Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA.
Unconditional Love Incorporated, Melbourne, FL, USA.
Addict Sci Clin Pract. 2024 Oct 4;19(1):71. doi: 10.1186/s13722-024-00491-5.
A minority of people who need alcohol treatment receive it. Unhealthy alcohol use is common among people with HIV (PWH) and can lead to negative health outcomes. The aims of this multi-methods study are to (1) quantitatively describe the prevalence, psychosocial characteristics, and demographic traits of a sample of PWH currently receiving HIV care in Florida who had a self-reported need for alcohol treatment but did not seek care and (2) qualitatively explore reasons why PWH did not seek treatment.
PWH enrolled in the Florida Cohort Study between October 2020 and February 2023 who had drinking history (N = 487) completed a cross-sectional survey that asked if there was a time when they recognized they needed help for their drinking but did not seek it. If yes, they were asked an open-ended follow-up question about reasons why they did not seek care. Demographic and behavioral differences between those who did and did not endorse a time when they needed alcohol treatment were determined using multivariable logistic regression, while qualitative data were analyzed with thematic analysis based in the Social-Ecological Model to assess reasons for not seeking care at the individual, social, and systems levels.
A quarter of PWH (n = 129) with lifetime drinking indicated a time they needed care but did not seek it. Patients who endorsed a time where they perceived the need for treatment but did not seek it were more likely to endorse current at-risk drinking and a history of ever trying to reduce their drinking or formally seek professional alcohol treatment. The most common reasons participants did not seek care were individual level factors and included shame, denial, fear, wanting to do it on their own, not feeling ready, and not wanting to seek care.
PWH experienced barriers largely at the individual level that prevented them from seeking alcohol treatment despite a recognized need, though many eventually sought care. Providers and public health professionals should consider helping to address various barriers, particularly internal barriers, when designing interventions to help PWH seek care.
需要接受酒精治疗的人中，只有少数人接受了治疗。艾滋病毒感染者（PLWH）中普遍存在不健康的饮酒行为，这可能导致不良的健康后果。本多方法研究的目的是：（1）定量描述目前正在佛罗里达州接受艾滋病毒护理的 PLWH 中，有自我报告的酒精治疗需求但未寻求治疗的人群的流行率、心理社会特征和人口统计学特征；（2）定性探讨 PLWH 未寻求治疗的原因。
2020 年 10 月至 2023 年 2 月期间，参加佛罗里达队列研究的 PLWH 完成了一项横断面调查，该调查询问他们是否有过意识到自己需要帮助戒酒但未寻求帮助的时期。如果是，他们会被问到一个关于为什么不寻求治疗的开放性后续问题。使用多变量逻辑回归确定了那些表示有过需要酒精治疗时期但未寻求治疗的人和未表示有过该时期的人之间的人口统计学和行为差异，而定性数据则基于社会生态模型进行了主题分析，以评估个体、社会和系统层面未寻求治疗的原因。
四分之一有终身饮酒史的 PLWH（n=129）表示有过需要治疗但未寻求治疗的时期。表示有过需要治疗但未寻求治疗时期的患者更有可能目前存在风险饮酒，并且有过试图减少饮酒或正式寻求专业酒精治疗的历史。参与者未寻求治疗的最常见原因是个人层面的因素，包括羞耻感、否认、恐惧、想要独自处理、没有准备好和不想寻求治疗。
尽管 PLWH 有需求，但他们经历了各种个人层面的障碍，导致他们未能寻求酒精治疗，尽管许多人最终还是寻求了治疗。提供者和公共卫生专业人员在设计帮助 PLWH 寻求治疗的干预措施时，应考虑帮助解决各种障碍，特别是内部障碍。
