Negative Consequences of Alcohol Use among People Living with HIV.

Introduction: Among people living with HIV (PLWH), alcohol use can have negative impacts beyond HIV-related outcomes. The objectives of this study are to identify the most common alcohol-related consequences among PLWH in Florida and describe factors associated with experiencing more alcohol-related consequences. Methods: Data were collected from PLWH in the Florida Cohort study who drank at least monthly in the past year (n=397). Self-reported consequences were assessed by the 15-item Short Inventory of Problems Revised (SIP-2R). Nonparametric tests and a generalized estimating equation model with inverse probability of exposure weighting were used to evaluate associations between the total SIP-2R score and socio-demographics, mental health, and substance use while controlling for alcohol use. Results: Over half (56%) endorsed at least one consequence and 29% endorsed 5 or more consequences. The most common consequences were doing something they regretted and taking foolish risks (both endorsed by 37% of participants), both in the impulse control domain. After controlling for alcohol use and other covariates, homelessness and injection drug use remained significantly associated with greater SIP-2R scores. Conclusion: PLWH who are experiencing homelessness or injecting drugs could benefit from receiving additional screening for alcohol-related consequences if they report any alcohol use.

Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States.

To date, the United States (U.S.) has been the most heavily impacted country by the coronavirus disease 2019 (COVID-19). By November 30, 2020, when this paper was written, 13.5 million cases were reported in the U.S. with over 268 000 deaths. Historically, vaccines have been one of the most effective and efficient technical tools for controlling a communicable disease. While the development of these vaccines has certainly been a challenge, it could be more challenging to achieve robust vaccine uptake because of many barriers. In this review, we focused on two types of barriers documented from long-term experience in the U.S.: structural and attitudinal. Structural barriers are systemic issues that impact one's ability to access a service, and they include time, transportation, cost, and clinic or outlet location; while attitudinal barriers are beliefs or perceptions that impact the willingness of at-risk individuals to seek out and/or accept a service. In the context of vaccination they include beliefs about the communicable disease, beliefs about vaccines, fear, and trust in healthcare and governmental agencies. Of the attitudinal barriers, public trust is a barrier that is of particular importance. In addition to affecting reception of vaccines, it may exacerbate disparities and reduce the likelihood of success of a vaccination program. Recommendations are made to overcome attitudinal barriers to help improve the effectiveness of vaccination programs for COVID-19 control in the U.S., such as building public support through bipartisan endorsements and leveraging social media platforms to promote vaccination.

Perceived Positive Consequences Are Associated with Unhealthy Alcohol Use Among Persons Living with HIV.

BACKGROUND: Understanding how perceived positive consequences are associated with drinking may help improve effectiveness of alcohol reduction interventions among people living with HIV (PLWH). We aimed to determine whether perceived positive consequence scores varied by sociodemographic, drinking, mental health or substance use variables. METHODS: Perceived positive consequences of drinking were assessed using the PROMIS: Positive Consequences-Short Form. Unhealthy alcohol use was measured using a modified AUDIT-C. We used multiple linear regression to identify factors associated with perceived positive consequence. RESULTS: 328 PLWH who consumed at least one alcoholic beverage in the last 6 months participated in the Florida Cohort study (mean age=46, 69% male, 58% Black). Perceived positive consequence scores ranged from 0 to 28 (mean=16.1, SD=6.9). Perceived positive consequence scores increased by 0.8 points for each 1-point increase in AUDIT-C score. Demographics, thoughts on reducing alcohol use, other substance use, depression, and anxiety were not significantly associated with perceived positive consequences. CONCLUSIONS: Our findings suggest perceived positive consequences are associated with unhealthy alcohol use. Positive consequences should be considered with negative consequences in a decisional balance when intervening on alcohol use among PLWH.

CONTEXTE: Comprendre comment les conséquences positives perçues sont associées à la consommation d'alcool peut aider à améliorer l'efficacité des interventions de réduction de l'alcool chez les personnes vivant avec le VIH (PVVIH). Nous avons cherché à déterminer si les scores des conséquences positives perçues variaient selon les variables sociodémographiques, de consommation d'alcool, de santé mentale ou de consommation de substances. MÉTHODES: Les conséquences positives perçues de la consommation d'alcool ont été évaluées à l'aide du PROMIS: Positive Consquences - Short Form -conséquences positives­version abrégée. La consommation d'alcool malsaine a été mesurée à l'aide d'un AUDIT-C modifié. Nous avons utilisé une régression linéaire multiple pour identifier les facteurs associés aux conséquences positives perçues. RÉSULTATS: 328 PVVIH ayant consommé au moins une boisson alcoolisée au cours des 6 derniers mois ont participé à l'étude de la cohorte de Floride (âge moyen=46 ans, 69% d'hommes, 58% de noirs). Les scores des conséquences positives perçues allaient de 0 à 28 (moyenne=16.1, ET=6.9). Les scores de conséquences positives perçues ont augmenté de 0.8 point pour chaque augmentation de 1 point du score AUDIT-C.Les données démographiques, les réflexions sur la réduction de la consommation d'alcool, la consommation d'autres substances, la dépression et l'anxiété n'étaient pas associées de manière significative aux conséquences positives perçues. CONCLUSIONS: Nos résultats suggèrent que les conséquences positives perçues sont associées à une consommation d'alcool malsaine. Les conséquences positives doivent être considérées avec des conséquences négatives dans le processus décisionnel lors de l'intervention sur la consommation d'alcool chez les PVVIH.

A Proof of Concept Study Demonstrating the Feasibility of a Text Message Prompt for Hepatitis C Testing in the 1945-1965 Birth Cohort.

Purpose Despite national recommendations stating all individuals in the 1945-1965 "birth cohort" be tested for hepatitis C virus (HCV), testing rates remain low. The purpose of this proof of concept study was to assess the feasibility of text messaging to promote HCV testing among birth cohort patients. Methods Participants were assigned to receive a text message to promote HCV testing, or a general health message as a control. Participants were sent the message immediately prior to an upcoming appointment. Patients not enrolled in the study were in the standard-of-care group. To assess the impact of the text on HCV test orders on the appointment date participant charts were reviewed. Results The sample was largely non-Hispanic, Caucasian, and female. Of participants sent the HCV message (n = 22), 50.0% had a test ordered, compared to 41.7% and 27.5% in the control (n = 13) and standard-of-care groups (n = 69), respectively. Conclusion This proof of concept study demonstrated the feasibility of text messaging to promote HCV testing among birth cohort patients. Those receiving the HCV message were more likely to have an HCV test ordered compared to those who received no message, although this difference was not statistically significant. A larger study is needed to confirm these results.