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Neighborhood Alcohol Environment: Differential Effects on Hazardous Drinking and Mental Health by Sex in Persons Living with HIV (PLWH)

AIDS and Behavior volume 23, pages 3237–3246 (2019)Cite this article

Abstract

Despite greater mental health co-morbidities and heavier alcohol use among PLWH, few studies have examined the role of the neighborhood alcohol environment on either alcohol consumption or mental health. Utilizing cross-sectional data from a cohort study in a southern U.S. metropolitan area, we examine the association between neighborhood alcohol environments on hazardous drinking and mental health among 358 in-care PLWH (84% African American, 31% female). Multilevel models were utilized to quantify associations between neighborhood alcohol exposure on hazardous drinking and effect modification by sex. Neighborhood alcohol density was associated with hazardous drinking among men but not women. Women living in alcohol dense neighborhoods were nearly two-fold likely to report depression compared to those in less dense neighborhoods, with no association between neighborhood alcohol density and depression among men. Neighborhood alcohol environments may be an important contextual factor to consider in reducing heavy alcohol consumption and improving mental health among PLWH.

Resumen

Aunque el uso de alcohol y los trastornos mentales son muy comunes en las personas que viven con VIH, muy pocos estudios han investigado el contexto social, específicamente las características del expendio de alcohol, en relación con su consumo y la salud mental de la población. Utilizando datos transversales de un estudio de cohorte de personas viviendo con VIH en un área metropolitana del Sur de Los Estados Unidos, nosotros examinamos la asociación entre las características del expendio de alcohol al nivel vecinal y el consumo de alcohol y la salud mental en 358 personas que viven con VIH (84% afroamericanos, 31% mujeres). Utilizamos modelos jerárquicos para examinar y cuantificar asociaciones entre el expendio de alcohol al nivel vecinal y el alto consumo de alcohol y un posible efecto de modificación por sexo. Encontramos que la densidad de establecimientos que expenden alcohol en el vecindario se asocia con un alto consumo de alcohol en los hombres, pero no así en las mujeres. Mujeres que viven en vecindarios caracterizados por una alta densidad de expendio de alcohol son dos veces más propensas a reportar depresión que aquellas que no viven en vecindarios con densidad alta. No hubo una asociación entre la densidad de expendio de alcohol a nivel vecinal y depresión en los hombres. Las características del expendio de alcohol en un vecindario puede ser un factor importante para reducir el alto consumo de alcohol y mejorar la salud mental en las personas que viven con VIH.

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Acknowledgements

We thank the research subjects for their willingness to participate. We acknowledge the hard work and time devoted by study staff, and referring clinicians. They are key to the success of the study. The authors recognize the contributions of study personnel Mary Meyaski-Schluter, RN, and Virginia Garrison, RN. The study was supported by grants from the National Institutes of Health (NIH, P60AA009803). This study was approved by the Tulane University and Louisiana State University Health Sciences Center Institutional Review Boards. The data were collected in compliance with ethical standards regarding treatment of human participants. All authors have contributed significantly to the manuscript, approved the submission of this version, and consent to having their names on the manuscript. No form of payment was given to anyone to produce the manuscript.

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Affiliations

  1. Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    K. P. Theall, M. Wallace, E. Felker-Kantor & A. S. Madkour

  2. Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA

    K. P. Theall, M. Wallace, M. Brashear, T. Ferguson, D. Welsh & P. Molina

  3. Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA

    T. Ferguson

  4. Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA

    K. P. Theall

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  1. K. P. Theall
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  2. M. Wallace
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  3. E. Felker-Kantor
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  4. A. S. Madkour
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Correspondence to K. P. Theall.

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Theall, K.P., Wallace, M., Felker-Kantor, E. et al. Neighborhood Alcohol Environment: Differential Effects on Hazardous Drinking and Mental Health by Sex in Persons Living with HIV (PLWH). AIDS Behav 23, 3237–3246 (2019). https://doi.org/10.1007/s10461-019-02632-3

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Keywords

  • Neighborhoods
  • HIV
  • Alcohol
  • Sex
  • Mental health