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