the National Drug Abuse Treatment Clinical Trials Network provided information on program characteristics, patient characteristics (rates of risky sexual and drug behaviors and HIV infection), and the availability of 31 different HIV-related health services. Of 319 programs, 84% submitted surveys. Service availability rates ranged from: 10% (pneumococcal vaccination) to 86% (drug testing) for the 6 HIV-related services offered to all patients, 13% (Pap smear for women) to 54% (tuberculin skin testing) for the 6 services offered to new patients, 2% (sterile injection equipment) to 64% (male condoms) for the 4 risk-reduction services, 37% (Pap smear for women) to 61% (tuberculin skin testing) for the 11 biological assessments offered to HIV-positive patients, and 33% (medical treatments) to 52% (counseling) for the 4 other services offered to HIV-positive patients. The availability of these HIV-related services was associated with clinical settings, the types of addiction treatment services, the rates of risky drug and sexual behaviors, and HIV infection rates among patients. Availability of such services was below published guidelines. While the results provide another basis for the infection-related prevention benefits of substance abuse treatment, the variability in the availability of HIV-related health care deserves further study and has health policy implications in determining how to utilize substance abuse treatment in reducing drug-related HIV transmission.

5 CFR 792.101 - Statutory requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (CONTINUED) FEDERAL EMPLOYEES' HEALTH, COUNSELING, AND WORK/LIFE PROGRAMS Alcoholism and Drug Abuse Programs... for Federal civilian employees with alcohol and drug abuse problems. To the extent feasible, agencies... alcohol and/or drug abusing employees and to employees who have family members (including domestic...

5 CFR 792.101 - Statutory requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (CONTINUED) FEDERAL EMPLOYEES' HEALTH, COUNSELING, AND WORK/LIFE PROGRAMS Alcoholism and Drug Abuse Programs... for Federal civilian employees with alcohol and drug abuse problems. To the extent feasible, agencies... alcohol and/or drug abusing employees and to employees who have family members (including domestic...

Relationships as Risk: High risk sex, Substance Abuse, and Violence among Hispanic Men who have Sex with Men

PubMed Central

De Santis, Joseph P.; Vasquez, Elias Provencio; Deleon, Diego A.; Gonzalez-Guarda, Rosa M.

2012-01-01

Background Men who have sex with men (MSM) experience a number of health disparities including high rates of HIV from high risk sex. High rates of HIV infection are related to high risk sexual behaviors and multiple sexual partners. High rates of HIV infection in this population also may be related to high risk sexual behaviors that occur within the context of primary relationships. However, relatively little is know about about relationships among Hispanic MSM. In addition, little is known about the factors that contribute to risk within these primary relationships. Aims The purpose of this study is to use qualitative methods to explore the factors responsible for high risk sexual behavior within primary relationships among Hispanic MSM. Methods Twenty Hispanic MSM were recruited from various community sites in South Florida to participate in auditotaped focus groups. Data from the focus groups were transcribed and analyzed using content analysis. Data were collected until saturation was achieved. Results Participants identified a number of topics that contribute to risk: drugs/alcohol as risk, outside sex as risk, concealment of HIV infection, violence as risk, consensual and non-consensual sexual violence, and absent family support. Participants also described the relationship of sexual risk, substance abuse, and violence in the context of Hispanic MSM relationships. Conclusions The results of the study provided some important clinical implications for clinicians providing care to Hispanic MSM. From the results of this study, directions for future research focused on the relationships of Hispanic MSM are evident. PMID:25242861

Decreases in self-reported alcohol consumption following HIV counseling and testing at Mulago Hospital, Kampala, Uganda

PubMed Central

2014-01-01

Background Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT. Methods We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at baseline when they last consumed alcohol, and prior three month alcohol consumption was measured using the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) at baseline and quarterly for one year. Hazardous alcohol consumption was defined as scoring ≥3 or ≥4 for women and men, respectively. We examined correlates of alcohol use at baseline, and of hazardous and non-hazardous drinking during the year of follow-up using multinomial logistic regression, clustered at the participant level to account for repeated measurements. Results Prior to HCT, 30% were current drinkers (prior three months), 27% were past drinkers (>3 months ago), and 44% were lifetime abstainers. One-third (35%) of the current drinkers met criteria for hazardous drinking. Hazardous and non-hazardous self-reported alcohol consumption declined after HCT, with 16% of baseline current drinkers reporting hazardous alcohol use 3 months after HCT. Independent predictors (p < 0.05) of continuing non-hazardous and hazardous alcohol consumption after HCT were sex (male), alcohol consumption prior to HCT (hazardous), and HIV status (negative). Among those with HIV, non-hazardous drinking was less likely among those taking antiretroviral therapy (ART). Conclusions HCT may be an opportune time to intervene with alcohol consumption. Those with HIV experienced greater declines in alcohol consumption after HCT, and non-hazardous drinking decreased for those with HIV initiating ART. HCT and ART initiation may be ideal times to intervene with alcohol consumption. Screening and brief intervention (SBI) to reduce alcohol consumption should be considered for HCT and HIV treatment venues. PMID:25038830

Revisiting liver disease progression in HIV/HCV-coinfected patients: the influence of vitamin D, insulin resistance, immune status, IL28B and PNPLA3.

PubMed

Mandorfer, Mattias; Payer, Berit A; Schwabl, Philipp; Steiner, Sebastian; Ferlitsch, Arnulf; Aichelburg, Maximilian C; Stättermayer, Albert F; Ferenci, Peter; Obermayer-Pietsch, Barbara; Grabmeier-Pfistershammer, Katharina; Trauner, Michael; Peck-Radosavljevic, Markus; Reiberger, Thomas

2015-03-01

To perform a comprehensive study on independent modulators of liver fibrosis progression and determinants of portal pressure considering immune status, insulin resistance (IR), serum 25-hydroxyvitamin D (25(OH)D) levels, genetic variants of patatin-like phospholipase domain-containing protein 3 (PNPLA3) and interleukin 28B (IL28B) in a thoroughly documented cohort of HIV/hepatitis C-coinfected (HIV/HCV) patients. 25(OH)D deficiency (25(OH)DDEF), IR and low CD4(+) T-lymphocyte nadir (lowCD4NAD) were defined as 25(OH)D <20 ng × ml(-1) , HOMA-IR >2 and CD4nadir <200 cells × μl(-1) respectively. Liver fibrosis progression rate (FPR) was calculated as METAVIR F units divided by the number of years since HCV infection. Patients with a FPR > median FPR were assigned to the highFPR group. Among 86 HIV/HCV, the median FPR was 0.167 units × years(-1) . While the prevalence of prior alcohol abuse, lowCD4NAD and 25(OH)DDEF was higher among highFPR patients, the prevalence of IR was comparable. The association between 25(OH)DDEF and FPR was confirmed in a subgroup of patients with METAVIR stage F0/F1/F2 in which 25(OH)D levels are not affected by the severity of liver disease. The distribution of IL28B C/C and PNPLA3 non-C/C was similar, while PNPLA3 G/G was exclusively observed in highFPR patients. LowCD4NAD (OR: 2.95; 95% CI: 1.05-8.24; P = 0.039) and 25(OH)DDEF (OR: 5.62; 95% CI: 2.05-15.38; P = 0.001) were independently associated with highFPR and showed an additive effect. Portal pressure correlated with prior alcohol abuse, HCV-genotype 3, CD4(+) nadir and 25(OH)D levels. Two potentially modifiable factors, CD4(+) nadir and 25(OH)D levels, were both independent modulators of liver fibrosis progression and determinants of portal pressure. Further studies are warranted to assess the relevance of PNPLA3 for FPR in HIV/HCV. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Risk Bases in Childhood and Adolescence among HIV-negative Young Adult Gay and Bisexual Male Barebackers

PubMed Central

Halkitis, Perry N.; Siconolfi, Daniel; Fumerton, Megan; Barlup, Kristin

2009-01-01

We sought to consider the phenomenon of intentional unprotected intercourse, known colloquially as barebacking, with regard to identities that gay men develop as barebackers and the developmental bases which may predispose some men to this identity. As part of a larger study, we analyzed the life history interviews of 12 diverse HIV-negative men in early adulthood, using thematic coding procedures to identify events, conditions, and emotional states in childhood and adolescence that might help to explain why uninfected young men might place themselves at risk for HIV seroconversion. These analyses elicited various risk bases in childhood and adolescence, including early sexual experiences, pronounced experimentation with and abuse of drugs and alcohol, feelings of loneliness, a lack of love relationships despite sexual activity, and early experiences of loss. These findings suggest a complex interplay between emotional factors and life events, which may help to explain these men as sexual risk takers. PMID:19946573

Psychiatric Disorders of Children Living with Drug-Abusing, Alcohol-Abusing, and Non-Substance-Abusing Fathers.

ERIC Educational Resources Information Center

Kelley, Michelle L.; Fals-Stewart, William

2004-01-01

Objective: The present study examined lifetime psychiatric disorders and current emotional and behavioral problems of 8- to 12-year-old children living with drug-abusing (DA) fathers compared to children living in demographically matched homes with alcohol-abusing (AA) or non-substance-abusing fathers. Method: Children's lifetime psychiatric…

Personality disorders among alcohol-dependent patients manifesting or not manifesting cocaine abuse: a comparative pilot study.

PubMed

Echeburúa, Enrique; De Medina, Ricardo Bravo; Aizpiri, Javier

2009-01-01

This study assessed personality disorders (PDs) in 158 alcohol-dependent outpatients (62 manifesting cocaine abuse and 96 without cocaine abuse) with the International Personality Disorders Examination interview between 2003 and 2006. Thirty-nine alcohol-dependent/cocaine abusers (62.9% of this group) and 51 only alcohol-dependent patients (53.1% of this group) manifested at least one PD. There were no statistically significant differences between groups in the overall prevalence rate of PDs. The most prevalent PDs, among the alcohol-dependent/cocaine abusers, were antisocial (21%), narcissistic (14.5%), and borderline (11.3%) PDs. The most frequently diagnosed PDs among the only alcohol-dependent patients were obsessive-compulsive (20.8%), paranoid (10.4%), and dependent (9.4%) PDs. There were significant differences between the groups. The study limitations are discussed.

The influence of parental divorce and alcohol abuse on adult offspring risk of lifetime suicide attempt in the United States.

PubMed

Alonzo, Dana; Thompson, Ronald G; Stohl, Mahlki; Hasin, Deborah

2014-05-01

The influences of parental divorce and alcohol abuse on adult offspring lifetime suicide attempt have not been examined in national data. This study analyzed data from the 2001-2002 NESARC to estimate main and interaction effects of parental divorce and alcohol abuse on lifetime suicide attempt. Adjusted for controls, parental divorce and parental alcohol abuse independently increased odds of lifetime suicide attempt. The effect of parental divorce was not significantly moderated by parental alcohol abuse. Further research is needed to examine whether additional parental and offspring psychiatric and substance use covariates attenuate the association between parental divorce and lifetime suicide attempt. PsycINFO Database Record (c) 2014 APA, all rights reserved

Exploring the nature of the relationship between child sexual abuse and substance use among women.

PubMed

Jarvis, T J; Copeland, J; Walton, L

1998-06-01

This study investigated whether child abuse (CSA) was associated with earlier substance use and greater severity of substance dependence and what aspects of CSA might predict substance abuse. The study compared (a) drug and alcohol treatment clients with and without a history of CSA and (b) CSA survivors outside drug and alcohol treatment who did or did not have current substance abuse. Semi-structured interviews took place at participants' homes, treatment agencies or the research centre. Volunteer participants included 100 women recruited from drug and alcohol treatment programmes and 80 CSA survivors recruited through CSA counseling services and medial advertising. The results focus on data from the Opiate Treatment Index, Severity of Alcohol Dependence Questionnaire, Substance Dependence Scale, Self-Esteem Inventory and self-reported histories of CSA. There were no differences between CSA survivors and other drug and alcohol treatment clients in their severity of dependence. Women with a history of CSA more frequently identified stimulants as their main problem drug and reported an earlier age of first intoxication and earlier use of inhalants. Among abused CSA survivors outside drug and alcohol treatment, women with current substance abuse had typically been abused during adolescence by someone outside the family, whereas those without current substance abuse were typically abused by family members before adolescence. The results suggest that adolescence is a crucial time for the influence of CSA experiences on substance abuse.

Reducing HIV Risks in the Places where People Drink: Prevention Interventions in Alcohol Venues

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.

2015-01-01

Apart from individual alcohol drinking behavior, the context or places where people drink play a significant role in HIV transmission risk. In this paper, we review the research that has been conducted on alcohol venues to identify the social and structural factors (e.g., social norms, sexual behavior) that are associated with HIV risk in these places, to review HIV prevention interventions based in alcohol venues, and to discuss appropriate methodologies for alcohol venue research. Alcohol venues are defined here as places that sell or serve alcohol for onsite consumption, including bars, bottle stores, nightclubs, wine shops, and informal shebeens. Despite the many established HIV risk factors at play in alcohol venues, limited prevention strategies have been implemented in such places. A total of 11 HIV prevention interventions or programs were identified. HIV prevention interventions in alcohol venues may be conducted at the individual, social, or structural level. However, multilevel interventions that target more than one level appear to lead to the most sustainable behavior change. Strategies to incorporate alcohol venues in biomedical prevention strategies including antiretroviral therapy for alcohol users are also discussed. PMID:26099244

Is HIV a model of accelerated or accentuated aging?

PubMed

Pathai, Sophia; Bajillan, Hendren; Landay, Alan L; High, Kevin P

2014-07-01

Antiretroviral therapy has reduced the incidence of adverse events and early mortality in HIV-infected persons. Despite these benefits, important comorbidities that increase with age (eg, diabetes, cardiovascular disease, cancer, liver disease, and neurocognitive impairment) are more prevalent in HIV-infected persons than in HIV-uninfected persons at every age, and geriatric syndromes such as falls and frailty occur earlier in HIV-infected persons. This raises a critical research question: Does HIV accelerate aging through pathways and mechanisms common to the aging process or is HIV simply an additional risk factor for a wide number of chronic conditions, thus accentuating aging? Extensive literature review. The purpose of this review is to briefly outline the evidence that age-related clinical syndromes are exacerbated by HIV, examine the ways in which HIV is similar, and dissimilar from natural aging, and assess the validity of HIV as a model of premature aging. Specific biomarkers of aging are limited in HIV-infected hosts and impacted by antiretroviral therapy, and a high rate of modifiable life style confounders (eg, smoking, substance abuse, alcohol) and coinfections (eg, hepatitis) in HIV-infected participants. There is a need for validated biomarkers of aging in the context of HIV. Despite these differences, welldesigned studies of HIV-infected participants are likely to provide new opportunities to better understand the mechanisms that lead to aging and age-related diseases. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Drug and alcohol abuse: The pattern and magnitude of the problem

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ajayi, P.A.

In the last 12 months, many more cases of alcohol and drug (substance) abuse in the workplace were seen in the Escravos operations of Chevron Nigeria Limited than in previous years. This called the attention to the rising prevalence of drug and alcohol abuse in contradistinction to reports from similar organizations in other parts of the world. Chevron Nigeria has a written Drug and Alcohol Policy which has been dormant for some time because of the apparent rarity of the problem of substance abuse in the workplace. This Policy is being reviewed to broaden its scope and make it moremore » effective. A total of 30 employees were tested for drugs and alcohol .6 exceeded the legal limits of Blood Alcohol Concentration (BAC) and 5 tested positive for drugs. Tests were mainly post-accident, reasonable cause and random. The common substances abused were alcohol, cannabis, cocaine and morphine in that order. The findings are compared with those of similar organizations in UK and USA. Efforts to control substance abuse in the workplace are being put into place.« less

Protein biomarkers of alcohol abuse

PubMed Central

Torrente, Mariana P; Freeman, Willard M; Vrana, Kent E

2012-01-01

Alcohol abuse can lead to a number of health and social issues. Our current inability to accurately assess long-term drinking behaviors is an important obstacle to its diagnosis and treatment. Biomarkers for chronic alcohol consumption have made a number of important advances but have yet to become highly accurate and as accepted as objective tests for other diseases. Thus, there is a crucial need for the development of more sensitive and specific markers of alcohol abuse. Recent advancements in proteomic technologies have greatly increased the potential for alcohol abuse biomarker discovery. Here, the authors review established and novel protein biomarkers for long-term alcohol consumption and the proteomic technologies that have been used in their study. PMID:22967079

Predictors of HIV-Risk Sexual Behavior: Examining Lifetime Sexual and Physical Abuse Histories in Relation to Substance Use and Psychiatric Problem Severity Among Ex-Offenders

PubMed Central

Majer, John M.; Rodriquez, Jaclyn; Bloomer, Craig; Jason, Leonard A.

2015-01-01

Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient treatment for substance dependence. Hierarchical linear regression was conducted to examine increases in participants’ number of sexual partners in relation to sociodemographic characteristics, recent substance use and current psychiatric problem severity in addition to lifetime histories of sexual and physical abuse. Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behaviors beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in the frequency of these practices based on lifetime abuse histories and gender were not significant. Findings suggest recent substance use and current psychiatric problem severity are risk-factors for HIV-risk sexual behavior among ex-offenders with and without lifetime abuse histories. PMID:24717831

The association of physical and sexual abuse with HIV risk behaviors in adolescence and young adulthood: implications for public health.

PubMed

Cunningham, R M; Stiffman, A R; Doré, P; Earls, F

1994-03-01

This paper explores the relationship between changes in HIV risk behaviors and physical and sexual abuse. A stratified random sampling procedure selected 602 youths from a sample of 2,787 patients seen consecutively at public health clinics in 10 cities. Face-to-face structured interviews conducted since 1984-85 provide a history of change in risk behavior from adolescence to young adulthood. Univariate and bivariate analyses assessed differences in demographic and number and type of risk behaviors between those experiencing single or multiple types of abuse and those with no abuse history at all. The results show that a history of physical abuse, sexual abuse, or rape is related to engaging in a variety of HIV risk behaviors and to a continuation or increase in the total number of these behaviors between adolescence and young adulthood. This information might help practitioners to both prevent initial involvement in HIV risk behaviors and to prevent continuation of behaviors as youths move into young adulthood.

Childhood Physical and Sexual Abuse and Social Network Patterns on Social Media: Associations With Alcohol Use and Problems Among Young Adult Women

PubMed Central

Oshri, Assaf; Himelboim, Itai; Kwon, Josephine A.; Sutton, Tara E.; Mackillop, James

2015-01-01

Objective: The aim of the present study was to examine the links between severities of child abuse (physical vs. sexual), and alcohol use versus problems via social media (Facebook) peer connection structures. Method: A total of 318 undergraduate female students at a public university in the United States reported severity of child abuse experiences and current alcohol use and problems. Social network data were obtained directly from the individuals’ Facebook network. Results: Severity of childhood physical abuse was positively linked to alcohol use and problems via eigenvector centrality, whereas severity of childhood sexual abuse was negatively linked to alcohol use and problems via clustering coefficient. Conclusions: Childhood physical and sexual abuse were linked positively and negatively, respectively, to online social network patterns associated with alcohol use and problems. The study suggests the potential utility of these online network patterns as risk indices and ultimately using social media as a platform for targeted preventive interventions. PMID:26562592

Childhood Physical and Sexual Abuse and Social Network Patterns on Social Media: Associations With Alcohol Use and Problems Among Young Adult Women.

PubMed

Oshri, Assaf; Himelboim, Itai; Kwon, Josephine A; Sutton, Tara E; Mackillop, James

2015-11-01

The aim of the present study was to examine the links between severities of child abuse (physical vs. sexual), and alcohol use versus problems via social media (Facebook) peer connection structures. A total of 318 undergraduate female students at a public university in the United States reported severity of child abuse experiences and current alcohol use and problems. Social network data were obtained directly from the individuals' Facebook network. Severity of childhood physical abuse was positively linked to alcohol use and problems via eigenvector centrality, whereas severity of childhood sexual abuse was negatively linked to alcohol use and problems via clustering coefficient. Childhood physical and sexual abuse were linked positively and negatively, respectively, to online social network patterns associated with alcohol use and problems. The study suggests the potential utility of these online network patterns as risk indices and ultimately using social media as a platform for targeted preventive interventions.

A history of alcohol dependence augments HIV-associated neurocognitive deficits in persons aged 60 and older.

PubMed

Gongvatana, Assawin; Morgan, Erin E; Iudicello, Jennifer E; Letendre, Scott L; Grant, Igor; Woods, Steven Paul

2014-10-01

Excessive alcohol use is common among people living with HIV. Given the growing prevalence of older HIV+ adults and observations indicating higher risk for neurocognitive impairment in older adults with either HIV infection or alcoholism, an increased understanding of their combined impact in the context of this increasingly aged population is crucial. We conducted comprehensive neurocognitive assessment in 112 older HIV+ individuals aged 50 to 69 years. Regression analyses were conducted to examine the interaction between age and the presence of lifetime alcohol dependence on neurocognitive measures, controlling for years of education, hepatitis C serostatus, and lifetime non-alcohol substance use disorder. Significant interactions of age and alcohol dependence history were found for global neurocognitive function, which was driven by the domains of executive function, processing speed, and semantic memory. Follow-up analyses indicated adverse effects of alcohol use history on neurocognitive measures that were evident only in HIV+ individuals 60 years and older. While mounting evidence in younger cohorts indicates adverse synergistic HIV/alcohol effects on neurocognitive function, our novel preliminary findings in this elderly HIV+ cohort demonstrated the importance of even a relatively distant alcohol use history on the expression of HIV-associated neurocognitive disorders that may not become apparent until much later in life.

The developmental effects of HIV and alcohol: a comparison of gestational outcomes among babies from South African communities with high prevalence of HIV and alcohol use.

PubMed

Donald, Kirsten A M; Fernandez, Anne; Claborn, Kasey; Kuo, Caroline; Koen, Nastassja; Zar, Heather; Stein, Dan J

2017-05-08

There is growing evidence of the negative impact of alcohol on morbidity and mortality of individuals living with HIV but limited evidence of in utero effects of HIV and alcohol on exposure on infants. We conducted a population-based birth cohort study (N = 667 mother-infant dyads) in South Africa to investigate whether maternal alcohol use and HIV affected gestational outcomes. Descriptive data analysis was conducted for all variables using frequency distributions, measures of central tendency, and estimates of variance. Hierarchical multiple regression was conducted to determine whether maternal alcohol use, maternal HIV status and other risk factors (socioeconomic status, smoking, depression) predicted infant outcomes. Our results showed severity of recent alcohol use and lifetime alcohol use predicted low birth weight. Similarly lifetime alcohol use predicted shorter infant length, smaller head length, smaller head circumference, and early gestational age. However, HIV status was not a significant predictor of gestational outcomes. The unexpected finding that maternal HIV status did not predict any of the gestational outcomes may be due to high rates of ART usage among HIV-infected mothers. The potentially negative effects of HIV on gestational outcomes may have been attenuated by improved maternal health due to high coverage of antiretroviral treatment in South Africa. Interventions are needed to reduce alcohol consumption among pregnant mothers and to support healthy growth and psychosocial development of infants.

"Booze is the main factor that got me where I am today": alcohol use and HIV risk for MSM in rural South Africa.

PubMed

Daniels, Joseph; Struthers, Helen; Lane, Tim; Maleke, Kabelo; McIntyre, James; Coates, Tom

2018-05-28

Excessive alcohol consumption has been shown to increase HIV risk for men who have sex with men (MSM) and compromise HIV prevention behaviors. However, there is limited contextual understanding of alcohol use for MSM in rural sub-Saharan African settings, which can inform and direct HIV interventions. Applying an adaptation of PhotoVoice, we worked with 35 HIV-positive MSM who created photo-essays about alcohol and HIV in Mpumalanga. A semi-structured protocol was used in focus group discussions that were audio-recorded, translated and transcribed. Transcript data and visual data of 24 photo-essays were analyzed using a constant comparison approach. We found that participants used alcohol to build and sustain social networks, meet sexual partners, and enhance sexual experience. Excessive alcohol use was common, which was associated with increased HIV risk behaviors within a community of MSM who maintained multiple partnerships. Our study suggests that HIV interventions need to address excessive alcohol use to mitigate the associated HIV risk at both the individual and community levels.

Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students.

PubMed

Jackson, Eric R; Shanafelt, Tait D; Hasan, Omar; Satele, Daniel V; Dyrbye, Liselotte N

2016-09-01

To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students. In 2012, the authors completed a national survey of medical students from the American Medical Association's Physician Masterfile containing validated items assessing alcohol abuse/dependence, burnout, depression, suicidality, quality of life (QOL), and fatigue. Descriptive and comparative statistical analyses were computed, including chi-square and multivariate logistic regression, to determine relationships between variables. Of the 12,500 students, 4,402 (35.2%) responded. Of these, 1,411 (32.4%) met diagnostic criteria for alcohol abuse/dependence. Students who were burned out (P = .01), depressed (P = .01), or reported low mental (P =.03) or emotional (P = .016) QOL were more likely to have alcohol abuse/dependence. Emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse/dependence. On multivariate analysis, burnout (OR 1.20; 95% CI 1.05-1.37; P < .01), having $50,000 to $100,000 (OR 1.21 versus < $50,000; CI 1.02-1.44; P < .05) or > $100,000 (OR 1.27 versus < $50,000; CI 1.08-1.48; P < .01) of educational debt, being unmarried (OR 1.89; CI 1.57-2.27; P < .001), and being younger (for every five years, OR 1.15; CI 1.02-1.28; P = .01) were independently associated with increased risk for alcohol abuse/dependence. Burnout was strongly related to alcohol abuse/dependence among sampled medical students and increased educational debt predicted a higher risk. A multifaceted approach addressing burnout, medical education costs, and alcohol use is needed.

Probability and predictors of treatment-seeking for substance use disorders in the U.S.

PubMed

Blanco, Carlos; Iza, Miren; Rodríguez-Fernández, Jorge Mario; Baca-García, Enrique; Wang, Shuai; Olfson, Mark

2015-04-01

Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence. The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment. In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment. Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD. Copyright © 2015. Published by Elsevier Ireland Ltd.

Probability and predictors of treatment-seeking for substance use disorders in the U.S

PubMed Central

Blanco, Carlos; Iza, Miren; Rodríguez-Fernández, Jorge Mario; Baca-García, Enrique; Wang, Shuai; Olfson, Mark

2016-01-01

Background Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence. Methods The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment. Results In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment. Conclusions Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD. PMID:25725934

The effects of cocaine on HIV transcription.

PubMed

Tyagi, Mudit; Weber, Jaime; Bukrinsky, Michael; Simon, Gary L

2016-06-01

Illicit drug users are a high-risk population for infection with the human immunodeficiency virus (HIV). A strong correlation exists between prohibited drug use and an increased rate of HIV transmission. Cocaine stands out as one of the most frequently abused illicit drugs, and its use is correlated with HIV infection and disease progression. The central nervous system (CNS) is a common target for both drugs of abuse and HIV, and cocaine intake further accelerates neuronal injury in HIV patients. Although the high incidence of HIV infection in illicit drug abusers is primarily due to high-risk activities such as needle sharing and unprotected sex, several studies have demonstrated that cocaine enhances the rate of HIV gene expression and replication by activating various signal transduction pathways and downstream transcription factors. In order to generate mature HIV genomic transcript, HIV gene expression has to pass through both the initiation and elongation phases of transcription, which requires discrete transcription factors. In this review, we will provide a detailed analysis of the molecular mechanisms that regulate HIV transcription and discuss how cocaine modulates those mechanisms to upregulate HIV transcription and eventually HIV replication.

Ethical Issues in mHealth Research Involving Persons Living with HIV/AIDS and Substance Abuse

PubMed Central

Labrique, Alain B.; Kirk, Gregory D.; Westergaard, Ryan P.; Merritt, Maria W.

2013-01-01

We aim to raise awareness and stimulate dialogue among investigators and research ethics committees regarding ethical issues that arise specifically in the design and conduct of mHealth research involving persons living with HIV/AIDS and substance abuse. Following a brief background discussion of mHealth research in general, we offer a case example to illustrate the characteristics of mHealth research involving people living with HIV/AIDS and substance abuse. With reference to a well-established systematic general ethical framework for biomedical research with human participants, we identify a range of ethical issues that have particular salience for the protection of participants in mHealth research on HIV/AIDS and substance abuse. PMID:24171110

Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected.

PubMed

Eyawo, Oghenowede; McGinnis, Kathleen A; Justice, Amy C; Fiellin, David A; Hahn, Judith A; Williams, Emily C; Gordon, Adam J; Marshall, Brandon D L; Kraemer, Kevin L; Crystal, Stephen; Gaither, Julie R; Edelman, E Jennifer; Bryant, Kendall J; Tate, Janet P

2018-02-01

Unhealthy alcohol use may be particularly detrimental among individuals living with HIV and/or hepatitis C virus (HCV), and is often under-reported. Direct biomarkers of alcohol exposure may facilitate improved detection of alcohol use. We evaluated the association of alcohol exposure determined by both self-report [Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)] and a direct biomarker [phosphatidylethanol (PEth)], with mortality among HIV-infected and HIV-uninfected in the Veterans Aging Cohort Study-Biomarker Cohort. We considered PEth <8 ng/mL to represent no alcohol use. Alcohol exposure by AUDIT-C scores [0, 1-3/1-2 (men/women), 4-7/3-7 (men/women), 8-12] and PEth (<8, ≥8) was combined into categories to model the relationship of alcohol with mortality. Participants were followed from blood collection date for 5 years or until death within 5 years. The sample included 2344 (1513 HIV+; 831 uninfected) individuals, 95% men. During a median follow-up of 5 years, 13% died. Overall, 36% were infected with HCV (40% HIV+/HCV+, 27% HIV-/HCV+). Overall, 43% (1015/2344) had AUDIT-C = 0 (abstinence). Of these, 15% (149/1015) had PEth ≥8 suggesting recent alcohol exposure. Among those with AUDIT-C = 0, HCV+ individuals were more likely to have PEth ≥8. After controlling for age, sex, race, HIV, HCV, and HIV viral suppression, those with AUDIT-C = 0 but PEth ≥8 had the highest risk of mortality (adjusted hazard ratio 2.15, 95% confidence interval: 1.40 to 3.29). PEth in addition to self-report may improve detection of alcohol use in clinical settings, particularly among those at increased risk of harm from alcohol use. Individuals infected with HCV were more likely to under-report alcohol use.

Factors associated with the perpetration of sexual violence among wine-shop patrons in Chennai, India

PubMed Central

Go, Vivian F.; Srikrishnan, Aylur K.; Salter, Megan L.; Mehta, Shruti; Johnson, Sethulakshmi C.; Sivaram, Sudha; Davis, Wendy; Solomon, Suniti; Celentano, David D.

2010-01-01

With an estimated 2.5 million people living with HIV/AIDS, India has the third highest number of HIV-infected people in the world. Despite reductions in prevalence among the general population, the percentage of all infections occurring among Indian women is continuing to rise. Women s risk of HIV infection from their partner and observed associations between sexual violence and HIV infection in India underscore the importance of understanding determinants of forced sex. A probability survey was conducted from June 2003 to August 2007 in Chennai, India among alcohol venue (“wine shops”) patrons to estimate the prevalence of sexual violence and to identify risk factors associated with perpetrating forced sex. Among 1499 men, 28.5% reported forced sex with at least one partner in the past 3 months. In multivariate analysis, earning income for less than 12 months a year, visiting the wine shop with friends, STD symptoms, perpetration of physical violence, and number of sexual partners were statistically significantly associated with perpetrating forced sex. Men who reported having 3 or more close friends were less likely to perpetrate violence. HIV interventions that facilitate formal groups that foster positive social support and address a range of HIV risk behaviors including sexually and physically abusive behaviors are recommended to reduce sexual violence. PMID:20692757

Correlates of having never been HIV tested among entrants to substance abuse treatment clinics: empiric findings from real-world New England settings.

PubMed

Chadwick, Jeanne J; Andrade, Leonardo F; Altice, Frederick L; Petry, Nancy M

2014-01-01

Routine testing is the cornerstone to identifying HIV, but not all substance abuse treatment patients have been tested. This study is a real-world evaluation of predictors of having never been HIV tested among patients initiating substance abuse treatment. Participants (N = 614) from six New England clinics were asked whether they had ever been HIV tested. Eighty-five patients (13.8%) reported having never been tested and were compared to those who had undergone testing. Clinic, male gender (adjusted odds ratio (AOR) = 1.91, 95% confidence interval (CI) = 1.07-3.41), and having fewer employment (AOR = 0.31; 95% CI = 0.11-0.88) and medical problems (AOR = 0.40, 95% CI = 0.17-0.99) were independently correlated with having never been HIV tested. Thus, there is still considerable room for improved testing strategies as a clinically significant minority of substance abuse patients have never undergone HIV testing when they initiate treatment.

HIV RISK REDUCTION INTERVENTIONS AMONG SUBSTANCE-ABUSING REPRODUCTIVE-AGE WOMEN: A SYSTEMATIC REVIEW

PubMed Central

Weissman, Jessica; Kanamori, Mariano; Dévieux, Jessy G.; Trepka, Mary Jo; De La Rosa, Mario

2017-01-01

HIV/AIDS is one of the leading causes of death among reproductive-age women throughout the world, and substance abuse plays a major role in HIV infection. We conducted a systematic review, in accordance with the 2015 Preferred Items for Reporting Systematic Reviews and Meta-analysis tool, to assess HIV risk-reduction intervention studies among reproductive-age women who abuse substances. We initially identified 6,506 articles during our search and, after screening titles and abstracts, examining articles in greater detail, and finally excluding those rated methodologically weak, a total of 10 studies were included in this review. Studies that incorporated behavioral skills training into the intervention and were based on theoretical model(s) were the most effective in general at decreasing sex and drug risk behaviors. Additional HIV risk-reduction intervention research with improved methodological designs is warranted to determine the most efficacious HIV risk-reduction intervention for reproductive-age women who abuse substances. PMID:28467160

Psychosocial stressors and alcohol use, severity, and treatment receipt across human immunodeficiency virus (HIV) status in a nationally representative sample of US residents.

PubMed

Williams, Emily C; Joo, Young Sun; Lipira, Lauren; Glass, Joseph E

2017-01-01

Human immunodeficiency virus (HIV) is stigmatized and disproportionately impacts vulnerable populations. Thus, people living with HIV (PLWH) may have greater exposure to psychosocial stressors than those without HIV. Exposure to psychosocial stressors may increase alcohol use and serve as barriers to alcohol treatment receipt. The authors evaluate whether psychosocial stressors and alcohol use, symptom severity, and treatment receipt vary across HIV status in a general population sample of US residents and assess whether psychosocial stressors mediate identified associations. Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were used to assess associations between HIV status and psychosocial stressors (perceived stress, alcohol-related stigma, and perceived discrimination based on race/ethnicity, sexual orientation, or sex) and alcohol-related outcomes (any use, heavy drinking, symptom severity, and treatment receipt). For each outcome, regression models were fit and iteratively adjusted for sociodemographic characteristics and comorbidities. Indirect effects of HIV on alcohol-related outcomes through stressors were estimated to assess mediation when main effects were significant. Among 34,653 NESARC Wave 2 respondents, 161 were PLWH. PLWH were more likely than those without HIV to experience discrimination and had higher levels of perceived stress than those without HIV (P values <.05), but the 2 groups did not differ regarding alcohol-related stigma. PLWH were less likely to use alcohol and had similar rates of heavy drinking relative to participants without HIV, but alcohol symptom severity and treatment receipt were greater among PLWH. Perceived stress but not discrimination mediated associations. Findings from this first study of variation in psychosocial stressors and alcohol use, severity, and treatment receipt across HIV status further highlight PLWH as a population that is particularly vulnerable to experiences of psychosocial stress and certain adverse alcohol-related outcomes. Future longitudinal research is needed in a larger sample of PLWH to identify intervention targets.

Reasons for drinking as predictors of alcohol involvement one year later among HIV-infected individuals with and without hepatitis C.

PubMed

Elliott, Jennifer C; Stohl, Malka; Aharonovich, Efrat; O'Leary, Ann; Hasin, Deborah S

2016-12-01

Heavy drinking can be harmful for individuals with HIV, particularly those coinfected with hepatitis C virus (HCV). HIV patients' reasons for drinking predict short-term alcohol involvement, but whether they predict longer-term involvement is unknown. Also, it remains unknown whether these motives are differentially predictive for HIV monoinfected and HIV/HCV coinfected patients. HIV-infected heavy drinkers (n = 254) participated in a randomized trial of brief alcohol interventions, 236 (92.9%) of whom reported on baseline motives and alcohol involvement 12 months later (77.1% male, 94.9% minority, 30.6% with HCV). Greater endorsement of baseline drinking to cope with negative affect predicted greater alcohol dependence symptoms at 12 months (incident rate ratio [IRR] = 1.80, p < 0.05), while greater endorsement of baseline drinking due to social pressure predicted fewer drinks consumed at 12 months (IRR = 0.67, p < 0.05). Coping and social reasons were both predictive for HIV monoinfected patients, whereas only coping reasons were predictive for HIV/HCV coinfected patients. Drinking for coping and social reasons predict alcohol involvement 12 months later; however, social reasons may only be important for HIV monoinfected patients. Understanding patient reasons for drinking may help predict patient risk up to a year later. KEY MESSAGES Among HIV patients, drinking motives predict alcohol involvement 12 months later. For HIV monoinfected patients, drinking to cope and drinking for social reasons predict 12-month alcohol involvement. For HIV/Hepatitis C coinfected patients, coping (but not social) motives predict 12-month alcohol involvement.

Alcohol Use and Human Immunodeficiency Virus (HIV) Infection: Current Knowledge, Implications, and Future Directions

PubMed Central

Williams, Emily C.; Hahn, Judith A.; Saitz, Richard; Bryant, Kendall; Lira, Marlene C.; Samet, Jeffrey H.

2016-01-01

Alcohol use is common among people living with human immunodeficiency virus (HIV). In this narrative review, we describe literature regarding alcohol’s impact on transmission, care, co-infections and comorbidities that are common among people living with HIV (PLWH), as well as literature regarding interventions to address alcohol use and its influences among PLWH. This narrative review identifies alcohol use as a risk factor for HIV transmission, as well as a factor impacting the clinical manifestations and management of HIV. Alcohol use appears to have additive and potentially synergistic effects on common HIV-related comorbidities. We find that interventions to modify drinking and improve HIV-related risks and outcomes have had limited success to date, and we recommend research in several areas. Consistent with Office of AIDS Research/National Institutes of Health priorities, we suggest research to better understand how and at what levels alcohol influences comorbid conditions among PLWH, to elucidate the mechanisms by which alcohol use is impacting comorbidities, and to understand whether decreases in alcohol use improve HIV-relevant outcomes. This should include studies regarding whether state-of-the-art medications used to treat common co-infections are safe for PLWH who drink alcohol. We recommend that future research among PLWH include validated self-report measures of alcohol use and/or biological measurements, ideally both. Additionally, subgroup variation in associations should be identified to ensure that the risks of particularly vulnerable populations are understood. This body of research should serve as a foundation for a next generation of intervention studies to address alcohol use from transmission to treatment of HIV. Intervention studies should inform implementation efforts to improve provision of alcohol-related interventions and treatments for PLWH in healthcare settings. By making further progress on understanding how alcohol use affects PLWH in the era of HIV as a chronic condition, this research should inform how we can mitigate transmission, achieve viral suppression, avoid exacerbating common comorbidities of HIV and alcohol use and make progress toward the 90-90-90 goals for engagement in the HIV treatment cascade. PMID:27696523

Research Priorities for the Intersection of Alcohol and HIV/AIDS in Low and Middle Income Countries: A Priority Setting Exercise.

PubMed

Gordon, Sara; Rotheram-Borus, Mary Jane; Skeen, Sarah; Perry, Charles; Bryant, Kendall; Tomlinson, Mark

2017-11-01

The harmful use of alcohol is a component cause for more than 200 diseases. The association between alcohol consumption, risk taking behavior and a range of infectious diseases such as HIV/AIDS is well established. The prevalence of HIV/AIDS as well as harmful alcohol use in low and middle income countries is high. Alcohol has been identified as a modifiable risk factor in the prevention and treatment of HIV/AIDS. The objective of this paper is to define research priorities for the interaction of alcohol and HIV/AIDS in low and middle income countries. The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities of the interaction of alcohol and HIV/AIDS. A group of 171 global and local experts in the field of alcohol and or HIV/AIDS related research were identified and invited to generate research questions. This resulted in 205 research questions which have been categorized and refined by senior researchers into 48 research questions to be evaluated using five criteria: answerability, effectiveness, feasibility, applicability and impact, as well as equity. A total of 59 experts participated independently in the voluntary scoring exercise (a 34% response rate). There was substantial consensus among experts on priorities for research on alcohol and HIV. These tended to break down into two categories, those focusing on better understanding the nexus between alcohol and HIV and those directed towards informing practical interventions to reduce the impact of alcohol use on HIV treatment outcomes, which replicates what Bryant (Subst Use Misuse 41:1465-1507, 2006) and Parry et al. (Addiction 108:1-2, 2012) found. Responses from experts were stratified by location in order to determine any differences between groups. On average experts in the LMIC gave higher scores than the HIC experts. Recent research has shown the causal link between alcohol consumption and the incidence of HIV/AIDS including a better understanding of the pathways through which alcohol use affects ARV adherence (and other medications to treat opportunistic infections) and CD4 counts. The results of this process clearly indicated that the important priorities for future research related to the development and assessment of interventions focusing on addressing alcohol and HIV/AIDS, addressing and exploring the impact of HIV risk and comorbid alcohol use, as well as exploring the risk and protective factors in the field of alcohol and HIV/AIDS. The findings from this priority setting exercise could guide international research agenda and make research funding more effective in addressing the research on intersection of alcohol and HIV/AIDS.

42 CFR 2.3 - Purpose and effect.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.3 Purpose and effect. (a) Purpose. Under the... use of alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program. The regulations specify: (1) Definitions...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.3 - Purpose and effect.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.3 Purpose and effect. (a) Purpose. Under the... use of alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program. The regulations specify: (1) Definitions...

42 CFR 2.3 - Purpose and effect.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.3 Purpose and effect. (a) Purpose. Under the... use of alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program. The regulations specify: (1) Definitions...

42 CFR 2.3 - Purpose and effect.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.3 Purpose and effect. (a) Purpose. Under the... use of alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program. The regulations specify: (1) Definitions...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.3 - Purpose and effect.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.3 Purpose and effect. (a) Purpose. Under the... use of alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program. The regulations specify: (1) Definitions...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland.

PubMed

Gilchrist, Elizabeth Allison; Ireland, Lana; Forsyth, Alasdair; Godwin, Jon; Laxton, Tim

2017-01-01

Scotland has a particular problem with alcohol, and the links between intimate partner abuse (IPA) and alcohol appear stronger here than elsewhere across Europe. This study explored differences in alcohol use, related aggression and relationship conflict across a number of groups: men convicted for intimate partner abuse, men convicted of general offences and men recruited from community sports teams. Participants (n = 64) completed three questionnaires exploring their experiences of alcohol use (Alcohol Use Disorders Identification Test, AUDIT); alcohol and aggression (Alcohol Related Aggression Questionnaire, ARAQ-28), and relationship conflict (Revised Conflict Tactics Scale, CTS-2). There were significant differences across the groups in terms of AUDIT and ARAQ-28 scores, IPA and general offenders scored higher than the community sample. CTS-2 scores showed significant differences: both offender groups reported more use of negotiation and psychological abuse, than the community men, and IPA offenders reported causing more physical harm than either general offenders or the community sample. ARAQ-28 scores correlated with psychological abuse for general offenders. Alcohol use was very high across all groups, but the community group did not endorse an aggression-precipitating view of alcohol and did not report high IPA. Discussed is the need for cross-cultural research to explore putative mediators and moderators in the relationship between alcohol, aggressiveness and IPA. [Gilchrist EA, Ireland L, Forsyth A, Godwin J, Laxton T. Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland. Drug Alcohol Rev 2017;36:20-23]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Neurotoxic Profiles of HIV, Psychostimulant Drugs of Abuse, and their Concerted Effect on the Brain: Current Status of Dopamine System Vulnerability in NeuroAIDS

PubMed Central

Ferris, Mark J.; Mactutus, Charles F.; Booze, Rosemarie M.

2008-01-01

There are roughly 30 to 40 million HIV infected individuals in the world as of December 2007, and drug abuse directly contributes to one-third of all HIV-infections in the United States. Antiretroviral therapy has increased the lifespan of HIV-seropositives, but CNS function often remains diminished, effectively decreasing quality of life. A modest proportion may develop HIV-associated dementia, the severity and progression of which is increased with drug abuse. HIV and drugs of abuse in the CNS target subcortical brain structures and DA systems in particular. This toxicity is mediated by a number of neurotoxic mechanisms, including but not limited to, aberrant immune response and oxidative stress. Therefore, novel therapeutic strategies must be developed that can address a wide variety of disparate neurotoxic mechanisms and apoptotic cascades. This paper reviews the research pertaining to the where, what, and how of HIV and cocaine/methamphetamine toxicity in the CNS. Specifically, where these toxins most affect the brain, what aspects of the virus are neurotoxic, and how these toxins mediate neurotoxicity. PMID:18430470

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men.

PubMed

Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim; McQuaid, John R; Patterson, Thomas L

2011-10-01

Drug assertiveness skills have been demonstrated to be effective in reducing substance use behaviors among patients with alcohol or heroin use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. Copyright © 2011 Elsevier Inc. All rights reserved.

75 FR 35818 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration... Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information.... Project: Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV...

Population attributable fraction of incident HIV infections associated with alcohol consumption in fishing communities around Lake Victoria, Uganda

PubMed Central

Kiwanuka, Noah; Ssetaala, Ali; Ssekandi, Ismail; Nalutaaya, Annet; Kitandwe, Paul Kato; Ssempiira, Julius; Bagaya, Bernard Ssentalo; Balyegisawa, Apolo; Kaleebu, Pontiano; Hahn, Judith; Lindan, Christina; Sewankambo, Nelson Kaulukusi

2017-01-01

Background Although the association between alcohol consumption and HIV risk is well documented, few studies have examined the magnitude of new HIV infections that could be prevented by controlling alcohol use. We report the population attributable fraction (PAF) of incident HIV infections due to alcohol consumption among the HIV high-risk population of fishing communities along Lake Victoria, Uganda. Methods In a community-based cohort study, 1607 HIV sero-negative participants aged 18–49 years were enrolled from eight fishing communities along Lake Victoria, Uganda. At follow up 12 months later, 1288 (80.1%) were seen and interviewed. At baseline and follow-up visits, participants completed interviewer-administered questionnaires on alcohol consumption, demographics, and sexual risk behavior, and were tested for HIV infection. HIV incidence and adjusted incident rate ratios (adjusted IRRs) were estimated using Poisson regression models; the crude and adjusted PAFs of incident HIV infections associated with alcohol consumption were calculated using the Greenland and Drescher method for cohort studies. Results Among the 1288 participants seen at follow up, 53.5% reported drinking alcohol of whom 24.4% drank occasionally (2 days a week or less) and 29.1% drank regularly (3–7 days a week). Forty eight incident HIV infections occurred giving an incidence rate of 3.39/100 person years at-risk (pyar) (95% CI, 2.55–4.49). Compared to non-drinkers, the adjusted IRR of HIV was 3.09 (1.13–8.46) among occasional drinkers and 5.34 (2.04–13.97) among regular drinkers. The overall adjusted PAF of incident HIV infections due alcohol was 64.1 (95% CI; 23.5–83.1); ranging from 52.3 (11.9–74.2) among Muslims to 71.2 (32.6–87.7) for participants who reported ≥ 2 sexual partners in the past 12 months. Conclusion In fishing communities along Lake Victoria, Uganda, 64% of new HIV infections can be attributed to drinking alcohol. Interventions to reduce alcohol consumption should be integrated in HIV/AIDS prevention activities for populations in whom both HIV and alcohol consumption are highly prevalent. PMID:28207844

History of childhood sexual abuse and unsafe anal intercourse in a 6-city study of HIV-positive men who have sex with men.

PubMed

Welles, Seth L; Baker, A Cornelius; Miner, Michael H; Brennan, David J; Jacoby, Scott; Rosser, B R Simon

2009-06-01

We assessed rates of childhood sexual abuse and its demographic and mental health correlates among HIV-positive men who reported unsafe anal intercourse with other men in the past year. We conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men enrolled in the Positive Connections intervention. Childhood sexual abuse was reported by 47% of participants; 32% reported frequency as often or sometimes. Men reporting abuse were more likely to be Latino (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.6, 4.2; P < .001) or African American (OR = 1.8; 95% CI = 1.2, 2.7; P = .005) than White. Among those who were abused, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR] = 1.3; P < .001) and unsafe anal intercourse (often, RR = 1.5; sometimes, RR = 2.0; P < .001) compared with men who were not abused. History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color. Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections.

Cocaine-mediated impact on HIV infection in humanized BLT mice

PubMed Central

Kim, Sohn G.; Lowe, Emily L.; Dixit, Dhaval; Seyeon Youn, Cindy; Kim, Irene J.; Jung, James B.; Rovner, Robert; Zack, Jerome A.; Vatakis, Dimitrios N.

2015-01-01

Cocaine abuse has been shown to have broad-ranging effects on human immunity. With regards to HIV infection, in vitro studies have shown that cocaine enhances infection of stimulated lymphocytes. Moreover, cohort studies in the pre- and post-HAART era have linked stimulant abuse with increased HIV pathogenesis. The latter data, however, have been undermined by a series of confounding factors underscoring the importance of controlled in vivo models to fully assess the impact of cocaine use and abuse on HIV infection and pathogenesis. Here, we have infected humanized mice with HIV-1 following acute cocaine exposure to assess the impact on infection. Stimulant exposure resulted in increased inflammatory cytokine expression, accelerated HIV infection, while blunting effector function of cytotoxic T lymphocytes. These data demonstrate cocaine’s multifactorial impact on HIV infection that extends beyond high-risk behavior. PMID:26084721

Hispanic women's experiences with substance abuse, intimate partner violence, and risk for HIV.

PubMed

Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P; Urrutia, Maria T; Villarruel, Antonia M; Peragallo, Nilda

2011-01-01

Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo ) in interventions targeting Hispanics.

Nontobacco substance use, sexual abuse, HIV, and sexually transmitted infection among street children in Kolkata, India.

PubMed

Bal, Baishali; Mitra, Rupa; Mallick, Aiyel H; Chakraborti, Sekhar; Sarkar, Kamalesh

2010-08-01

A community-based cross-sectional study among 554 Kolkata city street children assessed nontobacco substance use and sexual abuses along with human immunodeficiency virus (HIV)/ sexually transmitted infections (STIs) during 2007, using conventional cluster sampling technique for "hard-to-reach population" with a field-tested questionnaire and the collection of a blood sample for HIV and syphilis serology testing as a composite indicator of STIs. The reported prevalence of nontobacco substance use was 30%; 9% reported having been sexually abused. Some factors (age, lack of contact with family, orphan children, night stay at public place, etc.) were documented to be associated with substance use and sexual abuses. Seroprevalence of HIV was found to be 1% and that of STIs was 4%. This 1% HIV seroprevalence in street children is a matter of concern. Community-based intervention is necessary for them. The study's limitations are noted.

Factors Associated with HIV Viral Load in a Respondent Driven Sample in Los Angeles

PubMed Central

King, WD; Larkins, S; Hucks-Ortiz, C; Wang, J; Gorbach, P; Veniegas, R; Shoptaw, S

2008-01-01

This study used a modified version of the Behavioral Model for Vulnerable Populations to examine the predisposing, enabling, and need factors associated with detectable viral load (VL). HIV status was measured using saliva and confirmed by blood. Of 835 persons enrolled, 193 were HIV positive and provided VL counts. A multistage logistic regression demonstrated that the predisposing factors of homelessness and recent substance abuse, particularly methamphetamine abuse, had a negative association with VL. The negative association of homelessness was lessened with the introduction of enabling and need utilization factors in the model. In contrast, the negative association with recent substance abuse on VL was sustained in the final model. Provision of HIV care and medications attenuated the negative association of homelessness within this sample. Guided policy to address substance abuse among those who are HIV positive is needed to improve biological outcomes. PMID:18064555

Alcohol misuse, depressive symptoms, and HIV/STI risks of US Hispanic women.

PubMed

McCabe, Brian E; Schaefer Solle, Natasha; Peragallo Montano, Nilda; Mitrani, Victoria B

2017-10-01

Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study's objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = -.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women's health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.

Fetal Alcohol Syndrome "Chemical Genocide."

ERIC Educational Resources Information Center

Asetoyer, Charon

In the Northern Plains of the United States, 100% of Indian reservations are affected by alcohol related problems. Approximately 90% of Native American adults are currently alcohol users or abusers or are recovering from alcohol abuse. Alcohol consumption has a devastating effect on the unborn. Fetal Alcohol Syndrome (FAS) is an irreversible birth…

78 FR 42530 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group; Clinical, Treatment and Health Services Research Review... & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 2019, Rockville, MD 20852, 301-443-4032...

76 FR 77841 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group, Clinical, Treatment and Health Services Research Review... & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 2019, Rockville, MD 20852, (301) 443-4032...

76 FR 2128 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group. Epidemiology, Prevention and Behavior Research Review... Alcoholism, Extramural Project Review Branch, 5635 Fishers Lane, Room 2085, Bethesda, MD 20892. 301-451-2067...

76 FR 26735 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group, Clinical, Treatment and Health Services Research Review... & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 2019, Rockville, MD 20852, 301-443-4032...

Gender and racial/ethnic disparities in the impact of HIV prevention programming in substance abuse treatment.

PubMed

Cao, Dingcai; Marsh, Jeanne C; Shin, Hee-Choon

2008-01-01

The objective of the study was to evaluate the capacity of HIV prevention programs offered in substance abuse treatment to reduce HIV-related risk behavior for women and men and for Black, Latino, and White groups. Prospective data was collected at intake, discharage, and 12 months post-treatment from 1992 to 1997 for the National Treatment Improvement Evaluation Study with a sample consisting of 3,142 clients from 59 service delivery units: 972 females, 1,870 males, 1,812 Blacks, 486 Latinos, and 844 Whites. Study findings show that receipt of HIV prevention programming as part of substance abuse treatment services resulted in reductions in HIV-related risk behavior for the sample overall and for women as well as men. However, although Blacks received more prevention services than Latinos and Whites, the significant positive effect of HIV services on reduced HIVrisk behavior held only for Whites. Racial/ethnic disparities exist in the capacity for HIV prevention programming offered as part of substance abuse treatment to reduce HIV-risk behavior. The findings highlight the need for the development of culturally competent service delivery strategies to enhance the impact of these services for all groups.

77 FR 59405 - National Institute On Alcohol Abuse and Alcoholism; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Special Emphasis Panel; NIAAA AA-1 Member Conflict Applications. Date: October 9, 2012..., National Institute [[Page 59406

HIV-related risk behaviors among kathoey (male-to-female transgender) sex workers in Bangkok, Thailand.

PubMed

Nemoto, Tooru; Iwamoto, Mariko; Perngparn, Usaneya; Areesantichai, Chitlada; Kamitani, Emiko; Sakata, Maria

2012-01-01

Based on combined methods, this study investigated substance use and HIV risk behaviors among kathoey sex workers (KSWs) in Bangkok, Thailand. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months. About one third of the participants reported having engaged in unprotected anal sex with customers in the past six months. Almost all participants reported alcohol use, as well as having had sex with customers under the influence of alcohol. The prevalence of marijuana and ecstasy use in the past 12 months was high (32 and 36%, respectively); as was for ketamine (20%) and non-injecting methamphetamine (yaba) use (10%). A multiple regression analysis showed that the participants who were post-operative status, had used illicit drugs, or had been abused by their father and brothers were less likely to use condoms for anal sex with customers. Three quarters of the participants sent money to their families and 35% of the participants expressed their willingness to engage in unsafe sex when customers offer extra money. The qualitative interviews revealed that many identified as girl or kathoey in early age and had been exposed to transphobia and violence from father and brothers. Some reported support for gender transition from their mothers. More than half of the participants currently had difficulties in living as kathoey, such as challenges in the job market and relationship with family members. Family obligation for sending money and the Buddhist concept of karma were discussed in relation to risk behaviors among KSWs. The study provided implications for facilitating HIV testing and developing future HIV prevention intervention programs for KSWs in Thailand.

HIV-Related Risk Behaviors among Kathoey (Male-to-Female Transgender) Sex Workers in Bangkok, Thailand

PubMed Central

Nemoto, Tooru; Iwamoto, Mariko; Perngparn, Usaneya; Areesantichai, Chitlada; Kamitani, Emiko; Sakata, Maria

2011-01-01

Based on combined methods, this study investigated substance use and HIV risk behaviors among kathoey sex workers (KSWs) in Bangkok, Thailand. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months. About one third of the participants reported having engaged in unprotected anal sex with customers in the past 6 months. Almost all participants reported alcohol use, as well as having had sex with customers under the influence of alcohol. The prevalence of marijuana and ecstasy use in the past 12 months was high (32% and 36%, respectively); as was for ketamine (20%) and non-injecting methamphetamine (yaba) use (10%). A multiple regression analysis showed that the participants who were post-operative status, had used illicit drugs, or had been abused by their father and brothers were less likely to use condoms for anal sex with customers. Three quarters of the participants sent money to their families and 35% of the participants expressed their willingness to engage in unsafe sex when customers offer extra money. The qualitative interviews revealed that many identified as girl or kathoey in early age and had been exposed to transphobia and violence from father and brothers. Some reported support for gender transition from their mothers. More than half of the participants currently had difficulties in living as kathoey, such as challenges in job market and relationship with family members. Family obligation for sending money and the Buddhist concept of karma were discussed in relation to risk behaviors among KSWs. The study provided implications for facilitating HIV testing and developing future HIV prevention intervention programs for KSWs in Thailand. PMID:21780964

Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: its time to intervene.

PubMed

Chersich, M F; Rees, H V

2010-01-01

South Africa has a massive burden of HIV and alcohol disease, and these pandemics are inextricably linked. Much evidence indicates that alcohol independently influences decisions around sex, and undermines skills for condom negotiation and correct use. Thus, not surprisingly, people with problem drinking in Africa have twofold higher risk for HIV than non-drinkers. Also, sexual violence incidents often coincide with heavy alcohol use, both among perpetrators and victims. Reducing alcohol harms necessitates both population- and individual-level interventions, especially raised taxation, regulation of alcohol advertising and provision of Brief Interventions. Alcohol counselling interventions must include discussion of linkages between alcohol and sex, and consequences thereof. Within positive-prevention services, alcohol reduction interventions could diminish HIV transmission. A trial is needed to definitively demonstrate that reduced drinking lowers HIV incidence. However, given available evidence, implementation of effective interventions could alleviate much alcohol-attributable disease, including unsafe sex, sexual violence, unintended pregnancy and, likely, HIV transmission.

77 FR 69869 - National Advisory Council on Alcohol Abuse and Alcoholism, National Advisory Council on Drug...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Advisory Council on Alcohol Abuse and Alcoholism, National Advisory Council on Drug Abuse, and National Cancer Advisory Board; Notice of Joint Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given o...

NIH Institutes and MLN MedlinePlus Advisory Board

MedlinePlus

... 438-4380 National Institute on Alcohol Abuse and Alcoholism (NIAAA) www.niaaa.nih.gov (301) 443-3860 ... Shuly Babitz, National Institute on Alcohol Abuse and Alcoholism Joyce Backus, National Library of Medicine (ex-officio) ...

Laryngeal cancer in acquired immunodeficiency syndrome.

PubMed

Shushan, S; Cinamon, U; Levy, D; Sokolov, M; Roth, Y

2009-08-01

With improved survival, more AIDS patients, especially heavy smokers and alcohol abusers, may be confronted with laryngeal squamous cell carcinoma. Since curative treatment may require aggressive combined therapy, these patients, often suffering from immunosupression and poor general condition, present unique therapeutic challenges. The objective of the study was to describe treatment dilemmas. This case report presents a detailed description of an AIDS patient with carcinoma of the larynx. A patient with T3N0M0 laryngeal carcinoma and AIDS underwent tracheotomy and biopsy, followed by severe neck and pulmonary infection. After convalescence, radiotherapy was administered, with no evidence of a disease during a 3.5-year follow-up. During his remaining life, the patient developed severe psychoaffective disorder, his immune state deteriorated until he demised from sepsis. In conclusion, patients with HIV infection, especially having a history of tobacco or alcohol abuse, should be carefully examined for head and neck carcinoma that is likely to be more aggressive. Following surgery, AIDS patients may have worse wound healing and a greater tendency to contract infections. Radiotherapy and especially chemotherapy may cause life-threatening complications. Although early detection may increase survival, curative treatment should involve many disciplines and extra caution.

Aging and Alcohol Abuse: Increasing Counselor Awareness

ERIC Educational Resources Information Center

Williams, June M.; Ballard, Mary B.; Alessi, Hunter

2005-01-01

Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.

Buss-Durkee Assessment and Validation with Violent versus Nonviolent Chronic Alcohol Abusers.

ERIC Educational Resources Information Center

Renson, Gisele J.; And Others

1978-01-01

Chronic alcohol abusers who had been violent while intoxicated and nonviolent alcohol abusers were administered the Buss-Durkee Inventory. Violence was documented. Violent drinkers scored significantly higher than control subjects on the inventory total hostility score and on subscales measuring assault, irritability, verbal hostility, indirect…

Crossing the Quality Chasm: Challenges for Counselor Training Programs

ERIC Educational Resources Information Center

McCarty, Dennis; Gardin, John; Edmundson, Eldon

2007-01-01

Treatment for alcohol and drug disorders is changing. The evidence is emerging in federally sponsored reports, initiatives, and strategic plans from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The reports and…

Does comorbid alcohol and substance abuse affect electroconvulsive therapy outcome in the treatment of mood disorders?

PubMed

Moss, Lori; Vaidya, Nutan

2014-03-01

Antidepressant medications remain the principal agents used to treat patients with mood disorders, although 30% to 40% of these patients do not improve. One of the factors associated with poor medication response is alcohol and substance abuse. Persons with mood disorders are at the greatest risk for suicide, and alcoholism is a significant additional risk factor. Electroconvulsive therapy (ECT) is shown to be the most effective treatment for major depression especially when associated with psychosis, catatonia, and suicide intent. However, similar to most antidepressant trials, patients with depression and comorbid alcohol and substance abuse are excluded from ECT efficacy studies. Through a retrospective chart review, we compared response to ECT in patients with mood disorder and comorbid alcohol and drug abuse to those with mood disorder only. From 2004 to 2010, 80 patients with mood disorder received ECT. Fifty of these had comorbid alcohol or drug abuse. Using a 10-item psychopathology scale, we compared pre- and post-ECT symptom severity between the 2 groups. Outcome was determined by measuring a decrease in the pre-ECT and post-ECT score using Wilcoxon rank tests, with statistical significance at P = 0.05. There was no difference between the 2 groups in most demographics, ECT medication, or seizure quality. There was no difference in ECT outcome between those with comorbid alcohol abuse and those without based on percent decrease in pre- and post-ECT symptom scores (abuse: mean [SD], 0.89 [0.2] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 1332; P = 0.086). When we compared those who met the criteria for alcohol or drug dependence (19 patients) with those with no abuse, there was a trend for the dependence group to not do as well (dependence: mean [SD], 0.83 [0.25] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 405; P = 0.053). Those with combined drug and alcohol abuse (18 patients) did have a significantly worse outcome (combined: mean [SD], 0.82 [0.25] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 372; P = 0.033). Our results indicate that comorbid alcohol and drug abuse may influence the response to ECT in the treatment of mood disorders. Based on our results, patients with comorbid dependence and combined drug and alcohol abuse showed symptom improvement but did not do as well as those with nonabuse.

Contingency management in the treatment of adolescent alcohol drinking problems.

PubMed

Brigham, S L; Rekers, G A; Rosen, A C; Swihart, J J; Pfrimmer, G; Ferguson, L N

1981-09-01

Three case studies demonstrated that social and monetary reinforcement for abstinence reduced the rate of excessive alcohol drinking in adolescents. The self-monitoring and extrinsic reinforcement procedures (ABA reversal design) resulted in complete abstinence in a 15-year-old boy with a 10-year history of excessive alcohol abuse and hospitalization for an alcohol-induced psychosis. In the cases of the 13-year-old and 15-year-old girls with extensive alcohol abuse histories, the behavioral interventions decreased the rate of alcohol consumption during treatment phases, but alcohol abuse increased markedly with the removal of the intervention procedures.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): the association between birthplace, acculturation and alcohol abuse and dependence across Hispanic national groups.

PubMed

Caetano, Raul; Ramisetty-Mikler, Suhasini; Rodriguez, Lori A

2009-01-01

Hispanics are heterogeneous in national origin, evidenced by wide ranges of alcohol abuse and dependence rates across different Hispanic national groups. This paper examines associations between 12-month rates of DSM-IV alcohol abuse and dependence with birthplace and acculturation. The 2006 Hispanic Americans Baseline Alcohol Survey, using a multistage cluster sample design, interviewed 5224 adults (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. Comprehensive data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Alcohol abuse and dependence rates were higher among U.S.-born Puerto Ricans and South/Central Americans compared to their foreign-born counterparts, while no such differences were found for Cuban and Mexican Americans. Overall, those with higher acculturation report higher rates of abuse and dependence (statistically significant only for abuse among Puerto Ricans). Risk factors for abuse include being male and being in the high acculturation group. Risk factors for dependence include being male, being Puerto Rican or Mexican American, having less than a college education, and being U.S.-born. Hispanics were found to share several common risk factors with the larger U.S. population for abuse and dependence, such as male gender, lower education, and lower income.

Innovative Surveillance and Risk Reduction Systems for Family Maltreatment, Suicidality, and Substance Problems in USAF

DTIC Science & Technology

2005-03-01

prevention, spouse 13 abuse, child abuse , suicide, alcohol, drug abuse 16. PRICE CODE 17. SECURITY CLASSIFICA TION 18. SECURITY CLASSIFICA TION 19...cohesion 9 Triple P Command) • Spouse emotional 0 Depressive 9 Common Sense Parenting abuse symptomatology * Child abuse & neglect e Relationship...and secretive problems Partner Physical Prescr. Illicit Child Abuse Abuse Partner Emo. Abuse Alcohol Drug Drug Suicid- c3-to- Problems Misuse Use ality

Alcohol and Health. Fifth Special Report to the U.S. Congress from the Secretary of Health and Human Services.

ERIC Educational Resources Information Center

National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

This report is divided into an overview of alcohol and health, and eight chapters which deal with various aspects of alcohol use and abuse. The epidemiology of alcohol abuse and alcoholism is discussed. Data are presented on self-reported consumption of alcohol among youths and adults; alcohol consumption during pregnancy; alcohol-related…