Psychiatric disorders,suicidal ideation,and sexually transmitted infections among post-deployment veterans who utilize digital social media for sexual partner seeking

IntroductionDigital social media platforms represent outlets through which individuals may find partners for sexual encounters. Using a sample of US post-deployment military veterans, the current study evaluated the prevalence of digital sex seeking as well as clinical correlates of psychopathology, suicidal ideation, and sexually transmitted infections (STIs).MethodsUsing data from a baseline telephone interview and follow-up internet-based survey, we examined the prevalence of sexual partnering via digital social media platforms in a national sample of 283 US combat veterans.ResultsAmong veterans, 35.5% of men and 8.5% of women reported having used digital social media to meet someone for sex. Individuals who reported having used digital social media to find sexual partners (DSMSP+) as compared to those who did not (DSMSP-) were more likely to be young, male, and in the Marine Corps. After adjusting for sociodemographic variables, DSMSP+ status was associated with post-traumatic stress disorder (OR = 2.26, p = 0.01), insomnia (OR = 1.99, p = 0.02), depression (OR = 1.95, p = 0.03), hypersexuality (OR = 6.16, p < 0.001), suicidal ideation (OR = 3.24, p = 0.04), and treatment for an STI (OR = 1.98, p = 0.04).ConclusionAmong US post-deployment military veterans, DSMSP+ behaviors were prevalent, particularly among men. The association between DSMSP+ behaviors and PTSD, insomnia, depression, hypersexuality, suicidal ideation, and STIs suggest that veterans who engage in DSMSP+ behaviors should be particularly thoroughly screened and evaluated for these psychiatric concerns and counseled on the benefits of safe sexual practices.     

Minority stress is longitudinally associated with alcohol-related problems among sexual minority women

Compared to sexual minority men and heterosexual women, sexual minority women report elevated alcohol use in young adulthood. Heavy alcohol use and alcohol use disorders disproportionately affect sexual minority women across the lifespan, yet there is limited research investigating reasons for such associations. The present study investigates longitudinal associations between minority stress and both alcohol use as well as self-rated drinking consequences. Participants (N = 1057) were self-identified lesbian (40.5%) and bisexual (59.5%) women between the ages of 18 to 25 recruited from across the U.S. using online advertisements. Participants completed four annual surveys. Hurdle mixed effects models were used to assess associations between minority stress and typical weekly drinking and drinking consequences one year later. Minority stress was not significantly associated with subsequent typical drinking. However, minority stress was significantly associated with having any alcohol consequences as well as the count of alcohol consequences one year later after controlling for covariates. Consistent with extant literature, this study provides evidence for a prospective association between minority stress experienced by sexual minority women and drinking consequences. This study also provides support for the potential impact of efforts to reduce minority stress faced by sexual minority women.     

Examining the effects of drinking and interpersonal protective behaviors on unwanted sexual experiences in college women

IntroductionRecent evidence suggests interpersonal protective behaviors (IPBs) may be more effective than alcohol-based strategies at decreasing alcohol-related sexual consequences. However, no studies have examined individual IPBs to assess their unique influences on specific sexual consequences. The current study used a longitudinal design to examine the direct effects of typical weekly drinking and specific IPBs on unwanted sex. IPBs were also examined as moderators of the relationship between drinking and unwanted sex.MethodsRandomly sampled female drinkers attending a northeastern university (N = 191) completed a baseline survey measuring typical weekly drinking and IPBs and a six-month follow-up assessing unwanted sex. Bootstrapped regression examined the effects.ResultsDrinking predicted unwanted sex after accounting for IPBs (range of bs = .008–.009, SE = .005, 95% CI [.000, .02]). Vigilance-related IPBs were negatively associated with unwanted sex after controlling for drinking (b = −.052, SE = .025, 95% CI [−.107, −.008]). The IPB “Talking to people who know one's potential dating or sexual partner to find out what s/he is like” significantly moderated the drinking–unwanted sex relationship (b = −.009, SE = .004, 95% CI [−.018, −.003]). At above-average drinking levels, women who used this IPB more frequently reported fewer episodes of unwanted sex.ConclusionFindings revealed obtaining information about a potential partner significantly reduced the impact of drinking on unwanted sex for heavier drinkers. Future research examining how women implement this IPB may clarify its role in reducing unwanted sex.     

Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses

AimTo explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour.DesignA clustered randomized controlled trial, with participants randomly assigned to a 2-session coping skills intervention or a control no-intervention condition.SettingFifteen secondary schools throughout The Netherlands; 7 schools in the intervention and 8 schools in the control condition.Participants699 adolescents aged 13–15; 343 allocated to the intervention and 356 to the control condition; with drinking experience and elevated scores in either negative thinking, anxiety sensitivity, impulsivity or sensation seeking.MeasurementsDifferential effectiveness of the Preventure program was examined for the personality traits group, education level and gender on past-month binge drinking (main outcome), binge frequency, alcohol use, alcohol frequency and problem drinking, at 12 months post-intervention.Intervention and comparatorPreventure is a selective school-based alcohol prevention programme targeting personality risk factors. The comparator was a no-intervention control.FindingsIntervention effects were moderated by the personality traits group and by education level. More specifically, significant intervention effects were found on reducing alcohol use within the anxiety sensitivity group (OR = 2.14, CI = 1.40, 3.29) and reducing binge drinking (OR = 1.76, CI = 1.38, 2.24) and binge drinking frequency (β = 0.24, p = 0.04) within the sensation seeking group at 12 months post-intervention. Also, lower educated young adolescents reduced binge drinking (OR = 1.47, CI = 1.14, 1.88), binge drinking frequency (β = 0.25, p = 0.04), alcohol use (OR = 1.32, CI = 1.06, 1.65) and alcohol use frequency (β = 0.47, p = 0.01), but not those in the higher education group. Post hoc latent-growth analyses revealed significant effects on the development of binge drinking (β = − 0.19, p = 0.02) and binge drinking frequency (β = − 0.10, p = 0.03) within the SS personality trait.ConclusionsThe alcohol selective prevention program Preventure appears to have effect on the prevalence of binge drinking and alcohol use among specific groups in young adolescents in the Netherlands, particularly the SS personality trait and lower educated adolescents.     

The effects of alcohol hangover on future drinking behavior and the development of alcohol problems

IntroductionAlcohol hangover experiences in young adulthood have been shown to predict more subsequent alcohol problems. Hangover susceptibility appears to be partially heritable and related to family history of alcohol use disorders. However, very little is known about the developmental course of these associations and whether they are accounted for by an individual's drinking history. The goal of this study is to investigate the prospective and unique relationships between family history of alcohol use disorders, severity of alcohol hangover experiences in adolescence, and later alcohol use and related problems measured over 13 years.MethodsParticipants were first assessed on family history at age 12–14, prior to initiating drinking, and re-assessed annually on hangover severity, drinks per drinking day (DPDD), and alcohol-related problems throughout the 13-year follow-up period (n = 205; 59% male).ResultsIn mixed effects negative binomial regression models, greater family history density scores predicted more future DPDD (Incidence Rate Ratio [IRR] = 1.19, p = 0.04), alcohol problems (IRR = 1.64, p = 0.05), and future hangover severity (IRR = 1.24; p = 0.01). In turn, greater hangover severity predicted more future DPDD (IRR = 1.03; p = 0.002) and alcohol problems (IRR = 1.12, p < 0.001), and hangover severity mediated the relationship between family history and alcohol use/problems. All models controlled for participant age, sex, and past drinking behavior (where relevant).ConclusionsThese results advance the alcohol hangover experience during late adolescence as a clinically relevant and uniquely informative marker of future alcohol use and problems, above and beyond that of prior personal or familial drinking history.     

Drinking motives and alcohol consumption behaviors among young French people

IntroductionNumerous studies suggest that social, enhancement, conformity and coping drinking motives each lead to unique behavioral patterns related to alcohol consumption. Recently it has been suggested to study specific coping motives that distinguish feelings of anxiety and depression. This study aims primarily to 1) psychometrically validate the recent five factor questionnaire of drinking motives among young French people, 2) explore differences in mean endorsements of motives across age and sex and 3) explore the concurrent validity of drinking motives by studying their associations with alcohol consumption behaviors.MethodsThe French Modified Drinking Motives Questionnaire Revised and the Alcohol Use Disorders Identification Test were administered to 314 university students and 193 high school students.ResultsThe 5-factor model of drinking motives provided a good fit to the data and a better fit than the 4-factor model. Conformity motives were more strongly endorsed among high school students than among university students (d = 0.26). Social motives were more endorsed by men than by women (d = 0.47), as were enhancement motives (d = 0.48). Our study suggests that each of the studied motives transcribes a specific set of drinking behaviors.ConclusionsResearchers and practitioners could effectively use this conception of drinking motives in order to better understand and prevent problematic alcohol use among young people.     

Alcohol consumption patterns and sexual risk behavior among female sex workers in two South Indian communities

BackgroundHIV transmission in India is primarily heterosexual and there is a concentrated HIV epidemic among female sex workers (FSWs). Earlier reports demonstrate that many FSWs consume alcohol regularly before sexual encounters. This qualitative study is part of a larger quantitative study designed to assess alcohol consumption patterns among female sex workers and their association with sexual risk taking. Here we investigate the environmental influence, reasons for and consequences of consuming alcohol in the FSW population.MethodsTrained staff from two Non-Governmental Organizations in Andhra Pradesh and Kerala conducted semi-structured interviews with 63 FSWs in Chirala, Andhra Pradesh (n = 35) and Calicut, Kerala (n = 28) following extensive formative research, including social mapping and key informant interviews, to assess drinking patterns and sexual risk behaviors.ResultsFSWs reported consuming alcohol in multiple contexts: sexual, social, mental health and self-medication. Alcohol consumption during sexual encounters with clients was usually forced, but some women drank voluntarily. Social drinking took place in public locations such as bars and in private locations including deserted buildings, roads and inside autorickshaws (motorcycle taxis). Consequences of alcohol consumption included failure to use condoms and to collect payments from clients, violence, legal problems, gastrointestinal side effects, economic loss and interference with family responsibilities.ConclusionFSWs consume alcohol in multilevel contexts. Alcohol consumption during transactional sex is often forced and can lead to failure to use condoms. Social drinkers consume alcohol with other trusted FSWs for entertainment and to help cope with psychosocial stressors. There are multiple reasons for and consequences of alcohol consumption in this population and future interventions should target each specific aspect of alcohol use.     

HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty,Kazakhstan: Implications for HIV prevention,research, and policy

BackgroundKazakhstan and other countries in Central Asia are experiencing a rapidly growing HIV epidemic, which has historically been driven by injection drug use, but is more recently being fueled by heterosexual transmission.MethodsThis paper examines HIV and HCV infection, as well as sexual and drug-related risks among female partners of men who inject drugs (MWID), comparing females who inject drugs (FWID) to non-injecting female partners on socio-demographic, relationship context, and structural characteristics.ResultsThe prevalence rate of HIV was 30.1% among FWID and 10.4% among non-IDU female partners of MWID. The prevalence rate of HCV was 89.8% among FWID and 14.8% among female non-IDUs. Less than one-fifth of all female participants had access to HIV education and services or harm reduction programs. Although high rates of non-injection drug use and sexual risk behaviors were found among both FWID and non-injecting female partners of MWID, we found that FWID were more likely to be HIV seropositive (aRR = 3.03; 95% CI = 1.78, 5.18) and HCV seropositive than non-IDU females (aRR = 6.05; 95% CI = 4.05, 9.04), were more likely to have used alcohol or drugs before sex (aRR = 1.67; 95% CI = 1.40, 2.00), and were more likely to have used sedatives, barbiturates, tranquilizers, sleeping pills, or painkillers that were not prescribed by a physician (aRR = 17.45; 95% CI = 8.01, 38.01).ConclusionGiven the spread of the HIV epidemic to heterosexual partners in Kazakhstan, more attention is needed in research, prevention, and policies regarding female partners of male injection drug users.     

Relationship of drinking motives with alcohol consumption and alcohol-related problems identified in a representative community-based study from Ningxia,China

BackgroundDrinking motives have been linked to alcohol consumption and drinking-related problems in western countries, but evidence about this relationship is largely lacking for Asian countries. We aim to assess the relationship between drinking motives and drinking-related outcomes in China, where alcohol use disorders are an increasingly important contributor to the overall burden of illness.MethodsValidated Chinese versions of the Drinking Motives Questionnaire-Revised (DMQ-R) and the Alcohol Use Disorder Identification Test (AUDIT) were used to assess drinking motives and drinking-related outcomes among 612 current drinkers identified from a cross-sectional survey of a representative sample of 2425 adults living in Ningxia Province in 2013. Structural equation modeling was used to estimate the relationships linking specific drinking motives (‘enhancement’, ‘conformity’, ‘social’ and ‘coping’) to drinking-related outcomes (‘level of alcohol consumption’, ‘alcohol dependence’ and ‘adverse consequences’).FindingsThe enhancement motive is significantly associated with the level of alcohol consumption (β = 0.52, 95% CI = 0.27, 0.78). The conformity motive is associated with higher levels of alcohol dependence (β = 0.74, 95% CI = 0.50, 0.98) and adverse consequences of drinking (β = 0.43, 95% CI = 0.04, 0.81). The social motive and drinking to cope motive are not significantly associated with any of the three drinking outcomes.InterpretationThe relationships between drinking motives and drinking-related outcomes in China are quite different from those reported in western countries. This study highlights the need to consider local context when adapting prevention or intervention strategies developed in western countries to address the problem of the harmful use of alcohol in China.     

Symptoms of depression and PTSD are associated with elevated alcohol demand

BackgroundBehavioral economic demand curves measure individual differences in motivation for alcohol and have been associated with problematic patterns of alcohol use, but little is known about the variables that may contribute to elevated demand. Negative visceral states have been theorized to increase demand for alcohol and to contribute to excessive drinking patterns, but little empirical research has evaluated this possibility. The present study tested the hypothesis that symptoms of depression and PTSD would be uniquely associated with elevated alcohol demand even after taking into account differences in typical drinking levels.MethodAn Alcohol Purchase Task (APT) was used to generate a demand curve measure of alcohol reinforcement in a sample of 133 college students (50.4% male, 64.4% Caucasian, 29.5% African-American) who reported at least one heavy drinking episode (5/4 or more drinks in one occasion for a man/woman) in the past month. Participants also completed standard measures of alcohol consumption and symptoms of depression and PTSD.ResultsRegression analyses indicated that symptoms of depression were associated with higher demand intensity (alcohol consumption when price = 0; ΔR² = .05, p = .002) and lower elasticity (ΔR² = .04, p = .03), and that PTSD symptoms were associated with all five demand curve metrics (ΔR² = .04–.07, ps < .05).ConclusionsThese findings provide support for behavioral economic models of addiction that highlight the role of aversive visceral states in increasing the reward value of alcohol and provide an additional theoretical model to explain the association between negative affect and problematic drinking patterns.     

Alcohol expectancies longitudinally predict drinking and the alcohol myopia effects of relief,self-inflation,and excess

IntroductionAlcohol myopia theory posits that alcohol consumption attenuates information processing capacity, and that expectancy beliefs together with intake level are responsible for experiences in myopic effects (relief, self-inflation, and excess).MethodsAdults (N = 413) averaging 36.39 (SD = 13.02) years of age completed the Comprehensive Effects of Alcohol questionnaire at baseline, followed by alcohol use measures (frequency and quantity) and the Alcohol Myopia Scale one month later. Three structural equation models based on differing construct manifestations of alcohol expectancies served to longitudinally forecast alcohol use and myopia.ResultsIn Model 1, overall expectancy predicted greater alcohol use and higher levels of all three myopic effects. In Model 2, specifying separate positive and negative expectancy factors, positive but not negative expectancy predicted greater use. Furthermore, positive expectancy and use explained higher myopic relief and higher self-inflation, whereas positive expectancy, negative expectancy, and use explained higher myopic excess. In Model 3, the seven specific expectancy subscales (sociability, tension reduction, liquid courage, sexuality, cognitive and behavioral impairment, risk and aggression, and self-perception) were simultaneously specified as predictors. Tension reduction expectancy, sexuality expectancy, and use contributed to higher myopic relief; sexuality expectancy and use explained higher myopic self-inflation; and risk and aggression expectancy and use accounted for higher myopic excess. Across all three predictive models, the total variance explained ranged from 12 to 19% for alcohol use, 50 to 51% for relief, 29 to 34% for self-inflation, and 32 to 35% for excess.ConclusionsFindings support that the type of alcohol myopia experienced is a concurrent function of self-fulfilling alcohol prophecies and drinking levels. The interpreted measurement manifestation of expectancy yielded different prevention implications.     

Police sexual coercion and its association with risky sex work and substance use behaviors among female sex workers in St. Petersburg and Orenburg,Russia

BackgroundExtensive research documents that female sex workers (FSWs) in Russia are very vulnerable to abuses from police, including police sexual coercion. However, despite qualitative data suggesting abusive policing practices are more likely for FSWs contending with substance abuse issues and risky sex work contexts, there is a paucity of quantitative study evaluating these associations specifically in terms of police sexual coercion. Such research is needed to guide structural interventions to improve health and safety for FSWs in Russia and globally.ObjectiveThe purpose of this study is to assess the prevalence of police sexual coercion among FSWs from two Russian cities, St. Petersburg and Orenburg, and to determine whether riskier sex work behaviors and contexts and substance use behaviors, including both IDU and risky alcohol use, are associated with increased risk for sexual coercion from police.MethodFSWs in St. Petersburg and Orenburg were recruited via time-location and convenience sampling and completed structured surveys on demographics (age, education), sex work risks (e.g., violence during sex work) and substance use. Logistic regression analyses assessed associations of substance use and risky sex work with police sexual coercion, adjusting for demographics.ResultsParticipants (N = 896) were aged 15 and older (94% were 20+ years). Most (69%) reported past year binge alcohol use, and 48% reported IDU the day before. Half (56%) reported 4+ clients per day. Rape during sex work ever was reported by 64%. Police sexual coercion in the past 12 months was reported by 38%. In the multivariate model, both current IDU (AOR = 2.09, CI = 1.45–3.02) and past year binge alcohol use (AOR = 1.46, CI = 1.03–2.07) were associated with police sexual coercion, as was selling sex on the street (not in venues) (AOR = 7.81, CI = 4.53–13.48) and rape during sex work (AOR = 2.04, CI = 1.43–2.92).ConclusionCurrent findings document the substantial role police sexual violence plays in the lives of FSWs in Russia. These findings also highlight heightened vulnerability to such violence among self-managed and substance abusing FSWs in this context. Structural interventions addressing police violence against FSWs may be useful to improve the health and safety of this population.     

Effects of alcohol on disinhibition towards alcohol-related cues

BackgroundWe investigated (1) the effects of acute alcohol on inhibition of alcohol-related versus neutral cues, (2) the effects of drinking status on inhibition of alcohol-related versus neutral cues, and (3) the similarity of any effects of alcohol or drinking status across two different cue types (lexical versus pictorial).MethodsParticipants received 0.0 g/kg, 0.4 g/kg or 0.6 g/kg of alcohol in a between-subjects design. Healthy, heavy and light social alcohol users (n = 96) completed both lexical and pictorial cue versions of an alcohol-shifting task. Participants were instructed to respond to target stimuli by pressing the spacebar, but to ignore distracter stimuli. Errors towards distracter stimuli were analysed using a series of mixed-model ANOVAs, with between-subjects factors of challenge and drinking status and within-subjects factors of distracter type (alcohol, neutral) and block (shift, non-shift).ResultsLexical commission error data indicated a main effect of distracter (F [1,90] = 43.25, p < 0.001, η² = 0.33), which was qualified by a marginal interaction with challenge condition (F [2,90] = 2.77, p = 0.068, η² = 0.06). Following an acute high dose of alcohol participants made more errors towards alcohol distracters. Pictorial commission error data indicated a significant main effect of distracter (F [1,90] = 67.40, p < 0.001, η² = 0.43), such that all participants made more errors towards neutral image distracters versus alcohol distracter images.ConclusionsOur results reveal acute alcohol's impairment of inhibitory control may be enhanced when a response towards alcohol-related lexical stimuli is required to be withheld.     

Does it really matter which drug you choose? An examination of the influence of type of drug on type of risky sexual behavior

This study investigates whether certain types of substances are differentially related to certain risky sexual behaviors (RSBs) within the same population and determines whether combination substance use (SU) has additive, redundant or antagonistic effects on RSBs. African-American youth aged 9–19 participated in a large, community-based survey assessing substance use and sexual behaviors. Multilevel modeling was used to predict the differential influence of alcohol, marijuana, and cocaine use on condom use measured in the past 90 days and at last intercourse, sex while drunk/high, and number of sexual partners. Tests of the within-participant relations showed that participants increasing their SU over time concurrently increased their RSBs, establishing a strong link between the two behaviors (alcohol: condom β = − 0.045, sex while drunk/high β = 0.138, sex partners β = 0.102; marijuana: condom β = − 0.081, sex while drunk/high β = 0.255, sex partners β = 0.166; cocaine: condom β = − 0.091, sex while drunk/high β = 0.103, sex partners β = 0.031; all p's < 0.01). Tests of the between-participant relations showed that, generally, youth reporting less SU across their teenage years were also more likely to report fewer RSBs over this period (alcohol: condom β = − 0.128, sex while drunk/high β = 0.120, sex partners β = 0.169; marijuana: condom β = − 0.170, sex while drunk/high β = 0.638, sex partners β = 0.357; cocaine: condom β = − 0.353; all p's < 0.05). Moreover, the combination of some substances has unique redundant or antagonistic effects on RSB. Such findings support the consideration of type of SU, and particular combinations of substances, on RSBs in intervention development.     

Limitations of lifetime alcohol use disorder assessments: A criterion-validation study

The goal of the present study was to compare etiologically and clinically relevant correlates of lifetime AUD (e.g., alcohol consumption, personality traits, psychiatric disorders) based on a single assessment compared to a cumulative, prospective assessment of lifetime AUD. Data were drawn from the Alcohol, Health and Behavior (AHB; baseline N = 489) study, which consisted of a prospective cohort of college students assessed seven times over a 16-year period ([M(SD) age at baseline = 18.56 (.97)] and [M(SD) age at final assessment = 34.33 (.82)]). The participants were assessed using the Diagnostic Interview Schedule (DIS) for DSM-III at Waves 1–7 and for DSM-IV at Waves 6–7. A single assessment and cumulative assessments of DSM-III lifetime AUD at Wave 6 (M[SD] age = 28.98 [1.03]) were used to predict past-year alcohol related variables (e.g., alcohol consumption, drinking motives, drinking expectancies), personality variables, general functioning, lifetime substance use, and lifetime psychiatric disorders at Wave 7. Significantly larger correlations were found between the cumulative assessment and eight of the 25 etiologically relevant correlates of AUD compared to the single assessment. Further, significant incremental validity of cumulative assessment over single, retrospective assessment was observed for 16 of the 25 covariates. Overall, this study provides further support for the value of using prospective data with multiple assessments when determining lifetime history of disorder.     

Injection drug use among female sex workers in Iran: Findings from a nationwide bio-behavioural survey

BackgroundGlobally, one in three women who inject drugs is involved in sex work which increases their vulnerability to sexually transmitted infections including HIV. This study was conducted to improve our understanding of injection drug use practices among Iranian female sex workers (FSWs) and shed light on the high-risk profile of FSWs who inject drugs (FSW-IDUs).MethodsThis survey was conducted in 2010, by recruiting 872 FSWs through facility-based sampling from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews and lifetime injection drug use was assessed through the responses to the question “Have you ever injected any illicit drugs?”. Independent variables included a range of socio-demographic and risk characteristics. Logistic regression models were applied to investigate the correlates of lifetime history of injection drug use.ResultsMedian (Q1, Q3) age of the participants was 30 (25, 37) and a total of 127 (14.6%, 95% confidence interval (CI): 12.3–17.1) had ever injected drugs. In the multivariable logistic regression model, older age (adjusted odds ratio (AOR) = AOR_{25–34 vs. <18} = 3.37, 95% CI: 1.64, 7.70; AOR_{≥35 vs. <18} = 2.80, 95% CI: 1.11, 7.10), longer duration (>5 years) of involvement in sex work (AOR = 1.06, 95% CI: 1.02, 1.10), and history of drinking alcohol (AOR = 4.42, 95% CI: 2.67, 7.32) were positively associated with lifetime history of drug injection and younger age at sex work debut (AOR = 0.52, 95% CI: 0.28, 0.96) was negatively associated with lifetime history of illicit drug injection among FSWs.ConclusionThe prevalence of injection drug use among FSWs in Iran is concerning. Given the potential of this sub-population in bridging HIV into the general population, gender-sensitive and peer-led harm reduction programs should be further scaled up to meet the special needs of this vulnerable population.     

Insomnia moderates the association between alcohol use and consequences among young adult veterans

ObjectiveSymptoms of insomnia and heavy alcohol use tend to co-occur among military and veteran samples. The current study examined insomnia as a moderator of the association between alcohol use and related consequences among young adult veterans in an effort to extend and replicate findings observed in samples of civilian young adults.MethodYoung adult veterans (N = 622; 83% male; age M = 29.0, SD = 3.4) reporting alcohol use in the past year completed measures of insomnia severity, alcohol use, and alcohol-related consequences as part of a larger intervention trial. Participants were classified as screening ‘positive’ (n = 383, 62%) or ‘negative’ (n = 239, 38%) for insomnia using the Insomnia Severity Index. Hierarchical regression was used to examine the interaction between drinking quantity and insomnia on alcohol-related consequences. Predictor and outcome variables were measured concurrently.ResultsBoth a greater number of drinks per week and a positive insomnia screen were associated with more alcohol-related consequences. Drinks per week and insomnia screen interacted to predict alcohol-related consequences, such that the effect of drinking on alcohol-related consequences was stronger in the context of a positive versus negative insomnia screen.ConclusionDrinking is associated with more alcohol-related consequences in the presence of clinically significant insomnia symptoms. These findings replicate those documented in civilian young adults and indicate that insomnia may be an appropriate target for alcohol prevention and intervention efforts among young adult veterans.     

Patterns of excess alcohol consumption among school children in two English comprehensive schools

BackgroundThe patterns of excess alcohol consumption among children aged 11–15 years are not routinely assessed in England and neither are the alcohol consumption patterns of adolescents aged 16–18 years. The aim of the present research was to examine patterns of excess alcohol consumption among English school children aged 11–18 years.Methods1230 children and adolescents, aged 11–18 years were surveyed about their alcohol consumption, and specifically their hazardous drinking, binge drinking and problem drinking.ResultsSixteen per cent of 11 year olds and 71% of 18 year olds reported having drunk any alcohol in the previous seven days. Thirty-two per cent (n = 199) of girls and 24% (n = 142) of boys gave an affirmative answer to at least one of the CAGE questions, indicating possible problem drinking. Hazardous drinking was associated with norms and age; binge drinking and problem drinking were associated with norms, age and gender.ConclusionsThe study provides further evidence to support the case that excessive alcohol consumption among girls now exceeds that of boys. It would be valuable to collect data on patterns of excess alcohol consumption routinely to enable policy makers to target information and resources appropriately.     

Effects of a stand-alone web-based electronic screening and brief intervention targeting alcohol use in university students of legal drinking age: A randomized controlled trial

BackgroundMany intervention efforts targeting student drinking were developed to address US college students, which usually involves underage drinking. It remains unclear, if research evidence from these interventions is generalizable to university and college students of legal drinking age, e.g., in Europe.ObjectiveTo evaluate the effectiveness of a translated and adapted version of the eCHECKUP TO GO, applied as stand-alone web-based electronic screening and brief intervention (e-SBI), in German university students at risk for hazardous drinking.MethodsA fully automated web-based two-arm parallel-group randomized controlled trial was conducted. Participants were randomized to an e-SBI or assessment-only (AO) condition. The current paper analyzed students with baseline AUDIT-C scores ≥ 3 for women and ≥ 4 for men (sample at baseline: e-SBI [n = 514], AO [n = 467]; 3-month follow-up: e-SBI [n = 194], AO [n = 231]; 6-month follow-up: e-SBI [n = 146], AO [n = 200]). The primary outcome was prior four weeks' alcohol consumption. Secondary outcomes were frequency of heavy drinking occasions, peak blood alcohol concentration, and number of alcohol-related problems.ResultsMixed linear model analyses revealed significant interaction effects between groups and time points on the primary outcome after 3 and 6 months. Compared to students in the AO condition, students in the e-SBI condition reported consuming 4.11 fewer standard drinks during the previous four weeks after 3 months, and 4.78 fewer standard drinks after 6 months. Mixed results were found on secondary outcomes.ConclusionsThe results indicate that evidence on and knowledge of web-based e-SBIs based on US college student samples is transferable to German university students of legal drinking age. However, knowledge of what motivates students to complete programs under voluntary conditions, although rare, is needed.     

Racial and ethnic differences in associations between psychological distress and the presence of binge drinking: Results from the California health interview survey

IntroductionRacial and ethnic minorities often suffer from poorer health than Whites given their exposure to more stressors and fewer resources that buffer the effects of stress. Given that alcohol is often consumed to alleviate the negative moods, the present study hypothesized that psychological distress may impact the involvement in binge drinking differently across racial and ethnic groups.MethodsWe used data from the California Health Interview Survey (CHIS) from 2007 to 2012. The sample consisted of 130,556 adults including African Americans (N = 6541), Asians (N = 13,508), Latinos (N = 18,128), and Whites (N = 92,379). Binary logistic regression analysis was used with consideration for complex survey design.ResultsThe results indicated that psychological distress was significantly associated with binge drinking across all racial and ethnic groups. However, this association differed by race and ethnicity adjusting for age, gender, marital status, education, poverty, and employment status. The results revealed that psychological distress had the largest effect on binge drinking for Asian Americans, particularly Filipinos and South Asians, compared to Whites.ConclusionsThis study highlights the importance of examining racial and ethnic differences in the impacts of psychological distress on alcohol consumption. Future research is needed to better understand the potential factors that mediate the effects of psychological distress on binge drinking specific to each racial and ethnic group in order to develop culturally sensitive interventions and hence decrease the alcohol-related racial health disparities.