Psychosocial Factors Associated with Problem Drinking Among Substance Users with Poorly Controlled HIV Infection.

Elliott, Jennifer C; Brincks, Ahnalee M; Feaster, Daniel J; Hasin, Deborah S; Rio, Carlos del; Lucas, Gregory M; Rodriguez, Allan E; Nijhawan, Ank E; Metsch, Lisa R

Aims We aimed to identify psychosocial factors related to problem drinking among patients with poorly controlled human immunodeficiency virus (HIV) infection. Short Summary We aimed to identify psychosocial factors related to problem drinking among those with poorly controlled HIV infection. Increased levels of interpersonal conflict were associated with greater severity of alcohol problems. Poorer mental health, medical mistrust and less satisfaction with one’s physician related to excessive drinking. Methods This secondary analysis used baseline data from a large multisite randomized controlled trial of substance users whose HIV infection was currently poorly controlled, from 11 urban hospitals across the USA. Participants were HIV-infected adult inpatients (n = 801; 67% male, 75% African American) with substance use histories. Participants self-reported on their drinking, perceived health, mental health, social relationships and patient–provider relationship. Structural equation models examined psychosocial factors associated with problem drinking, controlling for demographic covariates. Results Increased levels of interpersonal conflict were associated with greater severity of alcohol problems. Poorer mental health, medical mistrust and less satisfaction with one’s physician were associated with excessive drinking. Conclusions Several psychosocial factors, including interpersonal conflict, poor mental health (i.e. anxiety, depression and somatization), medical mistrust and less satisfaction with one’s provider, were associated with problem drinking among HIV-infected substance users with poorly controlled HIV infection. The co-occurrence of these concerns highlights the need for comprehensive services (including attention to problem drinking, social services, mental health and quality medical care) in this at-risk group.

UNITED States; HIV prevention; ANXIETY; CONFLICT (Psychology); MENTAL depression; DRINKING behavior; INTERPERSONAL relations; MENTAL health; PATIENT satisfaction; PHYSICIAN-patient relations; SELF-evaluation; SOMATOFORM disorders; URBAN hospitals; PSYCHOLOGY of Black people; DISABILITIES; SECONDARY analysis; BINGE drinking; STRUCTURAL equation modeling; PSYCHOLOGY of drug abusers

Alcohol & Alcoholism, 2018, Vol 53, Issue 5, p603

0735-0414

Academic Journal

10.1093/alcalc/agy021