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加拿大 HIV 女性性与生殖健康队列研究:基于潜类别分析的加拿大 HIV 女性饮酒影响因素研究

A Latent Class Analysis of the Social Determinants of Health Impacting Heavy Alcohol Consumption Among Women Living with HIV in Canada: The Canadian HIV Women's Sexual and Reproductive Health Cohort Study.

机构信息

Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.

Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.

出版信息

AIDS Behav. 2019 Dec;23(12):3226-3236. doi: 10.1007/s10461-019-02454-3.

Abstract

We used longitudinal data from the 2013-2017 Canadian HIV Women's Sexual and Reproductive Health Cohort Study (N = 1422) to assess the clustered impact of social determinants of health (SDoH) on hazardous drinking. Two measures of alcohol use were defined: (i) weekly alcohol use, with > 7 drinks/week as heavy drinking, and (ii) monthly binge drinking (≥ 6 drinks at one sitting), with ≥ 1/month as frequent binging. Twelve SDoH indicators were classified using latent class analysis: no/least adversities, discrimination/stigma, economic hardship, and most SDoH adversities. Inverse-probability weighted multinomial logistic regression was used to report relative-risk ratio (RRR). Women living with HIV (WLWH) in no/least adversity class had a substantially lower likelihood of both heavy weekly alcohol use and frequent binging than those in discrimination/stigma, economic hardship, and most SDoH adversities classes, with RRR estimates ranging from 0.02 to 0.18. Findings indicate the need to address SDoH to reduce hazardous drinking among WLWH.

摘要

我们利用 2013-2017 年加拿大艾滋病毒女性性健康和生殖健康队列研究(N=1422)的纵向数据,评估健康社会决定因素(SDoH)对危险饮酒的聚集影响。定义了两种酒精使用措施:(i)每周饮酒,每周饮酒>7 杯为重度饮酒,(ii)每月 binge 饮酒(一次饮酒≥6 杯),每月饮酒≥1 次为频繁 binge 饮酒。使用潜在类别分析对 12 项 SDoH 指标进行分类:无/最少逆境、歧视/污名、经济困难和最多 SDoH 逆境。使用逆概率加权多项逻辑回归报告相对风险比(RRR)。无/最少逆境类别的 HIV 阳性女性(WLWH)每周大量饮酒和每月频繁 binge 饮酒的可能性明显低于歧视/污名、经济困难和最多 SDoH 逆境类别的女性,RRR 估计值范围为 0.02 至 0.18。研究结果表明,需要解决 SDoH 问题,以减少 WLWH 中的危险饮酒。

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