Women Bar Drinkers: Exploring Risks for HIV

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DESCRIPTION (provided by applicant): This application responds to NIAAA's RFA AA-03-004, Research on Alcohol-related HIV/AIDS in Women. The proportion of AIDS cases occurring among women in the U.S. increased three-fold from 1985 to 1998 (CDC, 2002). If women contract HIV, their diagnosis is most likely to occur between the ages of 30 and 40 years (CDC, 2001a). Given that the incubation period for AIDS is estimated at 10-11 years, exposure to HIV is likely to occur between the ages of 18 and 30 years. The proposed research seeks to expand our knowledge of risks for HIV transmission among women by assessing the relationships among alcohol use and behavior in a sample of 300 young (18-30 years) women bar drinkers. Women report socializing in bars as a vehicle for finding companionship (e.g., Parks et al., 1998). For women bar drinkers, the combined influences of heavy alcohol use and expectations within the bar context may pose a substantial risk for HIV transmission through high-risk encounters that are either consensual (i.e., risky behavior) or nonconsensual (i.e., victimization). These relationships have received limited research attention. We propose a conceptual model of relationships among distal (e.g., history of victimization) and proximal (e.g., current alcohol use) factors as antecedents to consensual and nonconsensual high-risk encounters related to the bar context. The objectives of the proposed research are to: 1) explore the relationships outlined in the conceptual model, 2) assess the temporal association between alcohol use in bars and high-risk encounters, and 3) compare proximal factors for high-risk encounters on days of alcohol use in bars, days of alcohol use not in bars, and days of no alcohol use. This research uses an innovative design that incorporates an initial global assessment of the antecedent risk factors, followed by 12 weeks of prospective data collection. Daily reports (Interactive Voice Response) and event-based interviews will be used to assess alcohol use and risky behavior. Hypotheses will be tested using structural equation and hierarchical data modeling techniques. This research fills a significant gap in knowledge about bars as a context for increasing the likelihood that women will experience encounters that put them at elevated risk for HIV. It also has the potential to provide information that can be used to develop effective prevention programs to reduce women's risk for HIV.