Alcohol retail sales licenses and sexually transmitted infections in Texas counties, 2008-2015

Background: Research suggests that reduced retail alcohol outlet density may be associated with lower prevalence of HIV and other sexually transmitted infections (STIs). On-premise sale of alcohol for immediate consumption is theorized as increasing social interactions that can lead to sexual encounters. Objective: We examined associations between on- and off-premise retail alcohol sales licenses and number of newly diagnosed HIV and STI cases in Texas counties. Methods: Retail alcohol sales license data were obtained from the Texas Alcoholic Beverage Commission. HIV and bacterial STI data were obtained from the Texas Department of State Health Services. Associations between retail alcohol sales licenses and STIs were estimated using spatial linear models and Poisson mixed effects models for over-dispersed count data. Results: Adjusting for county-specific confounders, there was no evidence of residual spatial correlation. In Poisson models, each additional on-premise (e.g., bar and restaurant) alcohol license per 10,000 population in a county was associated with a 1.5% increase (95% CI: 0.4%, 2.6%) in the rate of HIV and a 2.4% increase (95% CI: 1.9%, 3.0%) in the rate of bacterial STIs, adjusting for potential confounders. In contrast, number of off-premise licenses (e.g., take-out stores) was inversely associated with the incidence of STI and HIV, although the association with HIV was not statistically significant. Conclusions: This study adds to the limited literature on the association between retail alcohol availability and STIs. Additional research is needed on the role of alcohol availability (and policies affecting availability) in the spread of HIV and other STIs.     

Self-reported use of novel psychoactive substances among attendees of electronic dance music venues

Background: Novel psychoactive substances (NPSs) continue to emerge in the United States and worldwide. Few epidemiological studies have examined the prevalence and correlates of use. Objective: We examined the extent of NPS use in a high-risk population—attendees of electronic dance music (EDM) parties at nightclubs and festivals. Methods: We surveyed 682 adults (age 18–25) entering EDM events at nightclubs and festivals in New York City (NYC) in 2015. A variation of time–space sampling was used. We examined the prevalence of self-reported use of 196 NPS and correlates of any NPS use. Results: Over a third (35.1%) of participants reported lifetime use of any NPS. Self-reported use of synthetic cannabinoids was most prevalent (16.3%), followed by psychedelic phenethylamines (14.7%; 2C series: 10.3%, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine [NBOMe] series: 9.0%, Dox series: 3.5%), synthetic cathinones (“bath salts”, 6.9%), other psychedelics (6.6%), tryptamines (5.1%), and dissociatives (4.3%). 2C-I was the most prevalent 2C series drug (5.1%); methylone was the most prevalent synthetic cathinone (3.3%), 2-MeO-ketamine was the most prevalent dissociative (3.7%), and 1P-lysergic acid diethylamide (LSD) (2.9%) was the most prevalent non-phenethylamine psychedelic. Risk factors for NPS use included Ecstasy/MDMA/Molly, LSD, and ketamine use; identifying as bisexual (compared to heterosexual), reporting higher frequency of nightclub/festival attendance, and being surveyed outside of a festival (compared to those surveyed outside of nightclubs). Discussion: NPS use is prevalent in the nightclub and festival scenes in NYC. Since individuals in these scenes—especially frequent attendees—are at high risk for use, prevention and harm reduction services need to be geared toward this population.     

Classification of alcohol use disorders among nightclub patrons: associations between high-risk groups,sociodemographic factors and illicit drug use

Background: Nightclubs are favorable environments for alcohol abuse and the use of other drugs among patrons. Objective: To identify patterns of alcohol use in a high-risk population and their relationship with sociodemographic factors and illicit drug use. Methods: A portal survey technique was used to recruit patrons in 31 nightclubs in the city of São Paulo, Brazil. A two stage sampling method allowed the selection of nightclubs and patrons within a nightclub. A total of 1057 patrons answered to a three stages-survey (nightclub entrance and exit face-to-face interviews and a day-after online questionnaire). Entrance survey offered information on sociodemographic data and history of drug use. The day-after survey used the Alcohol Use Disorders Identifications Test (AUDIT) that identified patterns of alcohol abuse disorders. Data were modeled using an ordered logit regression analysis, considering sample weights. Results: Almost half of the nightclub patrons presented any alcohol use disorder (AUDIT score ≥8). Being male (OR?=?1.68; 95% CI?=?1.09–2.60) and single (OR?=?1.71; 95% CI?=?1.05–2.76) increased the chances for more severe alcohol use disorders. Having a graduate degree (OR?=?0.57; 95% CI?=?0.38–0.87) and age ≥35 years (OR?=?0.48; 95% CI?=?0.27–0.85) decreased the chances of patrons’ alcohol use disorders. The prevalence rates of past-year marijuana, cocaine and inhalants use increased with the increased level of alcohol use disorders. Conclusions: Patrons of nightclubs show higher prevalence rates for any alcohol use disorders than the general population. Patrons could benefit from governmental brief intervention or referral to treatment for alcohol used disorders disclosed in nightclubs.     

Making licensed venues safer for patrons: what environmental factors should be the focus of interventions?

The Queensland Safety Action Projects operationalized a problem-focused responsive regulatory model in order to make nightclubs and other venues safer. A problem-focused approach requires a careful analysis of the total environment of licensed venues, including drinking and its controls but also the social and physical environments, patron mix and management practices. We present new analyses of observational data collected in 1994 and 1996 in the north Queensland cities of Cairns, Townsville and Mackay. Major reductions in aggression and violence were observed, as well as improvements in many aspects of the venue environment and management practices. We do not argue in this paper that the interventions caused the environmental and management changes, although we believe this to be true. Rather, our assumption is that whatever caused them, some of the environmental and management changes were critical to the reductions in aggression. Regression techniques were used to identify those factors that best explained the declines in aggression. For reduced physical violence four key predictors were identified: improved comfort, availability of public transport, less overt sexual activity and fewer highly drunk men. For reduced non-physical aggression, four key predictors were: fewer Pacific Islander patrons, less male swearing, fewer intoxicated patrons requiring that management be called and more chairs with armrests. The analyses are consistent with the argument that the control of drinking is necessary but not sufficient to reduce aggression and violence.     

Engagement with different nightlife venues and frequent ecstasy use in a young adult population

Abstract

Aims: Little is known about the possible influence of different social settings on changes in patterns of ecstasy use over time. This study explores the relationship between engagement with different types of nightlife venues and subsequent frequent ecstasy use in an Australian young adult population sample. Methods: Longitudinal data are from a population-derived sample of Australian young adult ecstasy users (n?=?265). Attendance at four types of venues (nightclubs, electronic dance music events/music festivals, venues playing live music, and pubs/bars) was measured at 6 months. Frequency of recent ecstasy use (last 12 months) was measured at 12 and 30 months. A prediction model of frequent ecstasy use at 30 months was developed using Poisson regression reporting adjusted relative risk. Findings: Regular attendance at nightclubs (≥monthly, adjusted relative risk 6.21, confidence interval 2.30–16.76) was associated with frequent ecstasy use at 30 months, independently of ecstasy use expectancies, ecstasy availability, ecstasy and methamphetamine dependence, frequent use of methamphetamine and alcohol, and other dimensions of ecstasy involvement (i.e. length of ecstasy use career and lifetime ecstasy consumption). Conclusions: Compared with attendees of other venues, nightclub attendees may be a special priority group for ecstasy harm and demand reduction interventions.     

Indicators of Club Management Practices and Biological Measurements of Patrons’ Drug and Alcohol Use

Background: Electronic music and dance events in nightclubs attract patrons with heavy alcohol/drug use. Public health concerns are raised from risks related to these behaviors. Practices associated with increased risk in these club settings need to be identified. Objectives: The relationship between club management practices and biological measures of patrons’ alcohol/drug use is examined. Methods: Observational data from 25 events across six urban clubs were integrated with survey data (N = 738 patrons, 42.8% female) from patrons exiting these events, 2010–2012. Five indicators of club management practices were examined using mixed model regressions: club security, bar crowding, safety signs, serving intoxicated patrons, and isolation. Results: Analyses revealed that serving intoxicated patrons and safety signs were related to substance use. Specifically, serving intoxicated patrons was related to heavy alcohol and drug use at exit, while safety signs were marginally related to less exit drug use. Conclusions/Importance: Findings indicate observable measures in nightclubs provide important indicators for alcohol/drug use, suggesting practices to target. Study strengths include the use of biological measures of substance use on a relatively large scale. Limitations and future directions are discussed.