Alcohol-related Risk Behaviors Research Articles

Associations between alcohol demand, delayed reward discounting, and high-intensity drinking in a diverse emerging adult sample.

The high-intensity drinking threshold (HID; 8+/10+ drinks for women/men) is more strongly associated with significant alcohol-related health consequences than the more common heavy episodic drinking threshold (HED; 4+/5+ drinks for women/men). Behavioral economic measures of alcohol reward value (demand) and delayed reward discounting (DRD) have shown associations with other alcohol-related risk behaviors and may contribute to efforts to identify individuals who are at risk for HID from the larger subgroup of at-risk drinkers who engage in HED. Logistic regression analyses tested if alcohol demand and DRD were associated with HID in a sample of 477 emerging adults who reported recent heavy drinking. Receiver operating curve (ROC) analyses were conducted to test these variables' ability to classify HID group membership and to select an optimal cutoff score. In logistic regression analyses controlling for typical weekly drinking, demographics, and other variables associated with HID, participants reporting higher demand intensity (amount of alcohol purchased when price is zero; Adjusted Odds Ratio (AOR) = 20.27, 95% CI [5.71, 71.91]) and lower demand elasticity (sensitivity of alcohol consumption to increases in cost; AOR = .29, 95% CI [.11, 72]) were more likely to report HID relative to HED. Omax (maximum alcohol expenditure) and DRD were associated with HID in bivariate, but not in multivariate models. The ROC analysis provided support for an intensity cutoff of 7.5 or higher. These findings suggest that brief alcohol demand curve measures, in particular demand intensity and elasticity, may have utility in identifying individuals who are at risk for HID. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of walking impairment on mental health burden, health risk behavior and quality of life in patients with intermittent claudication: A cross-sectional path analysis.

Intermittent claudication is the leading symptom of peripheral artery disease (leg pain when walking). The present study investigates the extent to which walking impairment is associated with health-related quality of life, mental health and health risk behavior. A theory-based, cross-sectional path model was empirically examined using pre-intervention baseline data from a multicenter, randomized-controlled trial of patients with intermittent claudication (PAD-TeGeCoach). Data were available from 1 696 patients who completed a battery of questionnaires between April 14, 2018 and March 12, 2019, including measures of walking impairment (Walking Impairment Questionnaire), health-related quality of life (SF-12), mental burden (GAD-7, PHQ-9), nicotine- and alcohol-related risk behavior (Fagerström-Test, AUDIT-C). Sociodemographic characteristics and comorbid conditions were included in the postulated model a priori to minimize confounding effects. Walking impairment was associated with an increase in depressive (β = -.36, p < .001) and anxiety symptoms (β = -.24, p < .001). The prevalence of depressive and anxiety symptoms was 48.3% and 35.5%, respectively, with female patients and those of younger age being at greater risk. Depressive symptoms were predictive of an increased tobacco use (β = .21; p < .001). Walking impairment had adverse effects on physical quality of life, both directly (β = .60, p < .001) and indirectly mediated through depressive symptoms (β = -.16, p < .001); and indirectly on mental quality of life mediated through depressive (β = -.43, p < .001) and anxiety symptoms (β = -.35, p < .001). The findings underscore the need for a comprehensive treatment strategy in patients with intermittent claudication. Measures to improve walking impairment (e.g. exercise training) are key to enhance quality of life and should be the primary treatment. As a key mediator of mental quality of life, depressive and anxiety symptoms should be addressed by rigorously including mental health treatment. Risky health behaviors should be approached by promoting behavior change (e.g. smoking cessation) as a secondary prevention of peripheral artery disease.

The Information-Motivation-Behavioral Skills Model and Unprotected Sex: Assessing the Model's Utility and Predictability Among Bar Patrons in Tshwane, South Africa.

The Information-Motivation-Behavioral skills (IMB) model has been a useful tool for understanding sexual risk behavior. However, its utility in predicting sexual risk behaviors among bar patrons, for whom the bar setting poses a higher risk of alcohol-related sexual risk behavior, has been underexplored. We assessed (1) the extent to which the IMB predicted number of episodes of unprotected sex in the past six months and (2) whether incorporating sex under the influence of alcohol and alcohol use improved the predictability of the model among bar patrons. Hierarchical regression models were conducted on data from 406 men and women from bars in rural areas of North-West province, South Africa. Behavioral skills were the sole IMB variable to predict unprotected sex with main partners (β = - 0.40; p < .001), explaining 18% of the variance. Variance explained increased to 21% with addition of sex under the influence of alcohol (β = 0.13; p = .019) and further increased to 26% with the addition of alcohol use (β = 0.24; p < .001). Motivation (β = - 0.21; p = .006) and behavioral skills (β = - 0.21; p = .006) were the significant IMB predictors of unprotected sex with casual partners (explaining 15% of the variance). Variance explained increased to 22% with the addition of sex under the influence of alcohol (β = 0.26; p = .001), but alcohol consumption was not an independent predictor of episodes of unprotected sex with casual partners. Interventions for improving HIV prevention behaviors among bar patrons should focus on enhancing individuals' behavioral skills and motivation and reducing their alcohol consumption.

Drinking motives mediate the associations between urgency and hazardous/harmful alcohol use among moderate-to-heavy drinking men who have sex with men (MSM)

Urgency, the tendency to act rashly under extreme emotions, has been associated with higher rates of hazardous/harmful drinking. Moreover, previous work suggests that the association between urgency and hazardous/harmful drinking may be mediated by drinking motives. The current study sought to replicate and extend this research to men who have sex with men (MSM), a population that has shown increased alcohol-related health risk behavior. Methods: Two-hundred-and-fifty-six moderate-to-heavy drinking MSM completed questionnaires assessing urgency, drinking motives, and hazardous/harmful drinking. Regression models were conducted to examine the direct effect of Urgency on heavy episodic drinking and alcohol-related consequences and its indirect effects on these outcomes through drinking motives. Results: Urgency was significantly associated with heavy episodic drinking and alcohol-related consequences. Bootstrapping procedures indicated significant indirect effects through coping and enhancement motives for both outcomes and also conformity for consequences. Conclusions: These results indicate urgency may be an important risk factor for hazardous/harmful drinking among adult MSM that may operate in part through its effects on coping and enhancement motives.

Using ecological momentary assessment (EMA) to explore mechanisms of alcohol-involved HIV risk behavior among men who have sex with men (MSM).

Heavy drinking is associated with increased risk of incident HIV infection among men who have sex with men (MSM). Past studies suggest that this association may be due to the tendency for intoxication to interfere with condom use. However, research on potential causal mechanisms explaining this relationship has been limited primarily to laboratory studies. In this study, we tested several potential mediators of the relationship between alcohol use level and HIV risk behavior. Ecological momentary assessment (EMA) methods conducted over a 30-day period. MSM (n=100) in the northeastern United States. Participants completed daily diary surveys and up to six experience sampling surveys randomly prompted throughout the day. Very heavy levels of drinking (12+ drinks) increased the odds of engaging in any sex [odds ratio (OR)=1.87, P<0.001]. Coefficient products and 95% confidence intervals indicated that both subjective sexual arousal (OR=1.52, P<0.001) and sex intentions (OR=1.74, P<0.001) significantly mediated the association between very heavy drinking and the odds of sex. When participants reported sex, the odds of engaging in high-risk condomless anal sex (CAS) increased incrementally after drinking heavily (five to 11 drinks; OR=3.27, P=0.006) and very heavily (12+ drinks; OR=4.42, P<0.001). Only subjective sexual arousal significantly mediated the association between alcohol use level and high-risk CAS (OR=1.16, P=0.040). Increases in subjective sexual arousal after drinking heavily appear to partly account for alcohol-related HIV risk behaviors in the daily lives of men who have sex with men. Alcohol's role in strengthening motivationally consistent emotional states may therefore play a more important role in facilitating alcohol-involved HIV risk than explicit sexual motivation.

Alcohol Use and HIV Risk Within Social Networks of MSM Sex Workers in the Dominican Republic.

To examine how alcohol-related HIV risk behaviors within MSM sex workers' social networks (SN) may be associated with individual risk behaviors, respondent-driven and venue-based sampling were used to collect demographic, behavioral and SN characteristics among MSM sex workers in Santo Domingo and Boca Chica (N=220). The majority of participants reported problem drinking (71.0%) or alcohol use at their last sexual encounter (71.4%). Self-reported problem drinking was associated with SN characteristics (at least one member who recently got drunk aOR=7.5, no religious/spiritual adviser aOR=3.0, non-sexual network density aOR=0.9), while self-reported alcohol use at last sex was associated with individual (drug use at last sex aOR=4.4) and SN characteristics (at least one member with previous HIV/STI testing aOR=4.7). Dominican MSM sex workers reported high alcohol use, which may increase their risk for HIV. A better understanding of SN factors associated with individual risk behaviors can helpguide appropriate intervention development.

The Association between Alcohol and Sexual Risk Behaviors among College Students: A Review.

Alcohol use is prevalent among college students and may contribute to sexual risk behavior engagement. A narrative review of the recent empirical literature examining the association between alcohol use and sexual risk behaviors among college student samples was conducted. The purpose of this review was to: (a) review studies examining the association between alcohol use and risky sexual behaviors; and (b) overview research investigating alcohol expectancies and partner characteristics as factors that may influence the alcohol-risky sex relation among college students. Findings regarding the direct link between alcohol use and sexual risk behaviors were mixed. Results suggest a more nuanced association between alcohol and risky sexual behaviors that is influenced by alcohol expectancies and partner characteristics. Results highlight the importance of considering additional factors that may influence the alcohol-risky sex relation. Future interventions targeting alcohol-related sexual risk behavior engagement among college students are needed.

Understanding emotional bond between the creator and the avatar: Change in behavioral intentions to engage in alcohol-related traffic risk behaviors

This study examines the joint impact of an individual's relationship with his or her avatar and negative consequences to the avatar on changing the individual's behavioral intentions (BI) in terms of alcohol-impaired driving. One hundred eleven participants volunteered to participate in several experimental conditions where the degree of choice of avatar features and the degree of control of the avatar's actions were manipulated in Second Life, an immersive 3D virtual environment. Participants who were allowed to customize their avatars viewed their avatars not only more similar but also emotionally closer to themselves, and perceived their avatars to be physically more attractive than those who were assigned basic avatars. After observing a car crash caused by drunk driving, participants in the choice and control condition were more likely to change BI positively when they identified their avatars to be similar to themselves, and regarded their avatars more attractive. Furthermore, participants who were allowed to control their avatars were more likely to attribute the responsibility of the car accident to themselves than those who observed someone else's avatar playing. Implications for the use of virtual reality games in promoting healthy behaviors are discussed in detail.

Demographic Predictors of Event-Level Associations between Alcohol Consumption and Sexual Behavior.

Alcohol consumption is associated with sexual behavior and outcomes, though research indicates a variety of moderating factors, including demographic characteristics. To better target interventions aimed at alcohol-related sexual risk behavior, our analyses simultaneously examine demographic predictors of both day- and event-level associations between alcohol consumption and sexual behavior in a sample of young adults (N = 301) who are sexually active and consume alcohol. Young adults (aged 18-29) recruited using time-space sampling and incentivized snowball sampling completed a survey and a timeline follow-back calendar reporting alcohol consumption and sexual behavior in the past 30 days. On a given day, a greater number of drinks consumed was associated with higher likelihood of sex occurring, particularly for women and single participants. During a given sexual event, number of drinks consumed was not associated with condom use, nor did any demographic predictors predict that association. Findings highlight associations between alcohol and sexual behavior, though not between alcohol and sexual risk behavior, highlighting the need for additional research exploring the complex role of alcohol in sexual risk behavior and the need to develop prevention efforts to minimize the role of alcohol in the initiation of sexual encounters.

Impulsive alcohol-related risk-behavior and emotional dysregulation among individuals with a serotonin 2B receptor stop codon.

A relatively common stop codon (Q20*) was identified in the serotonin 2B receptor gene (HTR2B) in a Finnish founder population in 2010 and it was associated with impulsivity. Here we examine the phenotype of HTR2B Q20* carriers in a setting comprising 14 heterozygous HTR2B Q20* carriers and 156 healthy controls without the HTR2B Q20*. The tridimensional personality questionnaire, Brown–Goodwin lifetime aggression scale, the Michigan alcoholism screening test and lifetime drinking history were used to measure personality traits, impulsive and aggressive behavior, both while sober and under the influence of alcohol, and alcohol consumption. Regression analyses showed that among the HTR2B Q20* carriers, temperamental traits resembled a passive-dependent personality profile, and the presence of the HTR2B Q20* predicted impulsive and aggressive behaviors particularly under the influence of alcohol. Results present examples of how one gene may contribute to personality structure and behaviors in a founder population and how personality may translate into behavior.

Drinking patterns of alcohol intoxicated adolescents in the emergency department: A latent class analysis

IntroductionThe increasing number of children and adolescents in need of emergency medical treatment following acute alcohol intoxication has been a major public health concern in Europe in recent years. However, little is known about drinking habits and associated risks in this population. To our knowledge, this is the first study to examine drinking patterns and associated risks in adolescent emergency department patients following alcohol intoxication. The aim of this study is to establish a classification system for admitted adolescents MethodsLatent class analysis was used to identify subgroups of adolescents with distinct patterns of habitual drinking as defined by the quantity of consumed alcohol on a typical drinking occasion, frequency of binge drinking and drunkenness, alcohol-related problems, prior alcohol-related hospitalizations and alcohol-related risk behaviors. Subgroup characteristics were examined with regard to sociodemographics, other substance use and psychosocial problems using analysis of variance (ANOVA) and chi-square tests. ResultsA total of 316 adolescents aged 12–17 treated in 6 urban emergency departments in Germany were analyzed. Five classes of drinking patterns were identified: one class representing low-risk drinking (class 1 “low-risk” (61.2%)), two classes representing risky drinking (class 2 “moderate-risk” (5.7%) and class 3 “frequent drunk” (15.8%)), as well as two classes representing high-risk drinking (class 4 “alcohol-related problems” (11.4%) and class 5 “excessive drinking” (5.1%)). Membership of classes 4 and 5 was associated with the most severe psychosocial problems, especially with regard to aggressive-dissocial behaviors. The CRAFFT-d and brief RAPI screening tools allowed identifying the two risky drinking classes and two high-risk drinking classes. ConclusionsOur findings provide the first in-depth analysis of habitual drinking in this study population and may help practitioners to better tailor interventions to patients' needs by using the identified classes as a form of classification system for admitted adolescents.

History of Childhood Abuse, Drinking Motives, Alcohol Use, and Sexual Risk Behavior Among STD Clinic Patients in St. Petersburg, Russia: A Cross-Sectional Study.

The relationship between level of childhood abuse (physical and emotional) and sexual risk behavior of sexually transmitted disease clinic patients in St. Petersburg, Russia was examined through path analyses. Mediating variables investigated were: Alcohol Use Disorder Identification Test (AUDIT), drinking motives (for social interaction, to enhance mood, to facilitate sexual encounters), intimate partner violence (IPV), anxiety, and depression symptoms. Results showed a significant indirect effect of childhood abuse on women's sexual risk behavior: higher level of childhood abuse was associated with a greater likelihood of IPV, motivations to drink, leading to higher AUDIT scores and correlated to higher likelihood of having multiple, new or casual sexual partner(s). No significant effect was identified in paths to condom use. Among men, childhood abuse had no significant effect on sexual risk behavior. Reduction in alcohol-related sexual risk behavior may be achieved by addressing the effects of childhood abuse among female participants.

Behavioral economic decision making and alcohol-related sexual risk behavior.

The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.

Women and alcohol. A survey in the city of Barletta.

The aim of this survey was to evaluate the qualitative and quantitative relationship among women from Barletta--a national renowned wine center--and their alcohol consumption. The AUDIT questionnaire was used to assess the prevalence of alcohol hazardous consumption among women. Questionnaires were submitted from March to November 2012. The sample was composed of 150 women older than 13 years of age, selected by stratified sampling based on age group. 107 women were enrolled with a total response rate of 71.3%. 62% of enrolled women consumes alcoholic beverages with a frequency that goes from 2-3 times a week to less than once a month, usually 1 or 2 alcoholic units. The binge-drinking was reported by 5% of women. Women who reported alcohol-related risk behaviors were less than 3%, they were single and between 18 and 60 years old and such behaviors occur less than once a month. The final score, calculated for all the women from their questionnaire answers, was not higher than 8, with an average score of 1.3 (SD = 1.5; range: 0 to 2.8). The comparison of the average scores of the three age groups showed a statistically significant difference (F = 5.8, p = 0.004). Data from literature showed a change in the habits of alcohol intake by the global, European and also Italian population. These changes also affect and involve female. Our study found a quite moderate alcohol consumption among women from Barletta, with only 1% who consumes 3 or more alcohol units and drink more than four times a week and 3% who had hazardous behavior related to their alcohol consumption. Statistical significance was found for the age and the lack of stable relationships. The analysis of characteristics of at risk women (old age and single-status) suggests that much attention should be paid to them and they should represent the main subject of future social interventions to prevent alcohol related problems in the city of Barletta.

Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania, Kenya, and Namibia

This article describes the frequency of alcohol use among HIV-positive patients attending clinical care in sub-Saharan Africa and explores the association between alcohol use, medication adherence, and sexual risk behavior. Data from 3538 patients attending an HIV clinic in Kenya, Tanzania, or Namibia were captured through interview and medical record abstraction. Participants were categorized into three drinking categories: nondrinkers, nonharmful drinkers, and harmful/likely dependent drinkers. A proportional odds model was used to identify correlates associated with categories of alcohol use. Overall, 20% of participants reported alcohol use in the past 6 months; 15% were categorized as nonharmful drinkers and 5% as harmful/likely dependent drinkers. Participants who reported missing a dose of their HIV medications [adjusted odds ratio (AOR): 2.04, 95% confidence interval (CI): 1.67, 2.49]; inconsistent condom use (AOR: 1.49, 95% CI: 1.23, 1.79); exchanging sex for food, money, gifts, or a place to stay (AOR: 1.57, 95% CI: 1.06, 2.32); and having a sexually transmitted infection symptom (AOR: 1.40, 95% CI: 1.10, 1.77) were more likely to be categorized in the higher risk drinking categories. This research highlights the need to integrate alcohol screening and counseling into the adherence and risk reduction counseling offered to HIV-positive patients as part of their routine care. Moreover, given the numerous intersections between alcohol and HIV, policies that focus on reducing alcohol consumption and alcohol-related risk behavior should be integrated into HIV prevention, care, and treatment strategies.

Brief Intervention and Social Work: A Primer for Practice and Policy

Most individuals in need of help for alcohol use disorders do not receive care. Screening and brief intervention (SBI) is an evidence-based practice for reducing at-risk drinking and alcohol-related risk behaviors. Health care reform sets the stage for a large expansion of SBI to individuals in the United States. Social workers have the opportunity to play an important role in helping establish SBI nationally, but they must become more involved in its delivery, educating new social workers with respect to SBI practice, and taking part in research to expand the field's knowledge of this service.

Evaluating an Integrative Theoretical Framework for HIV Sexual Risk among Juvenile Justice involved Adolescents

Juvenile justice involved youth are at great risk for negative outcomes of risky sexual behavior including HIV/AIDS. Given the strong connection between alcohol use and risky sex in this population, it is important to consider alcohol use in interventions designed to decrease risky sexual behavior. This paper provides support for an integrative translational model that incorporates psychosocial, neurobiological, and genetic factors to better predict alcohol-related sexual risk behavior. Specifically, we present the design, methods, and baseline data from a complex randomized control trial, Project SHARP (Sexual Health and Adolescent Risk Prevention) in order to illustrate how this broad array of factors can best predict alcohol-related sexual risk behavior. Participants were justice-involved adolescents (n=284) who completed an fMRI and self-report assessments prior to randomization to either a sexual risk plus alcohol risk reduction group intervention or to an information-only contact control group intervention. Structural equation modeling was utilized and findings supported the hypothesized relationships in the translational model. Preliminary data suggest that interventions among justice-involved adolescents targeting alcohol-related sexual risk behavior may be more effective if a biopsychosocial approach is considered.

Associations Between Selected State Laws and Teenagers' Drinking and Driving Behaviors

We examined the associations between selected state-level graduated driving licensing (GDL) laws and use-and-lose laws (laws that allow for the suspension of a driver's license for underage alcohol violations including purchase, possession, or consumption) with individual-level alcohol-related traffic risk behaviors among high school youth. Logistic regression models with fixed effects for state were used to examine the associations between the selected state-level laws and drinking and driving behaviors youth aged 16 to 17 years (obtained from the Youth Risk Behavior Surveillance System (YRBSS); responses dichotomized as "0 times" or "1 or more times") over an extended period of time (1999 to 2009). A total of 11.7% of students reported having driven after drinking any alcohol and 28.2% reported riding in a car with a driver who had been drinking on 1 or more occasions in the past 30 days. Restrictive GDL laws and use-and-lose laws were associated with decreased driving after drinking any alcohol and riding in a car with a driver who had been drinking alcohol. Restrictive GDL and use-and-lose laws may help to bolster societal expectations and values about the hazards of drinking and driving behaviors and are therefore partly responsible for the decline in these alcohol-related traffic risk behaviors.

A Cultural and Social Cognitive Model of Differences in Acculturation Orientations, Alcohol Expectancies, and Alcohol‐Related Risk Behaviors Among Hispanic College Students

The present study used a cultural and social cognitive conceptual framework to investigate whether alcohol expectancies and valuations would mediate the associations between specific acculturation orientations and alcohol-related risk behaviors. The sample comprised 1,527 Hispanic students attending colleges and universities in diverse regions of the United States. Respondents completed self-report measures of Hispanic and American cultural practices; alcohol expectancies and valuations; and self-reported frequency of hazardous alcohol use, binge drinking, sexual activity under the influence of alcohol, driving under the influence of alcohol, and riding with a drunk driver. Latent class analysis was used to classify participants into acculturation orientations. Results indicated that acculturation orientations were differentially associated with alcohol-related risk outcomes, with separated bicultural and low bicultural orientations inversely related to all of the alcohol-related risk behaviors except for riding with a drunk driver. Negative expectancy valuations were positively associated with endorsement of binge drinking and drunk driving and negative expectancies were negatively associated with binge drinking, drunk driving, and riding with a drunk driver. With the exception of sexual activity under the influence of alcohol, the associations between acculturation orientations and alcohol-related risk behaviors were partially mediated by positive alcohol expectancies. Our findings provided relevant data that are informative for preventing alcohol and related risk behaviors among Hispanic college students.

Alcohol Consumption in Relation to Work Environment and Key Sociodemographic Characteristics Among Female Sex Workers in China

The study explores the variation in pattern of alcohol use and related risk behaviors by types of sex work environments and sociodemographic characteristics among female sex workers (FSWs) in China. Data were collected from 1,022 FSWs in Guangxi, China, through a self-administered questionnaire. Chi-square and analysis of variance (ANOVA) were used to assess the variations. Results showed that younger FSWs were more susceptible than older FSWs to nearly all the risk drinking behaviors. FSWs of non-Han ethnicity as compared with those of Han ethnicity were more at risk of drinking large amounts of alcohol and having sex under the influence of alcohol. FSWs in entertainment establishments were most likely to have all kinds of risk drinking behaviors. Street-based FSWs were least likely to drink alcohol but more or equally likely to engage in alcohol-related sexual risk behaviors. The study highlights a need to develop tailored alcohol risk reduction intervention that takes into consideration these differences.