Drinking Risk Research Articles

Identification of Alcohol Risk Drinking Behaviour in Pregnancy Using a Web-Based Questionnaire: Large-Scale Implementation in Antenatal Care.

This study aimed to examine the feasibility of a web-based questionnaire when collecting information on alcohol consumption in pregnancy to identify women with risk drinking behaviour, and to describe factors associated with risk drinking behaviour, and the use of specialized care for prenatal risk drinking. In 2413 women referred to antenatal care at Odense University Hospital, Denmark, April-October 2018, self-reported alcohol intake was retrieved from a web-based questionnaire. Replies were screened for risk drinking behaviour: current intake of ≥7 drinks/week, ≥3 binge drinking episodes (intake of ≥5 drinks on a single occasion) in pregnancy, binge drinking after recognition of pregnancy and/or a TWEAK-score≥2 points. Women with risk drinking behaviour were called to clarify the need for specialized care. A summary of the interview was obtained from the medical records. Overall, 2168 (90%) completed the questionnaire. Of 2097 women providing information on alcohol intake, 77 (4%) had risk drinking behaviour. Risk drinking was associated with higher alcohol intake prior to pregnancy, spontaneous conception, younger age, nulliparity and higher level of physical activity in pregnancy. Amongst 47 women with risk drinking behaviour reached by phone, five (11%, 95% CI 4-23%) accepted examinations of the child by paediatrician and child psychologist, and<3 (not further specified due to small numbers) were referred to specialized antenatal care. A web-based questionnaire was feasible when collecting information on alcohol consumption in pregnancy to identify risk drinking behaviour. Women with risk drinking behaviour had a low acceptance of referral to specialized care.

Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women.

Females ages 12 and older are the fastest growing segment of alcohol consumers in the United States, with the past decade showing a 16% increase in alcohol use per 12-month period and a 58% increase in high-risk drinking (i.e., > 3 drinks in a day and/or > 7 drinks in a week) per 12-month period. The increase in alcohol use and risk drinking poses unique and serious consequences for women. Women have a more rapid progression to alcohol-related problems and alcohol use disorders (AUD) than men, and if pregnant, women can potentially expose the fetus to alcohol. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based, integrated public health approach used to identify and address risky alcohol use among women in a variety of health and social service settings. This article presents the current status of SBIRT among girls ages 12 and older, women of childbearing age, and older women. Screening instruments, brief interventions, and implementation issues specific to women of all ages are described. Through this review of the current literature, care providers can determine best practices for the prevention and treatment of risk drinking in women of all ages presenting in health care settings.

Prevalence of Alcohol Consumption and Alcohol Use Disorders among Adult Outpatient Attendees in Urban Primary Care Clinics in Miri Sarawak, East Malaysia

Background: In Malaysia, the prevalence of current adult alcohol drinker was 8.4%. However, there is no known published data on the prevalence of alcohol consumption and alcohol use disorder among adult outpatient attendees in primary care clinic in Miri Sarawak, East Malaysia. The aim of this study was to determine the prevalence of alcohol consumption and alcohol use disorder and its associated factors among adult outpatient attendees in urban primary care clinics in Miri Sarawak, Malaysia. Methods: We conducteda cross sectional study in two urban primary care clinics in Miriusing simple random sampling method. The validated AUDIT-10 questionnaire was used to determine alcohol consumption, hazardous, dependence and harmful use. Results: 404 subjects were selected into the study.46.3% were current alcohol drinkers,90.1% were low risk drinker,9.2% were hazardous drinker and 0.7% were harmful drinker. There was a statistically significant association between alcohol consumption and male, Iban ethnicity, Christianity, Buddhism and secondary school level. Hazardous and harmful drinking were significantly associated with male and Iban. Conclusions: There is high prevalence of alcohol consumption but low prevalence of alcohol use disorder among adult outpatient attendees in the urban primary care clinics in Miri.Increase public awareness of existing policies and alcohol intervention programmed in the primary care clinic, residential areas particularly the Iban long houses, secondary schools and place of worship against hazardous drinking and alcohol use disorder is recommended.

Perceptions of Alcohol Health Warning Labels in a Large International Cross-Sectional Survey of People Who Drink Alcohol.

This paper aimed to explore perceptions of alcohol health warning labels amongst a large international sample of people who drink alcohol. The Global Drug Survey (GDS) is the world's largest annual cross sectional survey of drug use. Seven health warning labels were presented (relating to heart disease, liver, cancer, calories, violence, taking two days off and the myth of benefits to moderate drinking). People were asked if they were aware of the information, believed it, if it was personally relevant, and if it would change their drinking. This paper included data from 75,969 respondents from 29 countries/regions who reported the use of alcohol in the last 12months, collected during November-December 2017 (GDS2018). The fact that drinking less can reduce the risk of seven types of cancer was the least well known, and yet was demonstrated to encourage almost 40% of drinkers to consider drinking less. Women and high risk drinkers were more likely to indicate they would reduce their drinking in response to all labels. Personal relevance was identified as a key predictor of individual responses. Findings highlight the potential of a range of health messages displayed on alcoholic beverages to raise awareness of alcohol-related harms and potentially support a reduction in drinking. Further research should explore what influences personal relevance of messages as this may be a barrier to effectiveness.

Alcohol consumption and self-rated health among older people: population-based study in Sweden.

To analyse alcohol consumption and its association with self-rated health among a representative sample of older people in mid-Sweden. Over the past decades, alcohol consumption has increased in the older population in Sweden, but few studies have investigated the association between alcohol consumption and self-rated health in this group. The aim was therefore to investigate alcohol consumption and self-rated health among older Swedes. The study is based on a cross-sectional study of 11,716 men and women, 65 years and over, answering a survey questionnaire sent to a random population sample in mid-Sweden in 2012. We assessed alcohol consumption with AUDIT-C and its association with self-rated health using logistic regression analysis, adjusting for age, economic situation, educational level, BMI, physical activity, social support and medication use. Men (83%) were more prone to drink alcohol compared to women (71%). The prevalence of risk drinking was about 2% for both genders. Alcohol consumption declined with age. Moderate consumption of alcohol was associated with lower probability of poor self-rated health compared to non-drinking with an adjusted odds ratio 0.64 (95% confidence interval: 0.54-0.76) for men and 0.68 (0.59-0.79) for women. Since the study was cross-sectional the direction of the association could not be determined, and the results should not be interpreted as an argument for promoting alcohol consumption among older people.

Prevalence of Moderate and Acute Suicidal Ideation among a National Sample of Tribal College and University Students 2014–2015

Objectives To examine the relationship between suicide risk and hazardous drinking, depression, and anxiety, adjusting for demographics, among tribal college students across the United States. Methods. We invited tribal college students enrolled in 22 tribal colleges from fall 2014 and 2015 to participate in the Creating Campus Change study, a cross-sectional online/paper survey assessing alcohol use patterns and mental health outcomes. 3,239 students participated in the survey, yielding a response rate of 31.3%. We assessed alcohol use, depression, and general anxiety, along with demographic characteristics. We used the Mini-International Neuropsychiatric Interview to assess suicide risk. Results. 8.5% indicated moderate or high suicide risk. In the final adjusted model, moderate/high depression was significantly associated with moderate/high suicide risk (OR = 6.64; 3.91–11.28, p < 0.001), as was moderate/high general anxiety (OR = 2.80; 1.58–4.97, p < 0.001), and moderate/high hazardous drinking (OR = 2.09; 1.19–3.66, p < 0.001). Conclusions. Students attending tribal colleges who report moderate/high levels of depression, anxiety, or hazardous drinking have a greater risk of suicidality. Identifying factors buffering the risk of suicidality could support policy changes necessary to address this critical public health issue.

Self-regulation, norms and alcohol consequences: study on university freshman from four EU countries

Abstract High alcohol consumption is undoubtedly one of the most serious health and public issues across Europe. In addition to other licit and illicit drugs, it causes more than 4% of all deaths in the EU for those aged between 25 and 39. Among protective factors the self-regulation (SR) has been frequently associated with lower levels of risky drinking. On the other hand, overestimated descriptive normative beliefs (NB) may serve as a powerful source of social influence on personal alcohol use. Both SR and NB may be especially important during the period when young adults leave their families and may feel less external control and more freedom to use alcohol what may lead to serious health consequences. Therefore this study explores the associations among SR and NB in relations to alcohol use and negative alcohol consequences. Data among 2671 first-year college students were collected in 2011. Students from the Czech Republic (n = 357), Hungary (n = 783), Lithuania (n = 928) and Slovakia (603) who filled in the AUDIT test, Self-Regulation Questionnaire and questions regarding NB. Regression models (separately for each country) were computed to test whether different level of SR influences the relationship between NB and alcohol use and between alcohol use and negative consequences. Overestimated NB were positively associated with risky drinking in all countries and similarly alcohol use increased the level of negative consequences. Moreover, in predicting risk drinking and alcohol consequences, a moderation effect of SR was confirmed as associations among NB and alcohol use and among alcohol use and negative consequences were stronger among those students with lower SR. The protective effect of SR on risky alcohol and consequences together with social norms approach may potentially improve the intervention accuracy and make it a promising target for intervention among young adults. Key messages Students from all explored countries highly overestimated the actual alcohol use what was significantly associated with theirs higher alcohol consumption. Those students who overestimated the actual alcohol consumption but had higher levels of self-regulation were less likely to drink or report negative alcohol consequences than their peers.

Alcohol Consumption and Current Situation of Drinking Risk Level Among University Students in Mandalay Region

Background: In Myanmar, alcohol consumption among university students had been recognized as a major public health concern. A cross-sectional study was done to investigate drinking alcohol and risk level assessment using the Alcohol Use Disorder Identification Test (AUDIT) and examined the reasons of alcohol uses and types of beverage preference consumed. Methods: The two universities from three districts in Mandalay region were randomly selected, from which 976 students (stratified by academic year and sex) were contributed in self-administered questionnaire. Results: The mean age at first drinking alcohol among the participants was 16.36_0.15 years with range of 16 to 19 years. The drinking risk level assessment using the AUDIT test, nearly half of the participants 48.7% were abstainers and 86 (8.8%) were high risk drinkers while 28 (2.9%) had alcohol dependency. Among those, 57.8% had experiences of alcohol drinking and the favorite beverage of the university students who drink alcohol was beer. Binary logistic regression analysis indicated that gender, smoking habit and living situation for drinking were significant predictors of alcohol consumption among university students. The results found out that living separately with parents and smoking habits were important factors for drinking alcohol with statistically significant at 95% confidence level. Conclusion: It provided evidence-based findings for knowing the alcohol consumption risk level among university students to prevent social deprivation and health risk behaviors. Findings from this study indicate a need for law governing, strictly prohibits the sale of alcohol directly or indirectly to those under the age of eighteen years. The alcohol intervention program can be helpful in modifying behaviors change communication in health promotion of university students. Keywords: Alcohol consumption, AUDIT test, drinking risk level, university students and binary logistic regression Received: 12 April 2019 Reviewed: 18 June 2019 Revised: 25 June 2019 Accepted: 8 July 2019 DOI: 10.35898/ghmj-33582

Alcohol Consumption and Current Situation of Drinking Risk Level Among University Students in Mandalay Region

Background: In Myanmar, alcohol consump on among university students had been recognized as a major pub- lic health concern. A cross-sec onal study was done to inves gate drinking alcohol and risk level assessment using the Alcohol Use Disorder Iden fica on Test (AUDIT) and examined the reasons of alcohol uses and types of beverage preference consumed. Methods: The two universi es from three districts in Mandalay region were randomly selected, from which 976 students (stra fied by academic year and sex) were contributed in self-administered ques onnaire. Results: The mean age at first drinking alcohol among the par cipants was 16.36±0.15 years with range of 16 to 19 years. The drinking risk level assessment using the AUDIT test, nearly half of the par cipants 48.7% were abstainers and 86 (8.8%) were high risk drinkers while 28 (2.9%) had alcohol dependency. Among those, 57.8% had experiences of alcohol drinking and the favorite beverage of the university students who drink alcohol was beer. Binary logis c regression analysis indicated that gender, smoking habit and living situa on for drinking were significant predictors of alcohol consump on among university students. The results found out that living separately with parents and smoking habits were important factors for drinking alcohol with sta s cally signifi- cant at 95% confidence level. Conclusion: It provided evidence-based findings for knowing the alcohol consump on risk level among univer- sity students to prevent social depriva on and health risk behaviors. Findings from this study indicate a need for law governing, strictly prohibits the sale of alcohol directly or indirectly to those under the age of eighteen years. The alcohol interven on program can be helpful in modifying behaviors change communica on in health promo on of university students.

Drinking patterns and the distribution of alcohol-related harms in Ireland: evidence for the prevention paradox

BackgroundAccording to the prevention paradox, the majority of alcohol-related harms in the population occur among low-to-moderate risk drinkers, simply because they are more numerous in the population, although high-risk drinkers have a higher individual risk of experiencing alcohol-related harms. In this study we explored the prevention paradox in the Irish population by comparing alcohol-dependent drinkers (high-risk) to low-risk drinkers and non-dependent drinkers who engage in heavy episodic drinking (HED).MethodsData were generated from the 2013 National Alcohol Diary Survey (NADS), a nationally representative cross-sectional survey of Irish adults aged 18–75. Data were available for 4338 drinkers. Respondents dependent on alcohol (as measured by DSM-IV criteria), respondents who engaged in monthly HED or occasional HED (1–11 times a year) and low-risk drinkers were compared for distribution of eight alcohol-related harms.ResultsRespondents who were dependent on alcohol had a greater individual risk of experiencing each harm (p < .0001). The majority of the harms in the population were accounted for by drinkers who were not dependent on alcohol. Together, monthly and occasional HED drinkers accounted for 62% of all drinkers, consumed 70% of alcohol and accounted for 59% of alcohol-related harms.ConclusionsOur results indicate that the majority of alcohol consumption and related harms in the Irish population are accounted for by low- and moderate-risk drinkers, and specifically by those who engage in heavy episodic drinking. A population-based approach to reducing alcohol-related harm is most appropriate in the Irish context. Immediate implementation of the measures in the Public Health (Alcohol) Act (2018) is necessary to reduce alcohol-related harm in Ireland.

Prevalence and Correlates of Past-Year Recovery From DSM-5 Alcohol Use Disorder: Results From National Epidemiologic Survey on Alcohol and Related Conditions-III.

Little is known about remission, recovery, and other outcomes of alcohol use disorder (AUD) as defined by the DSM-5. Data from a large representative sample of the United States was used to examine correlates of past-year AUD status among individuals with prior-to-past-year AUD: persistent AUD, symptomatic high-risk drinking, asymptomatic high-risk drinking, symptomatic low-risk drinking, asymptomatic low-risk drinking (nonabstinent recovery, NAR), and abstainer (abstinent recovery, AR). Multiple logistic regression analyses were conducted to compare: (i) AR and NAR with persistent AUD, (ii) AR with NAR, and (iii) asymptomatic and symptomatic high-risk drinking with AR and NAR. Among individuals with AUD prior to past year (n=7,785), 34.2% were classified with persistent AUD, 8.8 and 1.6% were symptomatic high-risk and symptomatic low-risk drinkers, respectively, 21.5% were asymptomatic high-risk drinkers, 17.9% were asymptomatic low-risk drinkers, and 16.0% were abstainers. One-quarter of individuals with AUD prior to past year achieved AR or NAR without the benefit of treatment, while a much greater percentage of individuals achieving AR (43.2%) reported receiving treatment relative to those with NAR (12.3%). The number of lifetime AUD symptoms was greater among those achieving AR (among the treated) and lower among those achieving NAR relative to persistent AUD. The number of AUD symptoms was also greater among those achieving AR than NAR and lower among asymptomatic and symptomatic risk drinkers relative to those achieving AR and NAR. Consumption was greater among those achieving AR relative to those achieving NAR and greater among asymptomatic and symptomatic risk drinkers relative to AR and NAR. Odds of achieving AR or NAR relative to persistent AUD were generally lower among non-Hispanic Blacks and those with higher education, greater among women and married individuals, and lower among illicit drug users and individuals with histories of a personality disorder or mood/anxiety disorder. There appears to be a substantial level of recovery from AUD. Information on specific factors associated with AUD outcomes can be useful in targeting appropriate treatment efforts.

Time trends in healthy lifestyle among adults in Germany: Results from three national health interview and examination surveys between 1990 and 2011.

The combined impact of multiple healthy behaviors on health exceeds that of single behaviors. This study aimed to estimate trends in the prevalence of a healthy lifestyle among adults in Germany. A data set of 18,058 adults aged 25-69 years from three population-based national health examination surveys 1990-92, 1997-99 and 2008-11 with complete information for five healthy behavior factors was used. A 'daily intake of both fruits and vegetables, 'sufficient physical exercise', 'no current smoking' and 'no current risk drinking' were assessed with self-reports and 'normal body weight' was calculated based on measured body weight and height. A dichotomous 'healthy lifestyle' indicator was defined as meeting at least four out of five healthy behaviors. Age-standardized prevalence was calculated stratified by sex, age groups (25-34, 35-44, 45-54 and 55-69 years) and education level (low, medium and high). Trends were expressed in relative change (RC) between 1990-92 and 2008-11. In Germany, the overall prevalence of healthy lifestyle increased from 9.3% in 1990-92 to 13.5% in 1997-99 and to 14.7% in 2008-11 (RC: +58.1%). The prevalence increased among men and women and in all age groups, with the exception of men aged 45-54 years. The RC of increasing healthy lifestyle prevalence between 1990-92 and 2008-11 was stronger albeit on a higher level among women compared to men. Therefore, the gender difference in healthy lifestyle has increased, but age-related differences have overall decreased in this period. Among high educated men the prevalence of a healthy lifestyle increased between 1990-92 and 2008-11 from 10.6% to 16.3% (p = 0.01) and among high educated women from 16.4% to 30.3% and also among medium educated women (10.9 to 16.6, p<0.01), but no significant increase in healthy lifestyle prevalence was observed among men with low and medium education and among women with low education level. The prevalence of a lifestyle with at least four out of five healthy behaviors markedly increased from 1990-92 to 2008-11. Nevertheless, additional health promotion interventions are needed to improve the number of combined healthy behavior factors and the awareness in the population that each additional healthy behavior factor leads to a further improvement in health, especially in men in the age-range 45 to 54 years, and among persons with low education level.

Changes in Alcohol Consumption and Associated Variables among Older Adults in Spain: A population-based cohort study

We examined prospective changes in drinking patterns and their associations with socio-behavioral and health status variables in older adults in Spain using data from a prospective cohort of 2,505 individuals (53.3% women) representative of the non-institutionalized population aged >60 years in Spain. Alcohol consumption was assessed at baseline (2008–10) and at follow-up (2012) with a validated diet history. At risk drinking was defined as consuming >14 g of alcohol/day on average or any binge drinking in the last 30 days; lower amounts were considered light drinking. A total of 26.5% of study participants changed their intake during follow-up. Most participants reduced alcohol intake, but 23.3% of men and 8.9% of women went from light to at risk drinking during the study period. Low social connectivity at baseline was linked to at risk drinking for both sexes. However, the observed associations between changes in social connectivity, morbidity, BMI, or dietary habits and changes in drinking patterns differed by sex. We concluded that since about a quarter of older adults in Spain consume more alcohol than recommended, identifying socio-behavioral factors associated with this behavior is key for designing health campaigns targeting excessive alcohol consumption in this vulnerable population.

표준잔 제정, 음주가이드라인 개발 과정 및 담론 지형

표준잔 제정, 음주가이드라인 개발 과정 및 담론 지형

Outcome in Relation to Drinking Goals in Alcohol-Dependent Individuals: A Follow-up Study 2.5 and 5 Years After Treatment Entry.

To evaluate the long-term treatment outcome (up to 5 years) with respect to different drinking goals of patients. Alcohol-dependent individuals (n = 349) were recruited from three alcohol treatment units. They were interviewed using the Addiction Severity Index (ASI). They were sub-grouped according to their goal at treatment entry: abstinence, low- risk drinking and no decided goal. Patients with abstinence as a goal at treatment entry reported at 2.5 years follow-up a higher abstinence rate, a more pronounced reduction in alcohol consumption, reduction in total number of DSM-IV criteria, higher frequency of low-risk drinking and fewer diagnoses of alcohol dependence compared to the groups who had low risk drinking as a goal or no decided goal. This improvement remained basically unchanged in all three groups at 5 years follow-up, suggesting long-term stability after the treatment interventions. The findings suggest that: (1) alcohol-dependent patients who have abstinence as their own drinking goal have a more favorable treatment outcome than those who have low-risk drinking as a goal or no decided goal. (2) Abstinence as a drinking goal should be considered for those who have a longer duration (for example more than 10 years) of their alcohol-related problems. (3) Patients who have no decided goal should be recommended abstinence as a drinking goal.

A comparison of implicit and explicit reward learning in low risk alcohol users versus people who binge drink and people with alcohol dependence

Chronic alcohol use leads to specific neurobiological alterations in the dopaminergic brain reward system, which probably are leading to a reward deficiency syndrome in alcohol dependence. The purpose of our study was to examine the effects of such hypothesized neurobiological alterations on the behavioral level, and more precisely on the implicit and explicit reward learning. Alcohol users were classified as dependent drinkers (using the DSM-IV criteria), binge drinkers (using criteria of the USA National Institute on Alcohol Abuse and Alcoholism) or low-risk drinkers (following recommendations of the Scientific board of trustees of the German Health Ministry). The final sample (n = 94) consisted of 36 low-risk alcohol users, 37 binge drinkers and 21 abstinent alcohol dependent patients. Participants were administered a probabilistic implicit reward learning task and an explicit reward- and punishment-based trial-and-error-learning task. Alcohol dependent patients showed a lower performance in implicit and explicit reward learning than low risk drinkers. Binge drinkers learned less than low-risk drinkers in the implicit learning task. The results support the assumption that binge drinking and alcohol dependence are related to a chronic reward deficit. Binge drinking accompanied by implicit reward learning deficits could increase the risk for the development of an alcohol dependence.

Patterns of Parental Interactions After Divorce and Individual Well-Being

This study sought to uncover patterns of parental interactions following divorce using multiple empirically-supported indicators related to cooperation, overt conflict, and covert conflict and to link patterns of parental interactions with indicators of adult well-being including stress, life satisfaction, alcohol use, and risk drinking. Using community-based sampling and latent profile analysis, patterns of parental interactions were identified and associations among such patterns and parental well-being were examined for recently divorced parents (N= 246). Reports of parental interactions included parents’ perceptions of their own and their former spouse’s cooperation and covert conflict behaviors, as well as perceptions of overt conflict behaviors in parental interactions. Two patterns of parental interactions were identified (Congruent and Divergent). Among the full sample, neither pattern was linked with any indicator of well-being. Examining these associations separately for mothers and fathers, fathers in the Divergent group reported higher levels of alcohol use than those in the Congruent group (χ2 = 4.64, p = .03). Mothers in the Divergent group reported marginally higher levels of life satisfaction than those in the Congruent group. Utilizing a person-centered approach to uncover patterns of parental interactions yielded groups that differentiated largely on the basis of participant’s perceptions of their former spouses’ behaviors. Future research might consider the impact of perception as a component of divorce education evaluation work.

Examining the Impact of a Psychosocial Syndemic on Past Six-Month HIV Screening Behavior of Black Men who have Sex with Men in the United States: Results from the POWER Study.

Syndemic production theory has been used to explore HIV transmission risk or infections but has not been used to investigate prevention behavior, or with large samples of non-Whites. This analysis is the first to explore the impact of syndemic factors on previous six-month HIV screening behavior among US Black MSM. Data from Promoting Our Worth, Equality and Resilience (POWER) were analyzed from 3294 participants using syndemic variable counts and measures of interaction/synergy. Syndemic variables included: past three-month poly-drug use, depression, last year intimate partner violence, HIV risk and problematic binge drinking. BMSM reporting two syndemic factors were more likely to report screening (AOR = 1.37, 95% CI 1.04-1.80; p = 0.028) with no significant associations for three or more conditions. Measures of joint effect revealed that there were synergies among depression, problematic binge drinking and poly-drug use but these psychosocial factors cannot entirely explain testing patterns and excess disease burden among BMSM.

The relationship between self-efficacy, readiness to change, and AUDIT risk levels in a sample of active duty emergency department patients

ABSTRACTThe purpose of this study was to test the relationship between self-efficacy, readiness to change, and Alcohol Use Disorders Identification Test (AUDIT) risk levels in a sample of active duty drinkers who were seeking care in a military emergency department. Civilian health educators screened participants for alcohol use with the AUDIT and collected sociodemographic, service, and drinking-related cognitions data from active duty patients admitted to an emergency department. A total of 787 active duty military personnel participated in the study. Almost half (48%) drank at least once a week and 32% reported consuming five or more alcoholic drinks during a typical drinking episode. One in five participants reported heavy episodic drinking weekly to almost daily. Results of a multinomial logistic regression model showed that active duty service members with a self-reported diagnosis of posttraumatic stress disorder since joining the military were more likely to be an at-risk or high/severe risk drinker relative to a low risk drinker. Higher controlled drinking self-efficacy was associated with a decrease in the odds of being either an at-risk or high/severe risk drinker. Increased readiness to reduce drinking was associated with an increase in the odds of being either an at risk or high/severe risk drinker. The results of this research suggest self-efficacy to control one’s heavy drinking as well as readiness to change may be important factors to consider when designing alcohol education programs within the military.

Prevalence and Correlates of Psychological Distress Among HIV Positive Individuals in South Africa: Findings from the 2012 HIV National Household Survey

Psychological distress symptoms like depression and anxiety are potentially dangerous conditions in HIV positive individuals influencing health-seeking behaviour, care and treatment leading to poor health outcomes. This study sought to determine the prevalence of psychological distress symptoms and associated socio-demographic and health-related factors amongst HIV positive individuals. The study used the 2012 data from a nationwide cross-sectional population-based household survey that was conducted using a multi-stage stratified cluster sampling design. Bivariate and multivariate logistic regression analysis were used to identify factors associated with psychological distress among HIV positive individuals. Of 2 536 HIV infected individuals found in the study, 34.5% reported psychological distress symptoms. The prevalence of reported psychological distress symptoms was significantly higher among females (38.2%) than males (28.5%). Increased likelihood of psychological distress among HIV positive males was significantly associated with residing in urban informal areas than urban formal areas [OR=2.5(95% CI: 1.2-5.6), p=0.021], not engaging in vigorous intensity sport [OR=2.1 (95% CI: 1.2-3.8), p=0.009]. The decreased likelihood was significantly associated with being employed [OR=0.6 (95% CI: 0.4-1.0), p=0.066], not having any chronic condition [OR=0.5(95% CI: (0.3-1.0), p=0.037], and low risk drinkers than hazardous drinkers [OR=0.3(95% CI: 0.1-0.9), p=0.036]. Among HIV positive females, increased likelihood of psychological distress was significantly associated with never seeing a health personnel [OR=2.8 (95% CI: 1.2-6.7), p=0.022]. The decreased likelihood was significantly associated with seeing a health personnel more than one year ago than in the past 6 months [OR=0.7 (95% CI: 0.4-1.0), p=0.051], and not having any chronic conditions [OR=0.6 (95% CI: 0.5-0.9), p=0.017]. The findings suggest a need for integrated interventions including those addressing mental health issues which target HIV positive individuals in urban informal areas, the unemployed, hazardous risk drinkers, and those with chronic medical conditions.