Despite national declines in HIV prevalence, adolescent girls and young women (AGYW) in South Africa continue to face a disproportionate burden of HIV infection. The syndemic theory provides a framework for understanding how interconnected epidemics such as alcohol use disorders, violence and HIV cluster together and reinforce each other. Using this theory, we aimed to test and explore the relationship between alcohol use and HIV risk and infection amongst AGYW in high HIV-burdened communities in South Africa. Data for this study were drawn from a mixed methods impact evaluation of a combination HIV prevention programme implemented across eight provinces in South Africa. A household survey was conducted among AGYW aged 15─24 years in the 12 intervention sub-districts selected by the Global Fund and 12 matching comparison sub-districts. Dried blood spot specimens were collected to test for HIV; alcohol use and sexual behaviours were reported through a self-completed electronic questionnaire. Generalised linear regression models were used to assess the relationship between alcohol use and HIV risk and infection as well as sexual risk behaviours and hazardous drinking. A subsample of 68 AGYW participated in qualitative in-depth interviews. Interview transcripts were translated into English and analysed using thematic analysis. Of the 5025 survey participants, 10% were living with HIV, and 35% engaged in hazardous drinking. No significant association was found between alcohol use and HIV risk or infection. However, a positive association was found between hazardous drinking and sexual violence (OR=1.51; 95% CI: 1.20─1.90), condomless sex (OR=1.25; 95% CI: 1.07─1.47), and condom counselling (OR=1.32; 95% CI: 1.14─1.53). Qualitative interview participants described how AGYW sought alcohol from older men, knowing that sex would be expected in exchange. This put them in high-risk situations where sexual violence was a concern and negotiating condom use became more challenging. These findings highlight the need for interventions that educate AGYW on the harmful effects of binge drinking and provide safer, healthier alternatives for recreation, particularly in low-resourced communities.

Alcohol use disorders are a group of behavioural, cognitive, and physical symptoms caused by repeated alcohol use. The impacts of alcohol consumption are particularly concerning in developing countries, where the burden of sickness and social repercussions linked to alcohol use are significantly greater than the global average. Alcohol consumption can affect the outcome of the disease and worsen its course through a number of mechanisms. Clinically, early intervention via creative screening, brief intervention, and referral strategies can successfully manage the hazardous drinking of diabetes mellitus in primary care settings. In Ethiopia, no research has been conducted on the prevalence of alcohol consumption among diabetes mellitus or the factors that are linked to alcohol consumption. To assess the prevalence and associated factors of alcohol consumption among diabetes mellitus patients who had follow up at selected Hospitals in the East Gojam Zone, Amhara Region, Northwest Ethiopia, in 2022. An institution-based cross-sectional study design was conducted at hospitals located in the East Gojam Zone. A total of 616 participants were selected via a systematic random sampling technique and interviewed via a structured questionnaire. The first participant was selected via the lottery method for each hospital, and other participants were selected every other interval. Alcohol consumption was assessed via the alcohol use disorder identification test (AUDIT). The data were coded and entered into Epi data version 4.4.2.1 and exported to SPSS version 25 for analysis. To indicate the strength of the association, odds ratios and 95% confidence intervals were used. A total of 616 participants were interviewed, for a response rate of 96.86. Once medication was started, 228 (37%) of the study participants consumed alcohol. Male sex (AOR = 3.26, 95% CI: 2.07-5.13), living in rural areas (AOR = 3.84, 95% CI: 1.85-8.00), poor social support (AOR = 1.76, 95% CI: 1.02-3.08) and moderate stress (AOR = 3.57, 95% CI: 1.12-11.31) were found to be significantly associated with alcohol consumption (p < 0.05). The prevalence of alcohol consumption among diabetes mellitus was high in this study area. Being male, living in rural areas, having poor social support and having moderate stress were found to be significantly associated with alcohol consumption (p < 0.05).

Background: Sociosexuality reflects behaviors, attitudes, and desires related to casual sex with multiple, concurrent, novel partners. Research on whether people high in sociosexuality are less likely to engage in safer sex practices (e.g., unprotected sex) is mixed, but there is evidence that those high in sociosexuality consume more alcohol than their peers, and drinking is associated with less likelihood of engaging in safer sex. Here we tested whether sociosexuality is associated with intoxicated and unprotected sex in a sample of college students (Study 1) and adults (Study 2). Methods: We hypothesized that sociosexuality would be associated with both intoxicated and unprotected sex on the premise that those high in sociosexuality tend to drink more (and those who drink more might be more likely to engage in sex while intoxicated) and less likely to engage in safer sex practices. Results: Across both studies we found that sociosexuality is associated with intoxicated and unprotected sex, and this association was partially mediated by alcohol use. Conclusions: These findings have important implications for public health interventions aiming to increase safer sex practices.

Few primary care patients with hazardous drinking initiate or engage in alcohol care. We conducted a formative evaluation of an intervention, Connect to Care (C2C), designed to support patients with hazardous drinking and mental health symptoms in initiating alcohol care. C2C's acceptability and barriers and facilitators to its use in the primary care setting were explored. Participants were enrolled in a pilot randomized controlled trial of C2C. Participants assigned to the C2C condition were selected to participate in a qualitative interview at the completion of their 3-month follow-up. Template analysis was used to analyze qualitative data. We interviewed 20 primary care patients (90% male) with a positive screen for hazardous drinking and depression and/or PTSD symptoms. Participants described four ways that C2C was helpful: Using a menu, the coach helped educate participants on their alcohol care options; participants' felt that the coach was non-judgmental, caring, and genuinely interested in helping them learn about their care options and link them to their preferred option; participants' appreciated the flexibility of how and when C2C was offered which facilitated engagement; and it was some participants' perception that C2C helped them reduce both their alcohol use and mental health symptoms. However, some patients reported that the length of C2C sessions, repetitive information provided by the coach, and not wanting to change their drinking habits as barriers to C2C session attendance. This qualitative study highlights helpful components, potential barriers to session attendance, and potential adaptations to C2C informed by primary care patients participating in a pilot RCT of this strengths-based intervention. The findings could help inform implementation of C2C in the primary care setting.

Although acculturative stress contributes significantly to internalizing problems among Latinos who drink hazardously, the individual difference variables that strengthen or weaken this relationship have remained elusive. To address this gap, we examined two cognitive-affective factors, namely, distress tolerance and emotion dysregulation, as candidate moderators. We expected that acculturative stress would be positively associated with internalizing problems (operationalized as anxious arousal, traumatic intrusions, and social anxiety) at lower levels of distress tolerance and/or higher levels of emotion dysregulation. A sample of Latinos who drink hazardously (N = 99) completed measures of acculturative stress, distress tolerance, emotion dysregulation, and internalizing symptoms. There was a significant Acculturative Stress × Distress Tolerance interaction explaining 5.02% and 4.19% of the variance in anxious arousal and traumatic intrusions, respectively. Acculturative stress was significantly positively associated with anxious arousal and traumatic intrusions only at lower levels of distress tolerance. There was also a significant Acculturative Stress × Emotion Dysregulation interaction explaining 7.46% of the variance in anxious arousal. Acculturative stress was significantly positively associated with anxious arousal only at higher levels of emotion dysregulation. Acculturative stress was associated with anxious arousal and traumatic intrusions among Latinos who drink hazardously with lower distress tolerance and/or higher emotion dysregulation. Enhancing distress tolerance and lowering emotion dysregulation may protect Latino individuals who engage in hazardous drinking and experience acculturative stress against internalizing problems, and these processes may serve as targets in future intervention programming. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

In the UK, consumption of alcohol-free (< 0.05% ABV) and low-alcohol (≤ 1.2% ABV; NoLo) drinks is more prevalent among heavier drinkers and socially advantaged groups. If heavier drinkers are substituting alcoholic drinks with NoLo drinks, this could improve public health. However, socioeconomic differences in consumption could exacerbate alcohol-related health inequalities. Socioeconomic groups vary in their reasons for drinking alcohol, with less advantaged individuals more likely to drink alcohol to cope. This study examined whether alcohol drinking motives can help explain differences in NoLo consumption. A total of 2549 adults residing in Great Britain provided data on at least monthly NoLo consumption, hazardous drinking (AUDIT-C), alcohol drinking motives, social grade, education, age and gender, via the Alcohol Toolkit Study. Path analysis explored mediating effects of drinking motives between sociodemographic characteristics, hazardous drinking and NoLo consumption. Drinking alcohol to conform, education and hazardous drinking were positively associated with NoLo consumption. Drinking alcohol to cope with depression was a serial mediator between social grade and NoLo. Drinking to cope with depression, more frequently reported among lower social grades, weakened the positive relationship between hazardous drinking and NoLo consumption (β = -0.001, 95% CI -0.002, -0.000). Enhancement and social motives also weakened this relationship, partially mediating pathways between age, gender, education and NoLo consumption. While hazardous drinking is positively associated with NoLo consumption, for those drinking to cope with depression, for enhancement or for social reasons, this effect diminishes, potentially limiting the public health potential for those who drink for these reasons, including disadvantaged groups.

Secondary traumatic stress impacts professionals working with trauma survivors. However, literature specific to the military legal community is limited. Additional research is needed to better understand how legal professionals cope with indirect exposure to trauma, including using alcohol as a coping mechanism. In a sample of U.S. Army Judge Advocate General's Corps (JAG-C) personnel, this study examined whether hazardous alcohol use was associated with career secondary trauma exposure indirectly via variance shared in common with secondary traumatic stress symptoms and drinking to cope. Judge Advocate General's Corps personnel completed validated questionnaires measuring career trauma exposure, secondary traumatic stress symptoms, drinking to cope, and hazardous alcohol use. Statistical mediation analyses tested sequential pathways linking these variables, controlling for race/ethnicity, gender, rank/pay grade, prior combat exposure, and depression and anxiety symptoms. Career trauma exposure significantly predicted hazardous drinking indirectly via secondary traumatic stress symptoms and drinking to cope. However, an alternative model-where coping preceded secondary traumatic stress-was not statistically significant, supporting the hypothesized temporal sequence. Findings suggest a potential sequential pathway from trauma exposure to secondary traumatic stress and coping-related hazardous drinking, underscoring an important downstream impact of occupation-specific stress within JAG-C personnel. Targeted interventions that simultaneously address secondary traumatic stress symptoms and alcohol-specific coping motives may mitigate hazardous drinking in this understudied, mission-critical population. Weaknesses of the study includes its cross-sectional design and limited generalizability to the Army at-large.

Exploratory analysis of the effect of a food security intervention on alcohol use among people with HIV in the Dominican Republic.

Loneliness, anxiety, and alcohol use across age and sex: The role of emotional regulation.

Trans and gender diverse (trans) people face substantial health and social inequities, yet limited data exist regarding substance use patterns among this population in Australia. Data were sourced from Private Lives 3, a large national survey of LGBTQ+ adults residing in Australia. Trans participants self-reported sociodemographic characteristics, experiences of discrimination, harassment, violence or exclusion, perceived acceptance and affirmation, psychological distress, sexual assault history and substance use behaviours. Multivariable regression analyses identified factors associated with potentially problematic illicit drug use (DAST-10 ≥ 3), potentially hazardous drinking (AUDIT-C ≥ 3), and daily smoking of cigarettes or other tobacco products. Of 1506 trans participants, 23.7% screened positive for potentially problematic illicit drug use, 49.8% for potentially hazardous alcohol use and 8.5% smoked daily. Potentially problematic illicit drug use was associated with unstable housing (aPR = 1.44, p = 0.001), psychological distress (aPR = 1.39, p = 0.022) and sexual assault history (aPR = 1.51, p = 0.001). Potentially hazardous alcohol use was less prevalent among those with affirming partners (aPR = 0.81, p = 0.001) and asexual identity (aPR = 0.65, p = 0.016), but more prevalent among those with a sexual assault history (aPR = 1.17, p = 0.012). Daily smoking was associated with unstable housing (aPR = 1.82, p = 0.002) and sexual assault history (aPR = 2.09, p = 0.002). At-risk substance use among Australian trans adults was most associated with sexual assault and unstable housing, but not gender identity, perceived acceptance, or most experiences of discrimination, harassment, violence, or exclusion. These findings differ from many US studies and may reflect regional sociocultural, legal or healthcare differences, or unmeasured determinants. These findings highlight the need for routine substance-use screening, trauma-informed care, and housing and sexual assault support initiatives for trans Australians.

ABSTRACT Background: Alcohol-induced hypertension (HTN) is linked to a 2.3-fold increase in cardiovascular-related death. Objective: We aimed to identify temporal trends in alcohol-induced HTN mortality among United States (US) adults stratified by year, sex, age, race, and region. Methods: Data on alcohol-induced HTN mortality among adults (≥25 years) in the US from 1999 to 2020 were extracted from the CDC WONDER database, utilizing ICD-10 codes. Crude (CMRs) and age-adjusted mortality rates (AAMRs) were calculated. Temporal trends in AAMRs were assessed using Joinpoint regression. Mortality forecasts through 2030 were generated using the ARIMA model in STATA software (version 17.0). Results: From 1999 to 2020, 50,793 alcohol-induced HTN-related deaths were recorded in the US, with an overall AAMR of 0.858 per 100,000. The AAMR increased from 0.279 (95% CI: 0.257–0.302) in 1999 to 1.348 (95% CI: 1.305–1.390) in 2018, rising further to 2.014 (95% CI: 1.963–2.066) in 2020. Mortality was higher in males (AAMR 2.16) than in females (0.55). The highest burden occurred among American Indians/Alaska Natives (AAMR 2.392), while the lowest was observed in Asians/Pacific Islanders (0.206). The Western region had the highest AAMR (1.116). CMR peaked among individuals aged 55–64 years (2.416), with slightly higher rates in rural areas. Forecast analysis projected the overall AAMR to increase from 2.01 in 2020 to 4.18 by 2030. Conclusion: Rising mortality from alcohol-induced HTN highlights an urgent need for strengthened control policies for alcohol use, early identification of hazardous drinking, and integrated management of hypertension and alcohol use to reduce preventable cardiovascular mortality in the US.

Alcohol marketing is harmful as it increases the consumption of alcohol, age of initiation of alcohol and hazardous drinking patterns. Dark nudges and sludge are behavioural economics techniques used to exploit cognitive biases to manipulate consumers to make decisions that are not in their best interest. These have previously been described in alcohol industry corporate responsibility materials and in digital tools and apps funded by the alcohol industry and are potentially being used in alcohol advertising including on social media. Dark nudges and sludge are potentially very influential within digital environments due to the potential for targeted advertising, the ubiquity of smartphones, the pervasive use of social media and the nature of the marketing, which is often difficult to identify. This commentary provides background information about the use of dark nudges and sludge on social media platforms, outlines key concerns in this space for critical health researchers, and outlines some future research directions for examining the alcohol industry's use of dark nudges and sludge in digital environments, including social media.

ABSTRACT Junior military officers and noncommissioned officers (NCOs) in South Korea are exposed to high levels of occupational and relational stress, placing them at increased risk for depression, burnout, and hazardous drinking. This study examined the effects of a family-based emotional intervention on these psychological outcomes among military personnel. Participants consisted of 59 officers and NCOs who voluntarily enrolled following unit-level recruitment and were assigned to either a treatment group (n = 30) or a comparison group (n = 29) using a preference-based allocation procedure. The treatment group participated in the Thank-You – Sorry – Love (TSL) program, while the comparison group received no intervention. Depression, burnout, and hazardous drinking were assessed at pretest and posttest using validated Korean versions of the PHQ-9, MBI-GS, and AUDIT, respectively. Mixed-design analyses indicated significant time × group interaction effects across outcomes, with participants in the treatment group demonstrating greater reductions over time compared to the comparison group. These findings suggest that family-based emotional interventions may contribute to improvements in psychological well-being and reductions in maladaptive coping behaviors among military personnel.

Imaging alkaline phosphatase activity in alcoholic liver disease via a rational-designed NIR fluorogenic probe.

Do adverse childhood experiences intensify the impact of hazardous drinking on depression? Application of quantile regression analysis.

Alcohol cue-reactivity, inhibitory control, and associated psychological factors in college binge drinkers.

Esophageal squamous cell carcinoma (ESCC) remains a major cause of cancer mortality in South Africa. Understanding locally relevant and modifiable risk factors is crucial for prevention. This study clarifies the syndemic role of lifestyle and environmental factors, such as alcohol, tobacco, socioeconomic indicators (rurality and education), and fuel use, in ESCC. We analyzed 939 histologically confirmed ESCC cases and 3,089 cancer controls from the Johannesburg Cancer Study. Multivariable logistic regression estimated adjusted odds ratios (aORs), with interaction terms for alcohol, tobacco, and sex. Population attributable fractions were calculated using both study-control and national prevalence estimates. Very high alcohol intake (≥840 g ethanol/wk) showed a modest independent association with ESCC (aOR, 1.56 [95% CI, 1.14 to 2.12]). Smoking was a strong risk factor, with aOR = 2.82 (95% CI, 2.20 to 3.62) for ex-smokers and 6.71 (95% CI, 5.15 to 8.76) for current smokers. Among never-smokers, alcohol showed little dose response. Among smokers, risks were high across all alcohol levels, with no consistent increase at higher intakes. Additional risks included rural origin or residence (aOR approximately equal to 1.22-2.38), lower educational attainment (aOR approximately equal to 1.45-1.69), and use of biomass or other fuels (aOR, 1.50 [95% CI, 1.21 to 1.87]). In this high-burden setting, tobacco remains the principal modifiable driver of ESCC. Alcohol showed only a modest independent effect, limited to very high intake, and did not increase the risk among smokers beyond the high risk from smoking. Socioeconomic and environmental disadvantages cluster with behavioral risks, underscoring a syndemic context. These findings, consistent with prior Johannesburg Cancer Study reports yet offering greater exposure granularity, support targeted prevention strategies focused on smoking cessation, mitigation of hazardous drinking patterns, and reduction of household environmental exposures.

Alcohol is one of Australia's most harmful recreational drugs, contributing more to death, disease and economic harm than all illicit drugs combined. Though it accounts for 4.1% of the national disease burden, it remains under-prioritised in health policy, prevention and treatment. Most of this harm is downstream of hazardous alcohol consumption and untreated alcohol use disorder (AUD), a common but stigmatised condition that is under-recognised and rarely treated with evidence-based therapies. Alcohol-related harm falls disproportionately on First Nations peoples, rural communities and socioeconomically disadvantaged Australians. Epidemiological trends are alarming: hospitalisations for alcohol-related liver disease are rising, and emerging data show a causal link between alcohol and early-onset colorectal cancer. These findings underscore alcohol's role as both a hepatotoxin and a multisystem carcinogen, with harms manifesting at younger ages and lower levels of consumption than previously recognised. Despite clear evidence that no level of alcohol use is safe, misconceptions persist, fuelled by industry influence and inconsistent public health messaging. Evidence-based treatments exist but are underused: only 2.9% of Australians with AUD receive approved pharmacotherapy, and delays to treatment average 18 years. Population-level strategies such as taxation, pricing and marketing restrictions remain the most effective levers, but progress is weak, as illustrated by the repeal of minimum unit pricing in the Northern Territory. Clinicians play a central role in reframing hazardous drinking and AUD as the root cause of alcohol-related disease and in advocating for evidence-based, patient-centred care and policy. Addressing AUD directly offers the clearest path to reducing Australia's alcohol burden.

To examine associations between mental health, substance use, and PrEP persistence among South African adolescent girls and young women (AGYW). Longitudinal analysis of a decentralized PrEP implementation program. We analyzed data from FastPrEP, a youth-focused program delivering PrEP with peer-navigator support through community-based mobile clinics and public clinics near Cape Town. Female participants aged 15-29 years who received a one-month supply of daily oral PrEP at program enrollment were included. Moderate to severe depression/anxiety symptoms (PHQ-4 ≥6) and hazardous alcohol use (AUDIT-C ≥3) were assessed at enrollment. Log-binomial regression was used to estimate overall and age-stratified adjusted prevalence ratios (aPRs) for associations with PrEP persistence at the one-month follow-up visit. From April 2022 to April 2024, 6,271 AGYW were enrolled in FastPrEP and dispensed daily oral PrEP (median age 21 years); 75% enrolled at mobile clinics. At enrollment, 8% reported moderate to severe depression/anxiety symptoms and 50% hazardous drinking. Only 10% returned and received PrEP within a 28-day window of their one-month follow-up visit. Moderate-severe depression/anxiety symptoms were associated with greater PrEP persistence (aPR=1.37, 95% CI 1.04, 1.79), as was hazardous drinking (aPR=1.46, 95% CI 1.23, 1.75). Associations were strongest among AGYW aged 15-19 years (depression/anxiety: aPR=1.71, 95% CI 1.11, 2.65; hazardous drinking: aPR=1.60, 95% CI 1.16, 2.19). Contrary to expectations, mental health and substance use challenges were associated with greater short-term PrEP persistence, particularly among younger AGYW. These findings suggest that youth-centered, peer-supported delivery models may help sustain engagement among higher-risk AGYW.

Objective Black individuals in the United States have high rates of obesity and cigarette smoking, both of which increase health risks. One factor that has demonstrated significant relations to cigarette smoking outcomes is anxiety sensitivity. Yet, work examining these relations among Black individuals with obesity who smoke is nonexistent. Therefore, the present study examined the role of anxiety sensitivity in relation to several smoking outcomes among Black individuals with obesity who smoke. Methods Participants were 161 Black adults with obesity who endorsed daily combustible cigarette smoking (M age = 47.1 years, SD = 14.19, age range 19–73 years; 65.2% female). Results Results indicated that greater levels of anxiety sensitivity were statistically significantly and positively related to increased cigarette dependence, severity of problems when trying to quit, perceived barriers to smoking cessation, and smoking abstinence expectancies, including negative mood, somatic symptoms, and harmful consequences. Importantly, findings were observed above and beyond the variance accounted for by age, sex, education, income, perceived physical health, average number of cigarettes smoked per day, hazardous drinking, and cannabis use. Conclusions These findings suggest that Black individuals with obesity who smoke and exhibit higher levels of anxiety sensitivity may be at increased risk for processes known to sustain smoking behavior and impede quitting success.