Female Alcohol Use Research Articles

Trends in socio-demographic characteristics and substance use among high school learners in a selected district in Limpopo Province, South Africa.

Substance use is an escalating public health problem in South Africa resulting in risky behaviours and poor educational attainment among adolescents. There is a huge battle to overcome substance use among learners as more drugs become easily available with the mean age of drug experimentation reported to be at 12 years of age. It is important to continuously understand the trends in substance use in order to assess if there are positive changes and provide evidence for the development of context-specific effective interventions. This paper outlines the prevalence of substance use among selected high schools in a district in Limpopo province. To determine the prevalence of substance use among selected high school learners in a district in Limpopo Province, a cross-sectional school survey of 768 learners was conducted. Data was analysed using SPSS v 26. Descriptive analysis was used to describe the independent and dependent variables and Chi-Square test was used to investigate associations between demographic characteristics and substance use among high school learners. The most abused substances by learners were alcohol (49%), cigarettes (20.8%) and marijuana (dagga/cannabis) (16.8%). In a lifetime, there was a significant difference (P < 0.05) in cigarette smoking with gender, school, and grade; with more use in males (14.2%) than females (7.6%); in urban schools (14.6) than peri-urban (6.7%) and more in Grade 12 (6.4%). There was a significant difference (P < 0.05) in alcohol use with more use in Grade 10 (12.6%) and varied use among male and female learners but cumulatively more alcohol use in females (27.7%). Drug use varied, with an overall high drug use in urban schools (20.7%). Substance use is rife among high school learners in the district and health promotion initiatives need to be tailored within the context of socio-demographic characteristics of learners including the multiple levels of influence such as peer pressure, poverty, unemployment and child headed families. Additional research is required to investigate the factors leading to a notable gradual increase in use among female learners and into the environmental and family settings of learners in influencing substance use.

Sex differences in neural response to an acute stressor in individuals with an alcohol use disorder.

Alcohol use disorder (AUD) and stress influence overlapping neural circuits in the brain. The literature is mixed regarding the presence of sex differences in the neural response to acute stressors, and this issue has not been examined in individuals with AUD. We validated a stress functional magnetic resonance imaging (fMRI) paradigm in individuals with AUD and tested for sex differences. Twenty-five treatment-seeking individuals with AUD (15M/10F) were recruited to participate in the neuroimaging study linked to a clinical trial of ibudilast (NCT03594435). To assess social-evaluative stress, participants completed the Montreal Imaging Stress Task (MIST). Whole brain and amygdala region-of-interest analyses were conducted. Subjective ratings of anxiety and distress were collected. Repeated measures ANCOVAs were performed to evaluate the effect of stress on anxiety and distress and to evaluate sex differences. There were trend-level effects of stress on anxiety ratings and amygdala activation (p's = 0.06). There was a significant effect of stress in the bilateral thalamus, ventral tegmental area, and paracingulate (Z's > 4.09, p's < 0.03). There was a trend-level effect of sex on subjective ratings of stress (p's = 0.07). Females had higher amygdala activation in response to stress (p = 0.02). Females also had greater activation than males in the precuneus, posterior cingulate cortex, and right inferior frontal gyrus during acute stress (Z's > 3.56, p's < 0.03). This study provides an initial validation of the MIST in a sample of individuals with AUD. It also provides preliminary evidence of sex differences in the response to social-evaluative stress, which is important, given the relevance of stress and negative emotionality as motivators for alcohol use in females.

Associations of Menstrual Cycle and Progesterone-to-Estradiol Ratio With Alcohol Consumption in Alcohol Use Disorder: A Sex-Separated Multicenter Longitudinal Study.

Alcohol use disorder (AUD) constitutes a critical public health issue and has sex-specific characteristics. Initial evidence suggests that progesterone and estradiol might reduce or increase alcohol intake, respectively. However, there is a need for a better understanding of how the menstrual cycle in females and the ratio of progesterone to estradiol in females and males influence alcohol use patterns in individuals with AUD. In this sex-separated multicenter longitudinal study, the authors analyzed 12-month data on real-life alcohol use (from 21,460 smartphone entries), menstrual cycle, and serum progesterone-to-estradiol ratios (from 667 blood samples at four individual study visits) in 74 naturally cycling females and 278 males with AUD between 2020 and 2022, using generalized and general linear mixed modeling. Menstrual cycle phases were significantly associated with binge drinking and progesterone-to-estradiol ratio. During the late luteal phase, females showed a lower predicted binge drinking probability of 13% and a higher predicted marginal mean of progesterone-to-estradiol ratio of 95 compared with during the menstrual, follicular, and ovulatory phases (binge drinking probability and odds ratios vs. late luteal phase, respectively: 17%, odds ratio=1.340, 95% CI=1.031, 1.742; 19%, odds ratio=1.523, 95% CI=1.190, 1.949; and 20%, odds ratio=1.683, 95% CI=1.285, 2.206; difference in progesterone-to-estradiol ratios, respectively: -61, 95% CI=-105.492, -16.095; -78, 95% CI=-119.322, -37.039; and -71, 95% CI=-114.568, -27.534). In males, a higher progesterone-to-estradiol ratio was related to lower probabilities of binge drinking and of any alcohol use, with a 10-unit increase in the hormone ratio resulting in odds ratios of 0.918 (95% CI=0.843, 0.999) and 0.914 (95% CI=0.845, 0.988), respectively. These ecologically valid findings suggest that high progesterone-to-estradiol ratios can have a protective effect against problematic alcohol use in females and males with AUD, highlighting the progesterone-to-estradiol ratio as a promising treatment target. Moreover, the results indicate that females with AUD may benefit from menstrual cycle phase-tailored treatments.

Phosphatidylethanol as a biomarker to assess alcohol exposure in women of reproductive age using retrospective data from a reference laboratory

Abstract Alcohol consumption during pregnancy may cause fetal alcohol spectrum disorder (FASD), which is a preventable disorder. Prenatal alcohol exposure during the first trimester of pregnancy is deemed most disruptive to the developing fetus. Pregnant women may be screened for alcohol use through self-reported measures. These subjective methods are known to underreport drug use. Therefore, a reliable method to detect and monitor alcohol use during pregnancy is needed. Phosphatidylethanol (PEth) is a specific biomarker associated with alcohol consumption that can be used to differentiate social drinking from heavy alcohol use. The predominant PEth homologues are PEth 16:0/18:1 (POPEth) and PEth 16:0/18:2 (PLPEth), which account for 37-46% and 26-28% of the total PEth homologues, respectively. PEth can reflect alcohol intake up to several days to weeks after consumption. The aim of this study is to investigate the prevalence of positive PEth samples in women of reproductive age to determine whether testing for PEth should be assessed in a three-month checkup in pregnant women. The first objective is to perform a retrospective study on the direct alcohol biomarker, PEth, to evaluate the true positivity rates of alcohol use in females and in women of reproductive age (14 - 44 years old) using retrospective data analysis from a reference laboratory. The initial data analysis demonstrated the positivity rate of PEth in females (N = 66,306) to be 32% for POPEth and 28% for PLPEth. Further retrospective data analysis of PEth in women of reproductive age (N = 19,366) was performed and the positivity rate of PEth in this population was quite similar between the ages of 27 to 40 years old, at around 35%. The data shows that the positivity rate of PEth in women of reproductive age (~35%) is slightly above the positivity rate for all females (~30%). These percentages are significantly higher than what is reported in the 2020 National Survey on Drug Use and Health (NSDUH). The NSDUH reported that 10.6% of pregnant women used alcohol in the past month. The second objective is to conduct a laboratory study where we will measure PEth concentrations by mass spectrometry using residual whole blood specimens from females in an OB/GYN clinic and compare the positivity rates to those determined by the retrospective analysis. This study will provide the opportunity to educate women of reproductive age on drinking during pregnancy and the long-term effects of alcohol use.

Status of the HIV epidemic in Manicaland, east Zimbabwe prior to the outbreak of the COVID-19 pandemic.

BackgroundManicaland province in eastern Zimbabwe has a high incidence of HIV. Completion of the seventh round of the Manicaland Survey in 2018–2019 provided the opportunity to assess the state of the epidemic prior to the start of the COVID-19 pandemic. The study aims were to: a) estimate HIV seroprevalence and assess whether prevalence has declined since the last round of the survey (2012–2013), b) describe and analyse the socio-demographic and behavioural risk factors for HIV infection and c) describe the HIV treatment cascade.MethodsParticipants were administered individual questionnaires collecting data on socio-demographic characteristics, sexual relationships, HIV prevention methods and treatment access, and were tested for HIV. Descriptive analyses were followed by univariate and multivariate analyses of risk factors for HIV seropositvity using logistic regression modelling based on the proximate-determinants framework.ResultsHIV prevalence was 11.3% [95% CI; 10.6–12.0] and was higher in females than males up to 45–49 years. Since 2012–2013 HIV prevalence has significantly declined in 30–44 year-olds in males, and 20–44 year-olds in females. The HIV epidemic has aged since 2012–2013, with an increase in the mean age of HIV positive persons from 38 to 41 years. Socio-demographic determinants of HIV prevalence were church denomination in males, site-type, wealth-status, employment sector and alcohol use in females, and age and marital status in both sexes. Behavioural determinants associated with increased odds of HIV were a higher number of regular sexual partners (lifetime), non-regular sexual partners (lifetime) and condom use in both sexes, and early sexual debut and concomitant STIs in females; medical circumcision was protective in males. HIV status awareness among participants testing positive in our study was low at 66.2%. ART coverage amongst all participants testing positive for HIV in our study was 65.0% and was lower in urban areas than rural areas, particularly in males.ConclusionsPrevalence has declined, and ART coverage increased, since 2012–2013. Majority of the associations with prevalence hypothesised by the theoretical framework were not observed in our data, likely due to underreporting of sexual risk behaviours or the treatment-as-prevention effect of ART curtailing the probability of transmission despite high levels of sexual risk behaviour. Further reductions in HIV incidence require strengthened primary prevention, HIV testing and linkage to risk behaviour counselling services. Our results serve as a valuable baseline against which to measure the impact of the COVID-19 pandemic on HIV prevalence and its determinants in Manicaland, Zimbabwe, and target interventions appropriately.

Is separate the new equal? A meta-analytic review of correlates of intimate partner violence victimization for Black and White women in the United States.

Black women experience intimate partner violence (IPV) at higher rates than White women, and are more likely to experience more serious injuries, serious mental health diagnoses, or even death as consequences of IPV. Most research on factors associated with physical IPV does not primarily focus on Black women experiencing IPV. To be able to offer targeted intervention and prevention services, understanding unique correlates is critical. To address these discrepancies and better conceptualize factors associated with IPV for Black women, a meta-analysis was conducted to examine correlates for male physical IPV perpetration/female IPV victimization among predominantly Black samples. Next, strengths of correlates for male IPV perpetration/female IPV victimization were compared between Black and White samples. From an original pool of 759 articles examining correlates for IPV perpetration and victimization, 21 articles were usable that had a sufficient percentage (at least 75%) of Black participants and 80 articles that had a sufficient percentage (at least 75%) of White participants. Five significant correlates for male perpetration and seven significant correlates for female victimization in predominantly Black samples were identified. Comparisons for male perpetration/female victimization between predominantly White and Black samples were conducted for nine correlates, and one-third of these correlates (male emotional abuse perpetration, female post-traumatic stress symptoms, and female alcohol use) were significantly stronger correlates in Black populations compared to White populations. Research and clinical implications are discussed.

TRANSTORNO MENTAL E COMPORTAMENTAL NO ESTADO DE SÃO PAULO: VARIAÇÕES DA MORTALIDADE E MORBIDADE DE 2017 A 2020

Mental and behavioral disorders are influenced by a combination of factors that affect an individual's emotional balance and affect people of all ages, sex and social classes, although each group has its specificities. The present study aims to determine the prevalence of hospitalizations caused by Mental and Behavioral Disorders (CMD), considering an age group, gender and an ICD-10 morbidity list in the State of São Paulo between the years 2017 to 2020. This research was an ecological study on the prevalence of cases of mental and commercial disorders in the State of São Paulo. Data were collected on the DATASUS platform, where the number of admissions according to gender, age and ICD-10 morbidity list in the 2017-2020 period were surveyed. The results obtained revealed a growing increase in CMD cases in the state, especially from 2018 to 2019 with a subsequent fall in 2020, with, from 2017 to 2020, approximately 58.81% prevalence of CMD in sex and approximately 41.19% prevalence in sex female, mainly affecting people aged 30 to 39 years, higher prevalence of mood in females (67.18%) and CMD due to alcohol use in females (87.89%). It is concluded that amidst the pandemic against COVID-19, several patients considered without a diagnosis of Mental and Behavioral Disorders, because of this, it is possible that after the pandemic there are a greater number than expected of patients with more advanced conditions due to the absence of an early diagnosis.

Sex-specific associations between subcortical morphometry in childhood and adult alcohol consumption: A 17-year follow-up study

Men and women tend to differ in the age of first alcohol consumption, transition into disordered drinking, and the prevalence of alcohol use disorder. Here, we use a unique longitudinal dataset to test for potentially predispositonal sex-biases in brain organization prior to initial alcohol exposure. Our study combines measures of subcortical morphometry gathered in alcohol naive individuals during childhood (mean age: 9.43 years, SD = 2.06) with self-report measures of alcohol use in the same individuals an average of 17 years later (N = 81, 46 males, 35 females). We observe that pediatric amygdala and hippocampus volume both show sex-biased relationships with adult drinking. Specifically, females show a stronger association between subcortical volumetric reductions in childhood and peak drinking in adulthood as compared to males. Detailed analysis of subcortical shape localizes these effects to the rostro-medial hippocampus and basolateral amygdala subnuclei. In contrast, we did not observe sex-specific associations between striatal anatomy and peak alcohol consumption. These results are consistent with a model in which organization of the amygdala and hippocampus in childhood is more relevant for subsequent patterns of peak alcohol use in females as compared to males. Differential neuroanatomical precursors of alcohol use in males and females could provide a potential developmental basis for well recognized sex-differences in alcohol use behaviors.. Thus, our findings not only indicate that brain correlates of human alcohol consumption are manifest long before alcohol initiation, but that some of these correlates are not equivalent between males and females.

Validation of the Substance Use Risk Profile Scale in Lithuanian population

BackgroundPersonality traits are related with risk of hazardous alcohol use and alcohol dependence. The Substance Use Risk Profile Scale (SURPS) measures personality traits associated with addictive substance abuse. We examined psychometric properties of the SURPS in Lithuanian population.Materials and methodsTwo hundred forty-seven participants (mean age 37.22 ± 0.78 years), were recruited from the local community and from an inpatient addiction treatment centre. Internal consistency, stability, factor structure, content validity, and external validity of the SURPS were examined. Hazardous alcohol use was evaluated by Alcohol Use Disorder Identification Test (AUDIT). Alcohol dependence diagnosis was established by International Classification of Diseases - 10 (ICD - 10). We also performed gender analyses for associations of personality traits with alcohol dependence and hazardous use of alcohol.ResultsThe SURPS scale demonstrated appropriate internal validity, good temporal stability, and adequate criterion validity and construct validity. The SURPS scores of hopelessness, anxiety sensitivity and impulsivity were higher in the alcohol dependence group than in the control group for both males and females. Impulsivity and sensation seeking were associated with hazardous alcohol use and these associations were more prevalent in females.ConclusionsLithuanian translation of the SURPS scale was appropriate. The SURPS demonstrated good sensitivity for discriminating on alcohol dependence and was more sensitive for discriminating on hazardous alcohol use for females.

Exploring Sex Differences in the Association between Bullying Involvement and Alcohol and Marijuana Use among U.S. Adolescents in 6th to 10th Grade

Objectives: The aim of the current study was to examine whether different types of involvement in bullying, together with a set of social-ecological correlates, were associated with alcohol and marijuana use for female and male adolescents. Methods: This study utilized data derived from the U.S. division of the 2005–2006 Health Behavior in School-Aged Children (HBSC) study, which include 7,084 U.S. 6th–10th graders (3,353 males and 3,731 females) in public and private schools. Results: The results showed that although some forms of involvement in bullying were associated with alcohol and marijuana use, some of these associations became non-significant when the social-ecological covariates were included in the models. The final logistic regression models revealed that being a traditional bully-victim increased the risk of alcohol use for males while being a traditional bully and cyber victim increased the risk of alcohol use for females. In addition, being a cyberbully increased the risk of marijuana use for males. While parental monitoring decreased the risk, delinquent peers increased the risk of both alcohol and marijuana use for both sexes. Parent/guardian support decreased the risk of alcohol use for females. The likelihood of alcohol use and marijuana use increased with age for both sexes, while being an African American was linked with a lower risk of alcohol and marijuana use among males. Conclusions/Importance: Our findings demonstrate the importance of examining the link between bullying involvement and substance use, together with social-ecological correlates for female and male adolescents.

Sex hormones in alcohol consumption: a systematic review of evidence.

Sex hormones play an important role in establishing sex‐distinctive brain structural and functional variations that could contribute to the sex differences in alcohol consumption behavior. Here, we systematically reviewed articles that studied sex hormone impacts on alcohol consumption and alcohol use disorder (AUD). An extensive literature search conducted in MEDLINE, PubMed, Scopus and CINAHL databases identified 776 articles, which were then evaluated for pre‐specified criteria for relevance and quality assurance. A total of 50 articles, including 19 human studies and 31 animal studies, were selected for this review. Existing evidence supports the association of increased testosterone level and increased risk for alcohol use and AUD in males but results are inconclusive in females. In contrast, the evidence supports the association of increased estrogen level and increased alcohol use in females, with mixed findings reported in males. Much less is known about the impact of progestins on alcohol use and misuse in human subjects. Future observational and experimental studies conducted in both sexes with a comprehensive hormone panel are needed to elucidate the impact of the interplay between various sex hormone levels during various developmental stages on alcohol use‐related phenotypes and AUD.

The Moderating Effect of Sibling Delinquency on Risky Behavior during Emerging Adulthood

This study examines the relationship between sibling delinquency and respondent risky behavior of emerging adults. This study attempts to understand the influence a sibling has on deviant behavior, sexual behavior and substance use during emerging adulthood. Sibling support and sibling contact were the two components of sibling relationships that were examined. A social learning theory framework was used. It was hypothesized that an individual who has high contact and support from a deviant sibling would be more likely to engage in risky behavior, be more sexually active and have increased alcohol use. The sample was comprised of 690 undergraduates enrolled in a large state university. A test of the moderating effects of sibling support and contact was conducted. Results indicate that there is a moderating relationship between the influence of sibling delinquency on respondent deviance, sexual permissiveness and alcohol use for females. As contact and support with a delinquent sibling increases, the level of respondent deviance, sexual permissiveness and alcohol use also increases.

The effects of gender, clothing style, and alcohol consumption on the perception of sexual intent

Background: Alcohol consumption in women is known to be perceived by men as signaling sexual intent. The current study investigated the influence of gender, female clothing style, and female alcohol use on the perception of sexual intent.Method: Eighty-seven men and 72 women viewed a one-minute video of a male–female interaction where clothing style and alcohol use were experimentally manipulated. Participants were then asked to rate the female target on sexual intent.Results: The female actor was rated higher on sexual intent when she was dressed revealingly, and consuming alcohol, compared to when she was wearing conservative clothing and drinking water. Gender differences were not found with respect to the effect of personality characteristics (sociosexual effectiveness, sexually preoccupation, masculine sex role orientation, limited sexual experience and negative sexual attitudes, and low self-esteem and traditional attitudes toward women) on sexual intent.Conclusions: These findings suggest that alcohol may be a social cue used by men to process sexual intent. The implications of the findings are discussed with reference to how women are viewed when consuming alcohol.

Sex-Specific Parental Behaviors and Attitudes as Predictors of Alcohol Use and Alcohol-Related Consequences Among Ninth Grade Students

This study examined maternal and paternal influences on adolescent alcohol use and alcohol-related consequences in a sample of ninth grade students (N = 205). Hierarchical regression analyses indicated maternal monitoring and maternal disapproval of teen drinking were significant predictors of teen alcohol use and alcohol-related consequences for males and females. Examination of interaction effects revealed sex differences between paternal variables and teen drinking behavior. Specifically, maternal monitoring was associated with female alcohol use, whereas paternal monitoring was associated with male alcohol use and alcohol-related consequences. In addition, father–daughter general communication was associated with alcohol use and alcohol-related consequences. Implications for sex-specific parent-based counseling interventions are discussed.

The association between depressive symptoms from early to late adolescence and later use and harmful use of alcohol.

Depressive symptoms and alcohol misuse contribute substantially to the global health burden. These phenotypes often manifest, and frequently co-occur, during adolescence. However, few studies have examined whether both baseline levels of depressive symptoms and change in symptoms are associated with alcohol outcomes. In addition, inconsistent findings could be due to sex differences or the use of different alcohol outcomes. Using data from a prospective population-based cohort in the UK, we estimated trajectories of depressive symptoms from 12 years 10 months to 17 years 10 months, separately for male and female participants. We assessed whether baseline and change in depressive symptoms were associated with use and harmful use of alcohol at 18 years 8 months. Among females, increasing depressive symptoms were associated with increased alcohol use; whilst for males, there was little evidence of this. When examining harmful levels of alcohol use, baseline levels of depressive symptoms in males were weakly related to later harmful alcohol use but this association was attenuated substantially through adjustment for confounders. In contrast, both baseline symptoms and increase in symptoms were associated with later harmful alcohol use in females and these associations were not diminished by confounder adjustment. Elevated depressive symptoms during adolescence are positively associated with increases in both use and harmful use of alcohol at 18 years 8 months. These findings differ between the sexes. Further research is needed to examine the mechanisms underlying the link between depressive symptoms and harmful alcohol use to identify potentially modifiable factors for intervention.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-014-0600-5) contains supplementary material, which is available to authorized users.

The Use of an Ecodevelopmental Approach to Examining Substance Use Among Rural and Urban Latino/a Youth: Peer, Parental, and School Influences

Using an ecodevelopmental framework, we examined how peer, parent, and student variables influence substance (tobacco, alcohol, and marijuana) use among rural and urban Latino/a adolescents (N = 2,500). Generally speaking, Latino/a adolescents in rural areas endorsed higher levels of substance use. Among the primary variables of study, there were a number of nuanced differences noted based on location, gender, and type of substance. Peer use was related to individual substance use in both rural and urban areas. However, peer use was a significantly stronger predictor of tobacco use among rural Latinas than urban dwelling. Parental monitoring was not predictive of urban marijuana use, yet was negatively associated with substance use for all subgroups and was especially pronounced for female alcohol use. Parental emotional involvement predicted higher alcohol use among urban boys. School achievement was negatively associated with substance use for all subgroups while, conversely, school involvement was associated with higher alcohol use for rural boys. Cultural and contextual implications for intervention and prevention are discussed.

Accepted, desired and ashamed: Images of female alcohol use and drinking-related gender orders described by Finnish women of different ages

Aims The article deals with how Finnish women of different ages perceive acceptable and desirable images of female alcohol use as well as gender orders associated with drinking. A focus on women and differences between women is motivated by the fact that women's increased drinking is one of the most significant changes in the Finnish alcohol landscape in recent history. Data and Design The data consists of group interviews with women aged 50–60, 35–40 and 25. The images of female alcohol use adopted in these groups are analysed by studying what representations of women's alcohol use and what drinking-related gender identities women in different age brackets identify themselves with as they interpret the stimulus images of drinking situations shown in interviews. Results The analysis suggests that women in different age groups have different ideas of what kind of images of female alcohol use are considered suitable, acceptable and desirable. The different generations also express and repeat different drinking-related norms and attitudes. Conclusions Overall, the analysis shows that women have achieved greater autonomy in their alcohol use and that the construction of women's gender identity in relation to drinking has expanded beyond traditional feminine values and become more varied and layered. Younger generations thus have access to a wider range of feminine imageries, norms and ways of being women.

IDRC public scandal: phase 2

OBJECTIVES: Few studies have evaluated the relation between male and female sexual behaviour and STD among married African women. The objectives of this study were to identify male and female sexual behaviour associated with female STD, and to explore whether incorporating male and female sexual behaviour and male symptoms can improve algorithms for STD management in married African women. METHODS: 99 married couples with one symptomatic member (58 males, 41 females) attending an STD clinic in Lusaka, Zambia were interviewed separately about sexual and contraceptive behaviour, and had physical examinations. Diagnostic tests for Neisseria gonorrhoeae (GC), Trichomonas vaginalis (TV), and HIV were performed. Bivariate and multivariate odds ratios for the association between sexual behaviour and STD were calculated. Predictive algorithms based on current Zambian guidelines for management of STD in women were created. RESULTS: Among women at baseline, 10% were positive for GC, 14% for TV, 52% for HIV. Female alcohol use before sex, a male9s paying for sex, and a couple9s having sex unprotected by condoms or spermicides were associated with female STD. Incorporation of these behaviours along with symptoms of urethral discharge and dysuria among husbands increased the predictive ability of algorithms for management of STD in women. CONCLUSIONS: The addition of male and female sexual behaviour and male STD symptoms to diagnostic algorithms for female STD should be explored in other settings. Both husbands9 and wives9 behaviour independently predict STD in these women; risk reduction programmes should target both men9s and women9s sexual behaviour.

Does Alcohol Involvement Increase the Severity of Intimate Partner Violence?

Most studies that have examined alcohol use immediately prior to intimate partner violence (IPV) have been limited to male-to-female partner violence (MFPV) and are subject to a number of methodological limitations. We add new information concerning the relationship between alcohol involvement and severity of IPV, MFPV, and female-to-male partner violence (FMPV). We analyzed data from a 1995 U.S. national population-based survey of couples > or = 18 years old. We examined 436 couples who reported IPV and had information on alcohol involvement with IPV. We measured IPV using a revised Conflict Tactics Scale, Form R that asked respondents about 11 violent behaviors in the past year. Respondents were classified into mutually exclusive categories as having experienced mild only or mild + severe ("severe") IPV, MFPV or FMPV. Respondents were also asked if they or their partner were drinking at the time the violent behavior occurred and were classified as exposed to IPV with or without alcohol involvement. We estimated proportions, odds ratios, 95% confidence intervals, and p-values of the proposed associations, accounting for the complex survey design. Overall, 30.2% of couples who reported IPV reported alcohol involved IPV; 69.8% reported no alcohol involvement. In adjusted analyses, those reporting severe (vs. mild only) IPV were more than twice as likely to report alcohol involvement. In adjusted analyses, those reporting severe (vs. mild) MFPV or FMPV were more likely to report female but not male alcohol involvement. Though estimates were positive and strong, most confidence intervals were compatible with a wide range of estimates including no association. Our findings suggest alcohol involvement of either or both in the couple increases the risk of severe IPV. Our findings also suggest female alcohol use may play an important role in determining the severity of IPV, MFPV or FMPV.

Caffeine, Alcohol, and Psychological Stress and In Vitro Fetilization

There has been an astounding explosion in the number of clinics offering ART techniques- 426 program in the US and 600 in Europe. Despite enormous advances regarding the technical aspects of the IVF procedure, the parents’ contribution has virtually been ignored. What is reassuring for patients is that lifestyle habits are within the patient’s control, and when modified, could lead to healthy babies. The focus of this paper will be on the current state of knowledge about the effects of female and male caffeine and alcohol use, and psychological stress on the reproductive endpoints of IVF. There is currently only one study on the effects of caffeine on IVF. In this study, caffeine intake by women had a profound effect on: 1) Miscarriages, 2) Not achieving a live birth and 3) Infant gestational age. The findings of this study require further confirmation. Success rates may be further affected by alcohol consumption. Female alcohol use was associated with: 1) A decrease in number of oocytes aspirated, 2) Not achieving a pregnancy, and 3) Increased risk of miscarriage. Male alcohol use was associated with: 1) Spontaneous miscarriages, and 2) Not achieving a live birth, particularly if consuming beer. Stress also has an impact on IVF success rates. There are several statistically significant studies on baseline and procedural depression, anxiety, stress, and mood, as well as stress hormones that all negatively affected pregnancy rates after IVF. However, the literature on stress and ART was devoid of an instrument that captures the female and male experience of going through ART. Thus, an instrument was developed that rated concern levels about anesthesia, surgery, pain, recovery time, side-effects, finances, missing work, insufficient information and delivering a healthy baby. At baseline, women who were concerned about the medical aspects of the procedure had fewer oocytes retrieved and fertilized. For women concerned about missing work, they had over twice the risk of not achieving a pregnancy, while women extremely concerned about finances had a very high risk of no live birth. Understanding both the independent and combined effects of stress, alcohol, and caffeine on ART may ultimately lead to effective interventions that will decrease adverse outcomes and in turn, produce healthy babies that mature into healthy children and adults.