Neighborhood-Level Drinking Norms and Alcohol Intervention Outcomes in HIV Patients Who Are Heavy Drinkers
Neighborhood-Level Drinking Norms and Alcohol Intervention Outcomes in HIV Patients Who Are Heavy Drinkers
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DOI：
10.1111/acer.13198
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发表时间：
2016-10-01
影响因子：
3.2
通讯作者：
Hasin, Deborah S.
中科院分区：
文献类型：
--
作者：
Elliott, Jennifer C.;Delker, Erin;Hasin, Deborah S.
背景大量饮酒可能是有害的，特别是对艾滋病病毒携带者。对旨在减少饮酒的干预措施的反应有很大的变异性。邻里之间的饮酒规范可能解释了艾滋病毒感染患者中这种差异的部分原因。因此，我们调查了社区水平的饮酒规范是否改变了HIV感染的酗酒者对酒精干预的反应。方法230名大量饮酒的HIV综合护理患者完成了3个简短酒精干预中的1个(教育干预、动机访谈[MI]干预，或具有技术增强功能的MI干预，称为HealthCall)。在基线和治疗结束时(60天)报告饮酒情况。社区水平的饮酒规范来自一项单独的普通人群研究。结果在饮酒规范更宽松的社区，患者因MI而每天饮酒的减少(与教育对照相比)更为明显。相比之下，患者每天因MI加HealthCall而减少的饮酒量在不同饮酒规范的社区之间没有显著差异。在其他3个探索性饮酒结果(饮酒频率、酗酒频率和最大饮酒量)上，常模与干预条件没有显著的交互作用。结论邻区水平的饮酒常模有助于解释HIV感染患者对酒精MI干预的不同反应。这项研究表明，将邻里环境作为酒精干预的效果修饰物是有用的。
BackgroundHeavy alcohol consumption can be harmful, particularly for individuals with HIV. There is substantial variability in response to interventions that aim to reduce drinking. Neighborhood drinking norms may explain some of this variability among HIV-infected patients. Therefore, we investigated whether neighborhood-level drinking norms modified response to alcohol intervention among HIV-infected heavy drinkers.MethodsHeavily-drinking HIV comprehensive care patients (n=230) completed 1 of 3 brief alcohol interventions (an educational intervention, a motivational interviewing [MI] intervention, or an MI intervention with a technological enhancement called HealthCall). Drinking was reported at baseline and end of treatment (60days). Neighborhood-level drinking norms were obtained from a separate general population study.ResultsPatients' reductions in drinks per drinking day in response to MI (as compared with the educational control) were more pronounced in neighborhoods with more permissive drinking norms. In contrast, patients' reductions in drinks per drinking day in response to MI plus HealthCall did not significantly vary between neighborhoods with different drinking norms. Norms did not evidence significant interactions with intervention condition for 3 other exploratory drinking outcomes (drinking frequency, binge frequency, and maximum quantity).ConclusionsNeighborhood-level drinking norms help explain differential response to an alcohol MI intervention among HIV-infected patients. This study suggests the utility of considering neighborhood context as an effect modifier of alcohol interventions.