Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
Alpert Medical School of Brown University, Providence, RI, USA.
Am J Community Psychol. 2018 Jun;61(3-4):276-284. doi: 10.1002/ajcp.12227. Epub 2018 Feb 5.
Youth living with HIV (YLH) experience multiple disease-related stresses along with the same structural and developmental challenges faced by their uninfected peers; alcohol use among YLH represents a risk behavior by virtue of potential effects on youth health and increased likelihood of engaging in unprotected sex while drinking alcohol. Research aimed at better understanding the interplay of individual- and neighborhood-level influences on alcohol use for YLH is needed to inform interventions. This study examined whether socioeconomic disadvantage (SED) and social support influence, independently and through interaction, alcohol use in YLH. Data from the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) consisted of YLH across 538 neighborhoods in the United States who acquired HIV behaviorally. Neighborhood-specific data were compiled from the 2010 U.S. Census Bureau and matched with individual-level data from the ATN (N = 1,357) to examine effects that contribute to variation in frequency of alcohol use. Other drug use, being male, being non-Black, and older age were associated with greater alcohol use. Higher social support was negatively associated with alcohol use frequency. A cross-level interaction indicated that the association found between decreasing social support and increasing alcohol use frequency was weakened in areas with lower SED. Implications are discussed.
青少年感染艾滋病毒者（YLH）除了要面对与未感染同龄人相同的结构性和发展性挑战外，还会经历多种与疾病相关的压力；YLH 中的饮酒行为是一种风险行为，因为它可能对青年健康产生影响，并增加饮酒时发生无保护性行为的可能性。为了为干预措施提供信息，需要研究更好地了解个体和社区层面的影响因素对 YLH 饮酒行为的相互作用。本研究考察了社会经济劣势（SED）和社会支持是否会独立地以及通过相互作用影响 YLH 的饮酒行为。来自艾滋病干预青少年医学试验网络（ATN）的数据包括在美国 538 个社区中通过性行为感染艾滋病毒的 YLH。从 2010 年美国人口普查局汇编了特定于社区的数据，并与 ATN 的个人数据进行了匹配（N=1357），以检查导致饮酒频率变化的影响因素。其他药物使用、男性、非黑人以及年龄较大与饮酒量增加有关。较高的社会支持与饮酒频率呈负相关。跨层次的相互作用表明，在社会经济地位较低的地区，社会支持减少与饮酒频率增加之间的关联减弱了。讨论了其影响。
