Subtypes of Alcohol Dependence and Their Effect on Sexual Behavior Change

Abstract

This study utilized data from a National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism funded community-based HIV prevention program in the Midwest in 2000. We categorized women who met lifetime criteria for alcohol dependence (using the DIS) and who also had used cocaine (n = 324) into four alcohol typologies based on onset of regular drinking and the length of time to dependence. The Risk Behavior Assessment measured sex behaviors, combined into a risk index, before and after the program. Generalized linear modeling compared decreases over time. Women who began drinking regularly later and became dependent more slowly significantly decreased risky sex behaviors. Tailored prevention protocols may more effectively decrease HIV risk.

RÉSUMÉ

Sous-types de dépendance à l'alcool et leur effet sur l’évolution du comportement sexuel

Parmi la communauté recruté des femmes à risque pour le VIH

Les données de l’étude utilisé de NIDA et NIAAA communautaires HIV prevention programme financé par dans le Midwest en 2000. Nous avons classé les femmes qui répond aux critères de la durée de vie pour la dépendance à l'alcool (en utilisant le DIS) qui avaient également consommé de la cocaïne (n = 324) dans 4 typologies d'alcool basés sur l'apparition de la consommation régulière d'alcool et de temps à la dépendance. L’évaluation du comportement risque mesurée des comportements sexuels, combinés dans un indice de risque, avant et après le programme. Modélisation linéaire généralisée comparée diminue au fil du temps. Les femmes qui commence à boire régulièrement plus tard et devint dépendante plus lentement significativement diminuent des comportements sexuels risqués. Protocoles de prévention adaptée peuvent diminuer plus efficacement les risque de VIH.

Mots clés : typologies, dépendance à l'alcool, les femmes, de prévention du VIH, toxicomanie, sexuels risqués, abus de drogues.

RESUMEN

Subtipos de dependencia del alcohol y sus efectos sobre el cambio de comportamiento sexual

entre la comunidad reclutó a mujeres en situación de riesgo para el VIH

El estudio utilizó los datos de un NIDA y financiado por NIAAA comunitarios VIH Programa de prevención en el medio oeste en 2000. Hemos clasificado las mujeres que cumplieron con los criterios de vida para la dependencia de alcohol (usando el DIS) que también habían consumido cocaína (n = 324) en 4 tipologías de alcohol basados en comienzo de consumo regular y tiempo a la dependencia. La evaluación del comportamiento de riesgo medido comportamientos sexuales, combinadas en un índice de riesgo, antes y después del programa. Modelo lineal generalizado en comparación disminuye con el tiempo. Mujeres que comenzaron a beber regularmente más tarde y se volvió dependiente significativamente más lenta disminución de comportamientos sexuales arriesgados. Protocolos de prevención a la medida más eficaz pueden disminuir el riesgo del VIH.

Palabras clave: tipologías, dependencia del alcohol, las mujeres, la prevención del VIH, abuso de sustancias, relaciones sexuales de riesgo, uso indebido de drogas.

Keywords :

• typologies
• alcohol dependence
• women
• HIV prevention
• substance abuse
• risky sex
• drug abuse

THE AUTHORS

Victoria Osborne is an assistant professor with a joint appointment in the School of Social Work and the Program in Public Health at the University of Missouri. She teaches courses in health behavior theory, personality theory, addictions, and research methods in the undergraduate and graduate programs. Her research area encompasses alcohol misuse prevention and improved healthcare quality for women. Her methodological interests focus on mixed methodology, utilizing quantitative, and qualitative designs. Her main focus of research is screening, brief intervention, referral, and treatment (SBIRT) in primary care settings. She is currently a coinvestigator on a grant that trains medical, nursing, and social work students on the SBIRT techniques. She also received a grant to examine the impact of the doctor–patient relationship on female patients’ barriers to being screened for alcohol misuse in primary care. Additionally, her alcohol misuse prevention research focus includes work with college students, specifically examining the relationship between disordered eating patterns and binge drinking (“drunkarexia”). Her overall research goal focuses on linking research and practice in order to change healthcare policy in the area of substance abuse prevention.

Linda Bauer Cottler, Ph.D., M.P.H., is Dean's Professor and Founding Chair of the Department of Epidemiology at the College of Public Health and Health Professions and the College of Medicine at the University of Florida, Gainesville. Prior to this, Cottler was at Washington University for nearly 31 years in the Department of Psychiatry. First, Dr. Cottler's NIH (National Institutes of Health) funding has been in several major areas including the development of culturally reliable and valid measures for identifying substance use, abuse, and dependence; psychiatric disorders; and their risk factors. Second, Dr. Cottler's work has focused on community-based peer-delivered interventions to change HIV risk behaviors and substance abuser. She and her team have worked with underrepresented populations including out of treatment crack cocaine and heroin users, seriously heavy drinkers, injection drug users, prescription drug misusers, sex traders, teens, inmate populations, and former National Football League players and professionals who are undergoing monitoring for addiction. Cottler has expanded her community focus to the Clinical and Translational Science Award (CTSA) Community Engagement Program—first at Washington University as Director and now at the University of Florida Clinical and Translational Science Institute as Codirector. Pertinent to this meeting is her HealthStreet Project, a hub for community outreach to link the community residents to social and medical referrals, health messages, and research opportunities. The HealthStreet model has leveraged funding from the Sentinel Network of National Center for Research Resources (NCRR), from NIDA, and from a GO! Grant from National Heart, Lung, and Blood Institute (NHLBI). It is this that is the focus of the Think Tank activity. The work extends internationally with WHO and studies in Sydney, Taipei, Bangalore, and Afghanistan. Her research has been funded since 1989 by NIDA, NIAAA, NCRR, NINR (National Institute of Nursing Research), NIMH (National Institute of Mental Health), NHLBI, Pinney Associates, and ESPN (Entertainment and Sports Programming Network). She is Principal Investigator of a Fogarty International Center Training Program partnering with the National Institute of Mental Health and Neurosciences in Bangalore, India.Dr. Cottler has received the Washington University Academic Women's Network Mentor Award, the Boston University School of Public Health Distinguished Alumni Award, and the Outstanding Faculty Mentor Award from the Post-doc Society at Washington University School of Medicine. She has accepted community-focused awards from the Missouri Public Health Association and the School of Medicine. She received the 2010 Marian Fischman Award from College of Problems of Drug Dependence, awarded to a woman in addiction science. Dr. Cottler has served on two National Academy of Sciences panels to study the social and economic impact of pathological gambling and the data on firearm injuries. She has reviewed for numerous journals and NIH institutes, was a 2006–2007 Executive Leadership in Academic Medicine (ELAM) fellow, and the American Psychopathological Association's Centennial 2010 President.