Higher Levels Of Alcohol Consumption Research Articles

Alcohol use and cannabis craving in daily life: Sex differences and associations among young adults.

Alcohol and cannabis are commonly used together by young adults. With frequent pairings, use of one substance may become a conditioned cue for use of a second, commonly co-used substance. Although this has been examined for alcohol and cannabis in laboratory conditions and with remote monitoring, no research has examined whether pharmacologically induced cross-substance craving occurs in naturalistic conditions. In a sample of 63 frequent cannabis-using young adults (54% female) who completed 2 weeks of ecological momentary assessment, we tested whether alcohol use was associated with stronger in-the-moment cannabis craving. We also examined whether sex moderated this association and whether cannabis craving was stronger at higher levels of alcohol consumption. Although alcohol use and cannabis craving were not significantly associated at the momentary level, there was evidence that this relation significantly differed by sex. Among female participants, there was a negative association between alcohol use since the last prompt and momentary cannabis craving (b = -0.33, SE = 0.14, p = 0.02), while the association among male participants was positive (b = 0.32, SE = 0.13, p = 0.01). Similarly, alcohol quantity was negatively associated with cannabis craving at the momentary level for female participants (b = -0.10, SE = 0.04, p = 0.009) but was not significantly associated for male participants (b = 0.05, SE = 0.04, p = 0.18). Alcohol may enhance cannabis craving among male individuals but reduce desire for cannabis among female individuals. This may point to differing functions of co-use by sex, highlighting a need for research to elucidate the mechanisms underlying this increasingly common pattern of substance use.

Alcohol-related stigma within the UK veterinary profession.

Veterinarians have poorer mental health and have higher levels of alcohol consumption compared to the general population. This study aimed to explore perceptions and experiences of problem drinking within the veterinary profession in the UK. Online semi-structured interviews were completed with multidisciplined practising veterinarians in the UK. The data were analysed using reflexive thematic analysis. Seventeen veterinarians were recruited. The participants were predominantly female (n = 15, 88%).Seven participants (41%) reported personal experience of problem drinking. Four main themes were identified: a normalised culture of drinking, the impact of drinking on mental health and suicide risk, perceptions and attitudes towards problem drinking, and impacts of formal intervention. Drinking to cope was normalised and widespread among veterinarians. Problem drinking was reported to negatively impact mental health and provoke high self-stigma. Both alcohol-related stigma and fear of involvement from the Royal College of Veterinary Surgeons (RCVS) were barriers to help-seeking. No other veterinary professionals or participants with lived experience of RCVS investigation for problem drinking were included. Alcohol-related stigma and fear of RCVS involvement reduce veterinary help-seeking for problem drinking, which may have a negative effect on veterinarians' mental health.

Climate anxiety and its association with health behaviours and generalized anxiety: An intensive longitudinal study.

The United Nations recognize the importance of balancing the needs of people and the planetary systems on which human health relies. This paper investigates the role that climate change has on human health via its influence on climate anxiety. We conducted an intensive longitudinal study. Participants reported levels of climate anxiety, generalized anxiety and an array of health behaviours at 20 consecutive time points, 2 weeks apart. A network analysis shows climate anxiety and generalized anxiety not to covary, and higher levels of climate anxiety not to covary with health behaviours, except for higher levels of alcohol consumption at the within-participant level. Generalized anxiety showed completely distinct patterns of covariation with health behaviours compared with climate anxiety. Our findings imply that climate anxiety, as conceptualized and measured in the current study, is not in itself functionally impairing in terms of associations with unhealthy behaviours, and is distinct from generalized anxiety. The results also imply that interventions to induce anxiety about the climate might not always have significant impacts on health and well-being.

Trends of fully alcohol-attributable mortality rates before and during COVID-19 in the Baltic and other European countries.

We tested the polarization hypothesis, which postulates that during times of crises, such as the COVID-19 pandemic, alcohol consumption increases among the heaviest drinkers but decreases among most other drinkers, resulting in an overall decrease in consumption among the population. We posited the increase in heavy drinking would lead to increases in 100% alcohol-attributable (AA) mortality. Furthermore, based on the high level of alcohol consumption in the Baltic countries compared to other European countries, we predicted that the increases in AA mortality would be more pronounced in these countries. Data for 100% AA deaths were obtained from the World Health Organization for the period 2010 to 2022, and standardized to the regional age distribution for 2010. Parametric and non-parametric tests were used to test the study hypotheses. The mean age-standardized 100% AA mortality rate increased during the COVID-19 pandemic in the 19 European countries with data by 3.12 deaths per 100,000 population, constituting an 18% increase (tested against no change: t = 2.52; df = 18; p = 0.021). This increase was higher in the Baltic countries (mean difference = 13.41 deaths per 100,000 population; standard deviation (SD) = 7.44; 46% increase) than for other European countries (mean difference = 1.19; SD = 1.55; 8% increase). The increases in 100% AA mortality were associated with decreases in the level of alcohol consumption in the majority of countries. As predicted, 100% AA mortality increased in 19 European countries during the COVID-19 pandemic, with the Baltic countries seeing a higher increase. Renewed alcohol control policy efforts should be considered.

Vaping among adults in England who have never regularly smoked: a population-based study, 2016–24

E-cigarettes are increasingly used by smokers and ex-smokers, often to support smoking cessation, but also among those who have never regularly smoked. The aim of our study is to estimate time trends in vaping prevalence among adults who have never regularly smoked and describe the profile of adult never-regular-smokers who vape. In this nationally representative, monthly cross-sectional survey in England, 153 073 participants (aged ≥18 years) were recruited from July, 2016, to April, 2024. 94 107 (61·5%) of the 153 073 participants had never regularly smoked. Logistic regression estimated associations between survey wave and current vaping, overall, and by sociodemographic characteristics and alcohol consumption. Vaping prevalence among never-regular-smokers was relatively stable up to 2021, at an average of 0·5% (95% CI 0·5-0·6) between July, 2016, and December, 2020; it then increased rapidly, reaching 3·5% (2·8-4·4) in April, 2024. This increase was largely driven by young adults (19·0% [13·9-25·4] among individuals aged 18 years) and those with higher alcohol consumption levels (22·1% [11·7-37·8%] among the heaviest drinkers). By contrast, trends among all adults (including current and former smokers) suggested the rise in vaping prevalence plateaued among all ages by early 2023. In 2023-24, 55·6% (48·2-62·8) of never-regular-smokers who vaped reported vaping daily; 81·7% (75·4-86·7) had been vaping for 6 months or more. The most used devices in 2023-24 were disposables (50·2% [42·9-57·5]) and the most commonly used e-liquids contained 20 mg/mL or more nicotine (44·6% [37·4-52·0]). The number of adults in England who vape but have never regularly smoked rose rapidly between 2021 and 2024, particularly in younger age groups and most of these individuals reported vaping regularly over a sustained period. The public health impacts of this finding will depend on what these people would otherwise be doing: it is likely that some might have smoked if vaping were not an available option (exposing them to more harm), whereas others might not have smoked or vaped. Cancer Research UK.

Alcohol consumption in cancer patients receiving psycho-oncologic care analysis of socio-demographic, health-related and cancer-related factors.

The carcinogenic effects of alcoholic beverages and the negative impact of alcohol consumption on cancer progression and treatment outcomes are well established in oncology research. Many cancer patients experience significant psychological distress, often manifesting as elevated levels of depression and anxiety. In the general population, alcohol consumption is commonly used as a coping mechanism for such distress. For cancer patients facing substantial psychological challenges, psycho-oncology care is available to help manage their symptoms and the overall impact of their condition. However, there is limited understanding of the alcohol consumption patterns in this particularly vulnerable group of patients, as well as the disease-related factors that may influence their drinking behavior. This study aims to examine the prevalence of potentially risky alcohol consumption in cancer patients receiving psycho-oncology care and to identify sociodemographic, health-related, and psychosocial factors associated with alcohol consumption after cancer diagnosis. By understanding drinking patterns and the factors associated with them, we aim to promote healthier behaviors and enhance treatment outcomes for cancer patients receiving psycho-oncology care. A consecutive sample of 1.225 patients from the psycho-oncology outpatient clinic of the University Medical Center Hamburg Eppendorf (UKE) was analyzed with regard to their alcohol consumption behavior using the Alcohol Use Disorders Identification Test-Consumption Items (AUDIT-C). Self-report questionnaires were employed to assess sociodemographic, health-related, and cancer-specific information. For statistical analysis, multiple linear regression was utilized. In the sample of cancer patients receiving psycho-oncology support one in six of both female and male patients showed risky alcohol drinking behavior (e.g. AUDIT-C above three for women and four for men). In the analysis (R-Square: 0.056) male gender (regression coefficient B 0.686, 95% CI: 0.453-0.919) and patientsreporting a higher physical health-related quality of life (SF8-PCS) (B 0.021, 95% CI: 0.011-0.032) were associated with higher levels of alcohol consumption, whereas having children (B -0.481, 95%CI: -0.700- -0.262) was associated with lower alcohol consumption. With regard to cancer type, a single-factor analysis of variance with gender as the centered covariate showed that patients with gastrointestinal cancer had had lower average consumption levels compared to the groups of patients with breast cancer, melanoma, genitourinary cancer, and lymphoma. Also, patients with sarcoma had lower average consumption levels than patients with lymphoma. The results allow to identify patient characteristics and cancer types associated with higher or lower alcohol consumption levels and higher likelihood of risky consumption behavior in this sample of cancer patients receiving psycho-oncological support. Cancer patients are particularly susceptible to the hazardous effects of alcohol consumption. The results of this study help to identify cancer patients at risk of worsening prognosis due to alcohol consumption and to develop intervention programs to minimize alcohol consumption in this group.

An observational cohort study of alcohol use and cognitive difficulties among post-9/11 veterans with and without TBI and PTSD

BackgroundTraumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and alcohol use are highly prevalent among military Veterans and independently associated with cognitive difficulties; less is known about the combined effects. This study aimed to investigate the association between alcohol use patterns and cognitive diagnoses in Veterans with TBI and/or PTSD. MethodsUsing electronic health record data,193,663 Veterans were classified into three alcohol use trajectory groups (consistently low, initially high transitioning to low, initially moderate transitioning to high) based on self-reported Alcohol Use Disorders Identification Test-C (AUDIT-C) scores. Cox proportional hazards models were used to examine the association between alcohol use patterns, TBI, PTSD, and the risk of cognitive diagnosis, while adjusting for demographic factors and comorbidities. ResultsVeterans with initially high transitioning to low (HR = 1.21, 95 % CI: 1.11–1.31) and initially moderate transitioning to high (HR = 1.42, 95 % CI: 1.33–1.51) alcohol use patterns had a significantly greater risk of cognitive diagnosis compared to those with consistently low alcohol use when accounting for TBI, PTSD, and comorbidities. TBI (HR = 5.40, 95 % CI: 5.06–5.76) and PTSD (HR = 2.42, 95 % CI: 2.25–2.61) were also independently associated with an elevated risk of cognitive diagnosis. ConclusionsFindings suggest that Higher levels of alcohol consumption, even if decreasing over time, may confer an increased risk of cognitive diagnosis for Veterans with TBI and/or PTSD. Long-term alcohol use patterns should be considered in clinical assessments and interventions to identify individuals at greater risk for experiencing cognitive difficulties.

Biomarkers for Prediction of Alcohol-Related Liver Cirrhosis: A General Population–Based Swedish Study of 537,250 Individuals

The study sought to examine which biomarkers have the best predictive capabilities for future alcohol-related liver cirrhosis (ARLC) in a general population setting. This population-based cohort study includes approximately 35% of the inhabitants of Stockholm County who had left a blood sample at an outpatient visit in primary care or occupational health screening from 1985 to 1996. All subjects with a blood sample measurement of alanine aminotransferase and aspartate aminotransferase (AST) were included, exclusions were made for persons with known liver disease. We ascertained incident ARLC by linkage to Swedish national health registers between to the end of 2011. Associations between biomarkers and incident ARLC were analyzed with Cox regression models and discrimination was assessed using C-statistics. In all, 537,230 adult subjects were included. The mean age was 45 years and 53% were men. During a mean follow-up of 19.0 years, 2725 (0.51%) subjects developed ARLC. The biomarkers with the highest discrimination (C-index) for incident ARLC at 5 years were: AST (0.89), mean corpuscular volume (0.88), and γ-glutamyltransferase (0.81). Scoring systems including Fibrosis-4 (0.86) and the AST/alanine aminotransferase ratio (0.81) performed similarly well. The negative predictive value for ARLC was generally high (∼99.6%) across biomarkers, using routine clinical cutoffs to identify pathological values. However, positive predictive values were generally low (0.6%-15.9%). Biomarkers commonly used in primary care settings are highly associated with incident ARLC in the general population. Elevation of these commonly available biomarkers should prompt consideration of further investigation of a possible high level of alcohol consumption.

Availability of Alcohol on an Online Third-Party Delivery Platform Across London Boroughs, England: Exploratory Cross-Sectional Study.

Higher availability of alcohol is associated with higher levels of alcohol consumption and harm. Alcohol is increasingly accessible online, with rapid delivery often offered by a third-party driver. Remote delivery and online availability are important from a public health perspective, but to date, relatively little research has explored the availability of alcohol offered by online platforms. This cross-sectional exploratory study describes the availability of alcohol on the third-party platform Deliveroo within London, England. We extracted the number of outlets offering alcohol on Deliveroo for each London borough and converted these into crude rates per 1000 population (18-64 years). Outlets were grouped as outlets exclusively selling alcohol, off-licenses, and premium. We calculated Pearson correlation coefficients to explore the association between borough's crude rate of outlets per 1000 population and average Indices of Multiple Deprivation (IMD) 2019 scores. We extracted the number of outlets also selling tobacco or e-cigarettes and used non-Deliveroo drivers. We searched addresses of the top 20 outlets delivering to the most boroughs by outlet type (60 total) to determine their associated premise. We identified 4277 total Deliveroo-based outlets offering alcohol across London, including outlets delivering in multiple boroughs. The crude rate of outlets per 1000 population aged 18-64 years was 0.73 and ranged from 0.22 to 2.29 per borough. Most outlets exclusively sold alcohol (3086/4277, 72.2%), followed by off-licenses (770/4277, 18.0%) and premium (421/4277, 9.8%). The majority of outlets exclusively selling alcohol sold tobacco or e-cigarettes (2951/3086, 95.6%) as did off-licenses to a lesser extent (588/770, 76.4%). Most outlets exclusively offering alcohol used drivers not employed by Deliveroo (2887/3086, 93.6%), and the inverse was true for premium outlets (50/421, 11.9%) and off-licenses (73/770, 9.5%). There were 1049 unique outlets, of which 396 (37.8%) were exclusively offering alcohol-these outlets tended to deliver across multiple boroughs unlike off-licenses and premium outlets. Of outlets with confirmed addresses, self-storage units were listed as the associated premise for 85% (17/20) of outlets exclusively offering alcohol, 11% (2/19) of off-licenses, and 12% (2/17) of premium outlets. We found no significant relationship between borough IMD scores and crude rate of outlets per 1000 population overall (P=.87) or by any outlet type: exclusively alcohol (P=.41), off-license (P=.58), and premium (P=.18). London-based Deliveroo outlets offering alcohol are common and are sometimes operating from self-storage units that have policies prohibiting alcohol storage. This and the potential for increased alcohol accessibility online have implications for public health given the relationship between alcohol's availability and consumption or harm. There is a need to ensure that regulations for delivery are adequate for protecting children and vulnerable adults. The Licensing Act 2003 may require modernization in the digital age. Future research must explore a relationship between online alcohol availability and deprivation.

Standard rodent diets differentially impact alcohol consumption, preference, and gut microbiome diversity.

Alcohol use disorder (AUD) is a complex and widespread disease with limited pharmacotherapies. Preclinical animal models of AUD use a variety of voluntary alcohol consumption procedures to recapitulate different phases of AUD, including binge alcohol consumption and dependence. However, voluntary alcohol consumption in mice is widely variable, making it difficult to reproduce results across labs. Accumulating evidence indicates that different brands of commercially available rodent chow can profoundly influence alcohol intake. In this study, we investigated the effects of three commercially available and widely used rodent diet formulations on alcohol consumption and preference in C57BL/6 J mice using the 24 h intermittent access procedure. The three brands of chow tested were LabDiet 5,001 (LD5001), LabDiet 5,053 (LD5053), and Teklad 2019S (TL2019S) from two companies (Research Diets and Envigo, respectively). Mice fed LD5001 and LD5053 displayed higher levels of alcohol consumption and preference compared to mice fed TL2019S. We also found that alcohol consumption and preference could be rapidly switched by changing the diet 48 h prior to alcohol administration. Sucrose, saccharin, and quinine preferences were not altered, suggesting that the diets did not alter sweet and bitter taste perception. We also found that mice fed LD5001 displayed increased quinine-resistant alcohol intake compared to mice fed TL2019S, suggesting that diets could influence the development of compulsive behaviors such as alcohol consumption. We profiled the gut microbiome of water- and alcohol-drinking mice that were maintained on different diets and found significant differences in bacterial alpha- and beta-diversities, which could impact the gut-brain axis signaling and alcohol consumption.

Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic.

Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely to experience chronic pain than the general population. Conversely, individuals with chronic pain commonly alleviate their pain with alcohol, which may escalate into AUD. This narrative review discusses the intricate relationship between AUD and chronic pain. Based on the literature available, the authors present a theoretical model explaining the reciprocal relationship between AUD and chronic pain across alcohol intoxication and withdrawal. They propose that the use of alcohol for analgesia rapidly gives way to acute tolerance, triggering the need for higher levels of alcohol consumption. Attempts at abstinence lead to alcohol withdrawal syndrome and hyperalgesia, increasing the risk of relapse. Chronic neurobiological changes lead to preoccupation with pain and cravings for alcohol, further entrenching both conditions. To stimulate research in this area, the authors review methodologies to improve the assessment of pain in AUD studies, including self-report and psychophysical methods. Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously. Finally, the authors emphasize the need to manage both conditions concurrently, and encourage both the scientific community and clinicians to ensure that these intertwined conditions are not overlooked given their clinical significance.

Screening student drinking behaviors: examining AUDIT criterion validity using CIDI-based alcohol use disorder as the 'gold standard'.

High levels of alcohol consumption among college students have been observed across countries. Heavy drinking episodes are particularly prevalent in this population, making early identification of potentially harmful drinking critical from a public health perspective. Short screening instruments such as the Alcohol Use Disorders Identification Test (AUDIT) are serviceable in this regard. However, there is a need for studies investigating the criterion validity of AUDIT in the student population. The aim was to examine the criterion validity of the full AUDIT and AUDIT-C (the first three items directly gauging consumption patterns) in a sample of college and university students using 12-month prevalence of alcohol use disorder derived from an electronic, self-administered version of the World Health Organization (WHO) Composite International Diagnostic Interview, fifth version (CIDI 5.0), which serves as the 'gold standard'. The study population of the current study is derived from the SHoT study (Students' Health and Wellbeing Study), which is a large national survey of students enrolled in higher education in Norway. In a follow-up study of mental disorders among participants of the SHoT2022 study, students were invited to complete a self-administered electronic version of the CIDI. A random sample of 4,642 participants in the nested CIDI-sample was asked to fill out a set of screening instruments, including AUDIT, before starting CIDI. Based on Youden Index maximization, we estimated the sex-specific optimal cut-offs for AUDIT and AUDIT-C in relation to alcohol use disorder, as determined by CIDI. For the full AUDIT, the optimal cut-offs were 9 for males and 10 for females. The corresponding cut-offs for AUDIT-C were 6 for males and 5 for females. The same optimal cut-offs for both the full AUDIT and AUDIT-C were replicated in bootstrapped analyses with 1,000 runs. The full AUDIT demonstrated acceptable criterion validity with a balance between sensitivity and specificity. However, for AUDIT-C, caution should be exercised when interpreting screening results among college and university students. In conclusion, the full AUDIT is a reliable screening instrument for college and university students, while further modification may be needed for AUDIT-C in this setting.

The association between alcohol consumption and all-cause mortality: An umbrella review of systematic reviews using lifetime abstainers or low-volume drinkers as a reference group.

Systematic reviews of the relationship between alcohol consumption and all-cause mortality have reported different relative risk (RR) curves, possibly due to the choice of reference group. Results have varied from 'J-shaped' curves, where low-volume consumption is associated with reduced risk, to monotonically increased risk with increasing consumption. We summarised the evidence on alcohol consumption and all-cause mortality exclusively from systematic reviews using lifetime abstainers or low-volume/occasional drinkers as the reference group. We conducted a systematic umbrella review of systematic reviews of the relationship between alcohol consumption and all-cause mortality in prospective cohort studies using a reference group of lifetime abstainers or low-volume/occasional drinkers. Several databases (PubMed/Medline/Embase/PsycINFO/Cochrane Library) were searched to March 2022. Reviews were assessed for risk of bias, and those with reference groups containing former drinkers were excluded. From 2149 articles retrieved, 25 systematic reviews were identified, and five did not include former drinkers in the reference group. Four of the five included reviews had high risk of bias. Three reviews reported a J-shaped relationship between alcohol consumption and all-cause mortality with significant decreased risk for low-volume drinking (RR range 0.84 to 0.95), while two reviews did not. The one review at low risk of bias reported monotonically increased risk with greater consumption (RRs = 1.02, 1.13, 1.33 and 1.52 for low-, medium-, high- and higher-volume drinking, respectively, compared with occasional drinking). All five reviews reported significantly increased risk with higher levels of alcohol consumption (RR range 1.28 to 3.70). Sub-group analyses were reported by sex and age; however, there were evidence gaps for many important factors. Conversely, 17 of 20 excluded systematic reviews reported decreased mortality risk for low-volume drinking. Over 70% of systematic reviews and meta-analyses published to March 2022 of all-cause mortality risk associated with alcohol consumption did not exclude former drinkers from the reference group and may therefore be biased by the 'sick-quitter effect'.

Perceived Neighbourhood Disorder, Alcohol Consumption and Alcohol-Related Problems in Chile.

Background: Alcohol misuse is one of the most important preventable public health risk factors. Empirical research shows that alcohol misuse is related to social and economic losses. Both theoretical and empirical evidence suggests that neighborhood disorder impacts alcohol-related behavior. However, there is limited literature in the context of developing countries. Objectives: The aim of this research is to estimate the association between perceived neighborhood disorder and (1) alcohol-related behavior and (2) alcohol-related problems in the context of the Chilean population. Our contribution focuses on the examination of the perception of disorder in urban neighborhoods and alcohol use patterns in a wide age range and sample of Chilean cities. Results: High levels of neighbor disorder perception are associated with higher levels of drinking and hazardous alcohol use. In addition, perceived neighborhood disorder is directly associated with probability of alcohol-related problems (ranging from 2% to 11%). Conclusions/Importance: The results are consistent with empirical and theoretical frameworks. This research could be used to better guide place-based policies in emerging countries with high levels of alcohol consumption to prevent alcohol risk behaviors and alcohol-related problems.

The burden of liver disease in Latin America

Liver disease poses a substantial burden in Latin America. This burden is primarily attributed to a high level of alcohol consumption and the increasing prevalence of risk factors associated with metabolic dysfunction-associated steatotic liver disease (MASLD), such as sedentary lifestyles, easy access to ultra-processed foods, obesity, and type 2 diabetes mellitus. These epidemiological trends are cause for concern, especially considering that there are significant challenges in addressing them due to disparities in access to liver disease screening and care. In this article, we aim to provide an overview of the current situation regarding liver disease in Latin America. We also discuss recent multinational proposals designed to address the growing MASLD burden via its integration into existing non-communicable diseases policies, at both local and global levels. Additionally, we emphasize the urgent need to establish effective public health policies that target both MASLD risk factors and excessive alcohol consumption. Furthermore, we discuss the development of liver transplantation programs, areas for improvement in medical education and research capabilities, and how the fostering of extensive collaboration among all stakeholders is crucial for addressing liver disease in the region.

Hepatitis C virus prevalence among men who have sex with men: a cross-sectional study in 12 Brazilian cities

BackgroundDespite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities.MethodsThis study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation.ResultsA total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%—1.7%). The Southeast region showed a prevalence of 0.9% (95% CI: 0.3—2.6), followed by the South region, with 0.6% (95% CI: 0.2—2.1). The Northeast region had a prevalence of 0.3% (95% CI: 0.1—1.0) and the Midwest 0.1% (95% CI: 0.0—0.7). No positive cases were found in the North. Single men aged 40 years or older were the majority of participants exposed to HCV. High levels of alcohol consumption, illicit drug use, irregular condom use, in addition to infection with other STIs, were associated with exposure to HCV.ConclusionsSTIs continue to be important health problems in Brazil and globally. Many STIs are inapparent for many years until they bring more serious consequences. Extra investment in HCV is also warranted, given that it can be eliminated. Relying solely on clinical data to provide information about inapparent infection, especially in stigmatized populations, will make that goal more difficult to achieve. Surveillance studies, such as the one reported here need to be repeated over time to demonstrate trends and to provide information for evaluation, program and policies. Investments in the most vulnerable populations are critical to achieve the World Health Organization global health goals including the elimination of viral hepatitis by 2030.

Demographic predictors of experiences of homelessness among lesbian, gay, bisexual, trans, gender-diverse and queer-identifying (LGBTIQ) young people in Australia

ABSTRACT Homelessness among young lesbian, gay, bisexual, trans, gender-diverse and queer-identifying (LGBTQ+) persons is highly prevalent and constitutes a structural risk to health and future life chances. However, the distribution of homelessness burden is among different LGBTQ+ subgroups is poorly understood. An Australia-wide cross-sectional online survey was conducted involving 6,481 LGBTQ+ participants aged 14–21 years during 2019. Single-predictor logistic regression analyses identified factors associated with both lifetime and recent experiences of homelessness. Analyses also explored associations between recent (<12 months) experiences of homelessness, experiences of harassment, alcohol consumption, and psychological distress. Higher odds of experiencing homelessness were observed for trans and gender-diverse young people, individuals who identified with sexual identity labels other than lesbian, gay or bisexual, racially-minoritized persons, disabled persons and individuals from a religious family or household, compared to their respective counterparts. Experiencing homelessness was associated with higher levels of alcohol consumption and higher prevalence of experiencing verbal, physical and sexual harassment, but only modestly associated with higher levels of psychological distress. Homelessness risk and burden is unevenly distributed among LGBTQ+ youth and is linked to outcomes which may potentiate future homelessness. Interventions addressing homelessness among this group must be optimized for those subgroups most vulnerable to experiencing homelessness.

Acceptability and anklet user experience with the SCRAM-CAM transdermal alcohol concentration sensor in regularly drinking young adults' natural environments.

Recent developments in wearable technologies have allowed for device-based capture of alcohol concentration among participants in their natural environments. Currently, the Continuous Alcohol Monitor from SCRAM systems (SCRAM-CAM) is the most extensively studied and validated transdermal alcohol concentration (TAC) sensor. However, there has been relatively little work focusing on its acceptability from the participants' perspective. In the current study, we assess the user experience of the SCRAM-CAM anklet in a sample of 222 regularly heavy drinking young adults (mean age=22.3) who wore the anklet in their natural environments for five 24-h periods spanning 6 consecutive days. Differences in the anklet user experience were measured along a number of dimensions, and differences were tested by sex at birth, white/non-white racial/ethnic group membership, and alcohol use disorder (AUD) risk (measured through Alcohol Use Disorder Identification Test [AUDIT] scores). Males and females differed significantly on six of the eight acceptability items, with males showing more positive responses toward the anklet than females. No differences were found by white/non-white racial/ethnic groups nor AUD risk. Results suggest positive levels of acceptability toward the device overall while in natural environments, further validating the usage of the device in studies that measure alcohol consumption among different groups, including those with high levels of alcohol consumption. Researchers should take into consideration the different levels of burden or discomfort in male versus female participants when using the device.

The Relationship between Drunkorexia, Alcohol, and Blackouts Among College Students: An Exploratory Study.

College drinkers commonly report blacking out (i.e., alcohol-induced amnesia), and those who drink with the intention to blackout are at risk for harmful consequences. Drunkorexia (i.e., restriction of calories on planned drinking days) is a high-risk behavior potentially associated with blacking out. Informed by the Theory of Planned Behavior (TPB), this study explores blackout experiences and intentions to blackout association with drunkorexia. College students (n=2335) who primarily identified as female and White participated via an online survey. Participants received a $3 coupon for completion of the study. Consistent with the literature, 40% and 60.7% participants reported experiencing blackouts and drunkorexia respectively in the last year. Informed by the TPB, a structural equation model assessed if more frequency blackout experiences (IV) related to drunkorexia behaviors (DV1) and alcohol behaviors (DV2), and if there was a significant indirect effect through blackout intention. The model fit the data well (CFI=.98, TLI=.95) and suggests that more frequent blackout experiences relate to more drunkorexia experiences (R2=.04) and higher levels of alcohol consumption (R2=.44). In addition, the relationship between blackout experiences and drunkorexia flows through intentions to blackout (i.e., a significant indirect effect). Findings are consistent with TPB, which suggests intentions predict health behavior. Future interventions should consider modifying intentions and other possible TPB constructs to minimize high risk alcohol consumption and drunkorexia behaviors.

Relaxing parametric assumptions for non-linear Mendelian randomization using a doubly-ranked stratification method.

Non-linear Mendelian randomization is an extension to standard Mendelian randomization to explore the shape of the causal relationship between an exposure and outcome using an instrumental variable. A stratification approach to non-linear Mendelian randomization divides the population into strata and calculates separate instrumental variable estimates in each stratum. However, the standard implementation of stratification, referred to as the residual method, relies on strong parametric assumptions of linearity and homogeneity between the instrument and the exposure to form the strata. If these stratification assumptions are violated, the instrumental variable assumptions may be violated in the strata even if they are satisfied in the population, resulting in misleading estimates. We propose a new stratification method, referred to as the doubly-ranked method, that does not require strict parametric assumptions to create strata with different average levels of the exposure such that the instrumental variable assumptions are satisfied within the strata. Our simulation study indicates that the doubly-ranked method can obtain unbiased stratum-specific estimates and appropriate coverage rates even when the effect of the instrument on the exposure is non-linear or heterogeneous. Moreover, it can also provide unbiased estimates when the exposure is coarsened (that is, rounded, binned into categories, or truncated), a scenario that is common in applied practice and leads to substantial bias in the residual method. We applied the proposed doubly-ranked method to investigate the effect of alcohol intake on systolic blood pressure, and found evidence of a positive effect of alcohol intake, particularly at higher levels of alcohol consumption.