Current Alcohol Use Research Articles (Page 1)

To examine the prevalence of current substance and hazardous alcohol use in people with HIV and tuberculosis (TB) disease and its impact on TB treatment outcomes. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EMBASE, Scopus, PsycInfo and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to 3 April 2025. Risk of bias was assessed using the ROBINS-E tool. Prevalence estimates were synthesized using a random-effects model with between-study heterogeneity assessed via the I2 statistic. Eighteen studies were included. Prevalence of current hazardous alcohol use ranged from 7.4% to 33.7%, with a pooled estimate of 19.1% (95% CI [16.1%-22.5%], I2 = 92.5%) across 5310 individuals. Current substance use (excluding alcohol) ranged from 1.2% to 90.9%, with a pooled prevalence of 25.1% (95% CI [15.3%-38.8%], I2 = 96.8%) among 3709 individuals. Pooled prevalence estimates varied across WHO regions, with the Western Pacific Region reporting the highest prevalence of hazardous alcohol use (20.4%) and the Region of the Americas leading in substance use (29.9%). Only three studies assessed TB treatment, all showing poorer outcomes among people with substance use disorders. Heterogeneity and small sample size precluded pooled analysis. Most studies had high or very high risk of bias, primarily due to confounding, missing data and inconsistent definitions of substance and hazardous alcohol use. Current substance and hazardous alcohol use occurs frequently among people with HIV and TB, varying widely depending on the population. However, current substance and hazardous alcohol use, as opposed to any history of substance use, is rarely assessed systematically.

IntroductionAbout 70% of premature adult deaths are linked to health-related behaviours that begin in childhood and adolescence. This study aimed to assess the prevalence of major non-communicable disease (NCD) risk factors and their associated factors among school-going adolescents in Rapti-Sonari Rural Municipality, Banke, Nepal.MethodsA cross-sectional study was conducted among 630 adolescents selected using a two-stage cluster sampling technique. Data were collected through a self-administered questionnaire. Descriptive statistics summarised the data, while the χ² tests, bivariate and multivariate logistic regression identified associated factors. Statistical significance was set at p<0.05 at a 95% CI.ResultsThe mean age of participants was 15.5±1.3 years. Insufficient fruit and vegetable intake (98.4%) and physical inactivity (83.8%) were highly prevalent. Physical activity was significantly associated with male sex (adjusted OR (AOR): 2.1, 95% CI 1.3 to 3.2) and monthly pocket money >Nepalese Rupee (NRs) 500 (AOR: 1.9, 95% CI 1.2 to 3.0). Current alcohol use (29.0%) and smoking (8.1%) were also reported. Alcohol consumption was significantly associated with male (AOR: 2.6, 95% CI 1.6 to 3.3), Tharu ethnicity (AOR: 2.5, 95% CI 1.3 to 3.6) and pocket money >NRs 500 (AOR: 2.8, 95% CI 1.8 to 4.1). Smoking was significantly associated with male (AOR: 2.7, 95% CI 1.8 to 3.9) and pocket money >NRs 500 (AOR: 2.8, 95% CI 1.8 to 4.3).ConclusionsNearly all adolescents exhibited at least one behavioural risk factor for NCDs. The findings highlight inadequate diet, insufficient physical activity and substantial levels of alcohol and tobacco use among adolescents. As these behaviours often persist into adulthood, comprehensive interventions, promotion of extracurricular activities and stricter enforcement of alcohol and tobacco regulations in schools are urgently needed.

College students are known to frequently engage in alcohol consumption, and are at risk for developing dangerous drinking patterns (e.g., binge drinking). Since imposter syndrome occurs at high rates among undergraduate students, it is reasonable to assume that college students may experience its negative effects, such as anxiety and depression. Given the relation of anxiety and depression to worse drinking outcomes, imposter syndrome may also be related to greater drinking and related problems. Yet, this is the first known study to test whether imposter syndrome is related to drinking behaviors. 376 (87% female) undergraduates recruited through our psychology department research participant pool with current (past 3-month) alcohol use completed an online survey. Imposter syndrome was statistically significantly related to anxiety, depression, coping-motivated drinking, peak estimated blood alcohol content (eBAC), drinking frequency, and alcohol-related problems. Imposter syndrome, via the serial effects of depression and coping motives, was significantly indirectly related to eBAC, drinking frequency, and alcohol-related problems. Similarly, via the serial effects of anxiety and coping motives, imposter syndrome was significantly indirectly related to eBAC, drinking frequency, and alcohol-related problems. The results of this study can inform treatment and prevention efforts by suggesting that imposter syndrome may be an important yet thus far neglected target for interventions. The present study provides novel insight by identifying that imposter syndrome is related to worse alcohol outcomes and that these relations occur via negative affect and coping-motivated drinking.

Abstract The aim of this study was to assess the longitudinal associations between living alone and eight mental health indicators and mortality in ageing adults from 2015 to 2022 in rural South Africa. The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (analytic sample: n = 3,707, aged 40 years and older). The proportion of living alone was 9.3% in 2015, 10.6% in 2019 and 12.0% in 2022. In the adjusted model, living alone was positively associated depressive symptoms, loneliness, impaired cognition, current tobacco use, and mortality. Compared to not living alone in all three study waves, living alone in one wave and/or two to three waves was positively associated with incident loneliness, incident current tobacco use, and incident current heavy alcohol use. Living alone was positively associated with the prevalence and/or incidence of depressive symptoms, loneliness, impaired cognition, current tobacco use, current heavy alcohol use and mortality. Enhanced screening and management of living alone may reduce mental ill-health in South Africa.

BackgroundResearch on long-term functional recovery after stroke remains limited. This study aims to investigate the long-term functional recovery among ischemic stroke patients with functional disabilities in China.MethodsThis prospective cohort study used data from the China National Stroke Registry III, which had 15,166 patients consecutively enrolled across 201 hospitals in China between August 2015 and March 2018. We included 4086 patients with disabling ischemic stroke at discharge (the modified Rankin Scale [mRS] score of ≥2) after excluding 19 patients (0.47%) lost to follow-up by the 5-year endpoint, our final cohort included 4067 patients. The main outcome was 5-year functional recovery, defined as a ≥1-point reduction in the mRS score between discharge and 5-year follow-up. Multivariable Cox proportional hazards regression models were used to determine the factors of recovery.ResultsAmong 4067 patients, the mean±SD age was 63.3±11.5 years and 1416(34.8%) were female. The functional recovery rate was 86.8% within 5 years(n=3531/4067). In multivariable analysis, older age (adjusted hazard ratio [aHR], 0.86, [95% CI 0.84-0.89]), current alcohol use (aHR, 0.91, [95% CI 0.83-0.99]), history of stroke (aHR, 0.88, [95% CI 0.81-0.95]), higher National Institutes of Health Stroke Scale score at discharge (aHR, 0.96, [95% CI 0.95-0.97]) and stroke recurrence (aHR, 0.88, [95% CI 0.81-0.96]) were independently associated with reduced likelihood of 5-year functional recovery. Patients with small artery occlusion (aHR, 1.11, [95% CI 1.01-1.22]), without atrial fibrillation (aHR, 1.31, [95% CI 1.09-1.58]) and discharged with anticoagulant medication (aHR, 1.35, [95% CI 1.06-1.71]) were independently associated with increased likelihood of 5-year functional recovery.ConclusionIn this cohort study of patients with disabling ischemic stroke, long-term functional recovery rates were high, and key factors associated with recovery outcomes were identified, which may help guide personalized rehabilitation strategies.

Intimate partner violence in United States military veterans: Results from the National Health and Resilience in Veterans Study.

Previous research with U.S. Hispanic college students tends to find that higher levels of acculturation are associated with elevated alcohol use and that these effects are likely to be stronger for women than men. It is now important to consider the extent to which these associations remain once theoretically proximal predictors of alcohol use (e.g., drinking motives) are accounted for in multivariate models. Thus, we examined how multiple domains of acculturation were associated with alcohol use, high intensity drinking, and negative alcohol consequences, and whether direct associations and potential gender moderation of these relationships remained after drinking motives were included in the model. Hispanic undergraduates from 12 universities who reported current alcohol use (n = 1,131; Mage = 20.47, SD = 1.85, range = 18-25) completed self-report questionnaires online. After accounting for demographic variables and drinking motives, U.S. cultural practices were negatively associated with alcohol use, and ethnic identity was negatively associated with high intensity drinking. Heritage cultural practices were positively associated with high intensity drinking among women only. Finally, enhancement motives were positively associated with alcohol use and high intensity drinking, while social and coping-depression motives were positively related to negative alcohol consequences, even after accounting for demographic variables and multiple acculturation domains. The present findings paint a nuanced picture of the effects of ethnic identity and engagement with cultural practices on drinking behaviors, particularly among Hispanic college women. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Epidemiology of alcohol use in Sri Lanka: Findings of the SLHAS national survey

Prevalence and characterization of post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda

We investigated whether risk factors for intracerebral hemorrhage (ICH) among indigenous Africans (IA) would vary in prevalence and effect compared with self-reported African, Hispanic, and White Americans by comparing data from 2 independent population-based case-control studies conducted in West Africa and the United States. We compared ICH risk factors common to the SIREN (Stroke Investigative Research and Educational Network: 1100 case-control pairs) and the ERICH (Ethnic/Racial Variation of Intracerebral Hemorrhage: 999 case-control pairs Black participants, 998 case-control pairs, Hispanic Americans, 1000 case-control pairs, White Americans) studies. Ethnicity/Race was self-reported. The effect measure of interest is the odds ratio (OR). To test for differences in the effects of the risk factors between the SIREN IA study population and each of the ERICH study populations, a test for heterogeneity was computed using the R program, metagen (version 4.9-6). ICH occurred at a younger age among IA (54.3±13.4 years), Balck participants (58.0±12.7), and Hispanic Americans (58.9±14.3), compared with White Americans (69.1±13.9). The largest distinction was for hypertension, where IA exhibited a much larger risk of ICH than the American study population (OR, 67.02 [95% CI, 33.30-134.85]), Black population (OR, 3.71 [95% CI, 2.53-5.44]); Hispanic (OR, 3.55 [95% CI, 2.54-4.92]), and White population (OR, 2.69 [95% CI, 1.95-3.69]). Current alcohol use exhibited increased risk in IA (OR, 2.24 [95% CI, 1.36-3.67]), but not in Black participants (OR, 0.63 [95% CI, 0.46-0.86]), Hispanic (OR, 0.87 [95% CI, 0.65-1.17]), and White Americans (OR, 0.51 [95% CI, 0.38-0.69]). Identical or comparable risk factors do not consistently result in the same disease risk across different cultures and regions. Therefore, to improve our understanding of the genetic determinants and biological pathways driving ICH risk, it is crucial to study multiple populations, including IA, while accounting for the influence of environmental and social factors.

Understanding how place of residence affects cancer-related health risks is paramount to addressing health disparities in sexual and gender minority (SGM) cancer survivors. This study examined the associations between urbanicity and other social drivers of health on current tobacco and alcohol use in SGM cancer survivors. The OUT: National Cancer Survey Study was a cross-sectional, online survey created by the National LGBT Cancer Network (NLCN) from September 2020 to March 2021, targeting U.S. adults identifying as SGM and previously diagnosed with cancer. We examined associations between self-described residential area (urban, suburban, and rural) and other social drivers of health and tobacco and alcohol use. Of n = 2,371 participants, n = 350 reported tobacco use and n = 359 reported ≥ 2 alcoholic drinks/day. The odds of consuming ≥ 2 alcoholic drinks/day were lower among those living in suburban (vs urban) areas (adjusted odds ratio [AOR] = 0.74; 95% CI: 0.56-0.96) and those reporting a disability (AOR = 0.62; 95% CI: 0.46-0.83) and were higher among Black/African American (versus White) cancer survivors (AOR = 2.36; 95% CI: 1.32-4.22). The odds of current tobacco use did not differ significantly based on place of residence, but decreased with increasing age (AOR = 0.97; 95% CI = 0.96-0.98), were lower for those with graduate school education (AOR = 0.29; 95% CI = 0.16-0.54), and health insurance (AOR = 0.30; 95% CI = 0.16-0.59), and were greater among Black/African American (versus White) (AOR = 2.55; 95% CI: 1.36-4.80) and Hispanic (versus non-Hispanic) (AOR = 1.77; 95% CI = 1.04-3.00) SGM cancer survivors. Urbanicity/Rurality was significantly associated with alcohol use among SGM cancer survivors. Social drivers of health are crucial factors for researchers and clinicians intervening to improve the health of SGM cancer survivors.

ABSTRACTContext:Noncommunicable disease (NCD) risk factors are on the rise and often linked to the adoption of modern lifestyles. There have been a rapid social and economic transitions in last 3–4 decades. This study explores NCD risk in a rapidly modernizing indigenous population in West Bengal, the Santhal tribe of a rural block of Birbhum. Aims: To estimate the prevalence of behavioural and biological risk factors of NCD and to predict the risk of study participants of developing NCD.Settings and Design:It is a community based observational study, cross-sectional in design. Methods and Material: The study was conducted among 306 tribal people aged above 40 years selected by multistage cluster random sampling using WHO-STEPS instrument. Statistical Analysis Used: Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. WHO-ISH2020, IDRS tool and CAT questionnaire are used for risk assessment.Results:The prevalence of current tobacco and alcohol use were 48.7% and 19.6%, respectively. 91.5% consumed unhealthy diet and 7.5% have low physical activity. Odds of tobacco[AOR: 6.69 (3.93-11.39)] and alcohol[AOR: 14.69 (6.57-33.70)] use were significantly raised among men and increased age of the participants. Odds of abdominal obesity were higher among older participants and female [AOR 9.03 (3.45-25)]. Older age group have more risk of hypertension [AOR: 3.85 (1.82-7.69)], hypercholesteremia [AOR: 1.70 (1.01-3,52)] and physical inactivity [AOR: 6.29 (2.34–16.87)].Conclusions:Most of the behavioural and biological risk factors of NCDs were quite high among tribal population which may be reduced by increasing awareness about NCDs through locally accepted and culturally appropriate strategies.

BackgroundAsian American, Native Hawaiian, and Pacific Islander (AANHPI) populations have diverse cultural, immigration, and sociodemographic characteristics. Aggregated data could mask substantial differences in substance use between cultural subgroups in this population. Yet, studies examining substance use among the AANHPI population are limited.ObjectiveThis study aimed to describe cigarette, cannabis, and alcohol use among AANHPI adults by cultural subgroup and sex.MethodsWe analyzed data from 3411 AANHPI respondents of a multilingual national survey “COMPASS” during December 2021-May 2022. Primary outcomes were self-report current (every day or some days) use of cigarettes, cannabis, and alcohol. Cultural subgroups included Asian Indian, Ethnic Chinese, Filipino, Japanese, Korean, Native Hawaiian and Pacific Islander, Vietnamese, other cultural groups, and multicultural groups. Other covariates include sex, other sociodemographics, experiences of discrimination (Everyday Discrimination Scale), and mental health (Patient Health Questionnaire 4). Multivariable logistic regressions were used to examine correlates of each substance use among AANHPI adults.ResultsThe prevalence of current cigarette, cannabis, and alcohol use was 4.2% (142/3359), 5.5% (184/3235) and 37.6% (1265/3361), respectively. Cigarette use ranged from 1.0% (1/100) in Asian Indian females to 14.8% (10/71) in multicultural males. Cannabis use ranged from 1.9% among Asian Indian (1/53) and Vietnamese males (4/211) to 15.7% (11/70) in multicultural females. Alcohol use varied from 6.6% (4/61) in Native Hawaiian and Pacific Islander females to 56.3% (40/71) among multicultural males. Male participants with elevated depression and anxiety symptoms were more likely to report using all 3 substances than males with minimal symptoms. However, depression and anxiety symptoms were only associated with cannabis and alcohol use among female participants. US-born female participants were more likely to report using all 3 substances compared to foreign-born females, while being US-born was only associated with higher odds of alcohol use among males. Perceived discriminatory experience was associated with higher odds of smoking in both sexes and alcohol drinking in males.ConclusionsCigarette smoking, cannabis, and alcohol use varied widely across AANHPI cultural groups, between and within each sex. These findings underscore the necessity to disaggregate data for substance use behaviors to guide health policy and intervention programs for AANHPI adults.

Background/Objectives: Exposure to fine particulate matter (PM2.5) is linked to increased cardiovascular risk, particularly in individuals with hypertension. This study examined the association between dietary patterns, lifestyle factors, and vascular inflammation among individuals with hypertension living in rural and peri-urban areas of Chiang Mai Province, Thailand. Methods: A cross-sectional pilot study was conducted among 47 participants (23 rural, 24 peri-urban). Data on dietary intake, smoking, alcohol use, anthropometry, and blood chemistry were collected. Serum intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and interleukin-6 (IL-6) were measured. Partial correlation analysis was used to examine associations with lifestyle factors, adjusting for relevant covariates. Results: Peri-urban participants had significantly higher levels of ICAM-1 [83.0 vs. 50.1 ng/mL], VCAM-1 [639.3 vs. 376.5 ng/mL], and IL-6 [4.80 vs. 1.02 pg/mL] compared to rural participants. Rural individuals reported higher intakes of antioxidant-related nutrients (selenium, β-carotene, niacin, vitamins A, B6, and C), while peri-urban individuals had higher sugar intake. Sugar intake was positively associated with ICAM-1 and VCAM-1, whereas selenium and vitamin C were inversely associated with both ICAM-1 and VCAM-1, while vitamin B6 was inversely associated with VCAM-1 only. Although rural participants had a higher rate of current smoking (34.8% vs. 4.4%), smoking and alcohol use were not significantly associated with inflammatory markers. Conclusion: Rural dietary patterns may be linked to reduced vascular adhesion molecule levels. Further studies with larger samples are warranted to clarify these associations and guide lifestyle strategies for managing vascular inflammation in PM2.5-exposed individuals with hypertension.

Current understanding of associations between alcohol use and falls among people with HIV (PWH) is limited due to few and inconsistent studies. Given the prevalence of heavy episodic alcohol use reported among PWH, this remains an important question. Alcohol use was measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and self-reported alcohol use treatment and/or diagnosis of alcohol use disorder (collectively AUD) among PWH at 8 CFAR Network of Integrated Clinical Systems (CNICS) sites from 2021-2024. Falls were self-reported using components of the Falls Risk for Older People in the Community (FROP-Com) questionnaire. Cross-sectional associations between alcohol use and falls were examined using relative risk models adjusted for age, sex, race/ethnicity, and geographic location. Among 5,729 PWH, mean age was 55 years; 42% reported White and 41% reported Black/African American race/ethnicity; and 81% were male. Mean AUDIT-C score was 1.9 (range: 0-12); 27% reported heavy episodic drinking, 22% had AUD; and 22% reported falling in the past year. Reporting ≥1 fall in the past year was not associated with any measure of current alcohol use. AUD was associated with reporting ≥1 fall (prevalence ratio (PR)=1.54 (95%-CI: 1.39-1.70)) and number of falls (1-fall: PR = 1.27 (95%-CI: 1.08-1.50); ≥2-falls: PR = 1.84 (95%-CI: 1.58-2.15). Among PWH, 22% reported falling, which was associated with AUD, but not current alcohol use, suggesting that a mechanism other than acute intoxication could be responsible. Further longitudinal research is warranted to explore mechanisms for why AUD, but not current alcohol use, is associated with falls.

BackgroundThe decline in fertility intentions has emerged as a critical demographic and policy challenge within China, particularly in light of the introduction of the three-child policy. This situation necessitates a thorough examination of the multiple underlying factors that contribute to individuals’ decisions regarding family size. By analyzing these diverse influences, policymakers and stakeholders will be better equipped to design effective interventions aimed at addressing this urgent issue. A nuanced comprehension of the complexities surrounding low fertility intentions is essential for promoting family growth and fostering stability within the nation. Ultimately, a targeted approach informed by these insights will be vital for encouraging a cultural shift towards larger families and ensuring the long-term demographic health of China.MethodsIn our research, we performed a cross-sectional analysis using data gathered in 2022 from the Psychology and Behavior Investigation of Chinese Residents (PBICR), which encompassed 21,916 participants aged 18 to 49 years. We assessed fertility intention scores for respondents based on their preferences for having a first, second, and third child, employing a scoring system that ranged from 0 to 100. To investigate the impact of various factors on fertility intentions, we organized the independent variables into three primary domains: socio-demographic characteristics, lifestyle and health behaviors, and family structure. We utilized domain-specific multivariate linear regression analyses, along with gender-stratified models, and examined interaction effects. The explanatory capacity of each model was evaluated by calculating R² values, which offered insights into the variance accounted for by the independent variables.ResultsOur research indicated that men demonstrated significantly higher scores for fertility intention than women, with a meaningful statistical difference (β = 7.63, p < 0.001). Various factors were recognized as positive indicators of fertility intention, such as being younger, residing in rural areas, having a favorable self-evaluation of health, and marital status. Moreover, behaviors like smoking and current alcohol use showed significant associations with fertility intentions. In our examination of family-related factors, we discovered that dual-income households without children (DINK) and nuclear family setups were linked to lower fertility intentions, whereas those living with parents expressed greater intentions to parent. Importantly, the interaction effects suggested that women faced a more pronounced decline in fertility intentions as age increased. Among the factors studied, socio-demographic characteristics explained the largest proportion of variance in fertility intentions (R² = 0.086).ConclusionsFertility intentions in China are shaped by various factors, such as differences between genders, individual health, and family structure. To tackle the challenge of decreasing fertility rates effectively, it is essential that interventions focus on younger women and highlight the advantages of living with multiple generations. In addition, reproductive policies ought to consider health and lifestyle factors, establishing a more comprehensive strategy to encourage family expansion in urban settings. Through the adoption of these approaches, stakeholders can strive to counteract the patterns of low fertility intentions and create an environment that supports family growth.

BackgroundThis study examined the association between problematic smartphone use (PSU) and risk behaviors among Korean adolescents during the COVID-19 pandemic. It also aimed to develop preventive measures for adolescent health promotion in the event of future pandemics.MethodsA secondary analysis of data from the 16th Korean Youth Risk Behavior Web-based Survey (2020) was conducted, which included 54,948 middle and high school students. Smartphone use, PSU, alcohol use, and smoking status were assessed via self-reported questionnaires. Complex samples descriptive statistics and logistic regression analyses were performed using SPSS 25.ResultsKorean adolescents averaged 282.8 and 393.4 min of smartphone use across weekdays and on weekends, respectively, with a 25.5% prevalence of PSU. Female and high school students exhibited significantly higher PSU rates (p <.001). Current alcohol use and smoking increased PSU risk by 1.098- and 1.295-fold, respectively.ConclusionsThe findings emphasize the need for intervention strategies targeting PSU and associated risk behaviors. Continuous monitoring in home and school settings, along with gender-specific and educational-level interventions, is recommended to promote healthy smartphone use among adolescents.

Prevalence and associated factors of serious unintentional physical injury, road traffic injury and near drowning experience among a nationally representative sample of school-aged adolescents in the Philippines in 2019.

Clinical and inflammatory markers associated with metabolic dysfunction-associated fatty liver disease in a cohort of individuals with chronic schizophrenia (FACE-SZ).

This study examined the relationship between self-esteem and attitudes toward alcohol and other substance use (ASU) among undergraduate students in Nairobi, Kenya, focusing on sex differences. Studies across Africa have shown a high rate of ASU among university students due to the normalization of alcohol consumption and the accessibility of drugs. We analyzed data from 406 undergraduate students (51% male), with an average age of 19 years, at Self-Esteem, attitudes towards alcohol and other substance use among undergraduate students in Nairobi, Kenya: A sexdisaggregated cross-sectional analysis a public university in Nairobi. Alcohol andsubstance use were measured using the Assessment of Smoking and Substance Involvement Test (ASSIST), self-esteem was measured using the Rosenberg scale, and attitudes toward alcohol were assessed using the Attitudes Towards Alcohol scale. Sex disaggregated, modified Poisson regression models estimated the relative risk of ASU associated with covariates (self-esteem and attitudes towards alcohol use) as the primary explanatory variables of interest. Each per-point increase in social ease reduced the risk of current alcohol use by 17% in females and 18% in males. Living at home or in private residences consistently increased the risk of ASU for both sexes. These findings underscore the influence of social and contextual factors on ASU and highlight the need for universitybased prevention trategies to inform the ASU-related attitudes among students.