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

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.

Author information

1
Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada. mshokooh@uwo.ca.
2
Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
3
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
4
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
5
Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
6
Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, BC, Canada.
7
The Kirby Institute, University of New South Wales, Sydney, Australia.
8
School of Social Work, University of Michigan, Ann Arbor, MI, USA.
9
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
10
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

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.

KEYWORDS:

Alcohol drinking; CHIWOS; HIV; Social determinants; Women

PMID:
30863979
DOI:
10.1007/s10461-019-02454-3

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