Cancer risk assessment of ethyl carbamate in alcoholic beverages from Brazil with special consideration to the spirits cachaça and tiquira.

BACKGROUND: Ethyl carbamate (EC) is a multi-site carcinogen in experimental animals and probably carcinogenic to humans (IARC group 2A). Traces of EC below health-relevant ranges naturally occur in several fermented foods and beverages, while higher concentrations above 1 mg/l are regularly detected in only certain spirits derived from cyanogenic plants. In Brazil this concerns the sugarcane spirit cachaça and the manioc (cassava) spirit tiquira, which both regularly exceed the national EC limit of 0.15 mg/l. This study aims to estimate human exposure in Brazil and provide a quantitative risk assessment. METHODS: The human dietary intake of EC via alcoholic beverages was estimated based on WHO alcohol consumption data in combination with own surveys and literature data. This data comprises the EC contents of the different beverage groups cachaça, tiquira, other spirits, beer, wine, and unrecorded alcohol (as defined by the WHO; including alcohol which is not captured in routine government statistics nor taxed). The risk assessment was conducted using the margin of exposure (MOE) approach with benchmark doses obtained from dose-response modelling of animal experiments. Lifetime cancer risk was calculated using the T25 dose descriptor. RESULTS: Considering differences between pot-still and column-still cachaça, its average EC content would be 0.38 mg/l. Tiquira contained a considerably higher average EC content of 2.34 mg/l. The whole population exposure from all alcoholic beverages was calculated to be around 100 to 200 ng/kg bw/day, with cachaça and unrecorded alcohol as the major contributing factors. The MOE was calculated to range between 400 and 2,466, with the lifetime cancer risk at approximately 3 cases in 10,000. An even higher risk may exist for binge-drinkers of cachaça and tiquira with MOEs of up to 80 and 15, respectively. CONCLUSIONS: According to our risk assessment, EC poses a significant cancer risk for the alcohol-drinking population in Brazil, in addition to that of alcohol alone. Model calculations show that the implementation of the 0.15 mg/l limit for cachaça would be beneficial, including an increase of the MOE by a factor between 3 to 6. The implementation of policy measures for tiquira and unrecorded alcohol also appears to be advisable.

Alcohol use and risk of vehicle accidents: cross-sectional study in the city of São Paulo, Brazil.

BACKGROUND: Harm to other people caused by an individual under the influence of alcohol (UIA) can occur in a variety of relationship situations between the drinker and these other people. OBJECTIVES: To estimate the prevalence of the risk of vehicle accidents (RVA) involving people who are UIA, according to sociodemographic variables, respondent alcohol use and gender. DESIGN AND SETTING: Cross-sectional study, in which a household survey was carried out on a cluster-stratified representative sample of urban residents in the city of São Paulo. METHODS: The final sample was composed of 1,155 subjects aged 18-59 years, who were interviewed using the GENACIS Harm-to-Others questionnaire. Individuals were defined as having been harmed if an affirmative response was given to at least one of the questions that refers to RVA involving people who had been UIA in the last twelve months. Post-stratification weights were calculated to adjust for the study design and for no response. Since the outcome was binary, logistic regression was used in multivariable analysis. RESULTS: The final response rate was 58.6%. The overall prevalence of RVA was 13.6% (95% confidence interval, CI 11.0-16.7): 16.6% among men and 10.8% among women. After the logistic regression, age remained as a protective factor (odds ratio, OR 0.95) and binge drinking as a risk factor (OR 2.03). CONCLUSION: This study showed that binge drinking was associated with RVA.

Prevention of "risky" drinking among students at a Brazilian university.

AIM: The aim of this paper was to compare the quantity and frequency of alcohol use and its associated negative consequences between two groups of college students who were identified as being "risky drinkers." Subjects were randomly allocated in a clinical trial to intervention or control groups. METHODS: Risky drinking use was defined as Alcohol Use Disorders Identification Test (AUDIT) >or=8 and/or Rutgers Alcohol Problem Index (RAPI) >or=5 problems in the previous year. Students who had undergone the Brief Alcohol Screening and Intervention for College Students (BASICS) (N = 145 at baseline; 142 at 12 months, and 103 at 24 months, loss of 29.7%) were compared with a control group (N = 121 at baseline; 121 at 12 months and 113 at 24 months, loss of 9.3%), the nonintervention group. Variables included drinking frequency, quantity and peak consumption, dependence assessment, and family and friends' abuse assessment. RESULTS: Treated students at a 24-month follow-up decreased quantity of alcohol use per occasion and lowered AUDIT and RAPI scores. CONCLUSIONS: This is the first brief intervention work on risky drinking with college students in Brazil and the results are encouraging. However, it is difficult to conduct individual prevention strategies in a country where culture fosters heavy drinking through poor public policy on alcohol and lack of law enforcement.

Drinking patterns between men and women in two distinct Brazilian communities.

OBJECTIVE: A survey was conducted to compare gender differences in patterns of drinking in two stratified, urban and representative samples from two communities (B and RJr). METHOD: The Genacis (Gender, Alcohol, and Culture: an International Study) questionnaire was used. RESULTS: There were several significant differences in the demographics and patterns of alcohol use between these two samples. One had an older, more Catholic, educated, Caucasian population, with more women in the labor force. Data from B community showed that women and men had similar patterns of drinking. RJr had much higher use of alcohol among men, and almost 22% of those under 49 years old were binge drinkers. DISCUSSION: Access, smoking, income and having a heavy drinker partner were important risk factors for women's drinking. CONCLUSIONS: This study shows that when women's roles become more similar to men's, so do their drinking patterns.

Patterns of alcohol use between genders: a cross-cultural evaluation.

INTRODUCTION: Alcohol use by men and women is very much influenced by social habits and customs. Cultural peculiarities and biological differences between the sexes require more focused and standardized studies. The objective was to systematize information on patterns of alcohol use between the sexes. METHOD: A literary review (1972-2004) identified 96 publications (Lilacs, Scielo, Medline) and some related books. RESULTS AND CONCLUSIONS: Men drank more and presented more problems (legal, family, social, clinical, traumas and mortality) associated with alcohol use; the consequences of alcohol use in developing countries with low death rates is even higher. Women can face more discrimination by using alcohol as well as worse health problems when they abuse drinking (liver, pancreas, and central and peripheral nervous system problems, psychiatric comorbidity, etc.); sexual abuse is more commonly associated with women than discussing the different responses to treatment. As for social roles/responsibilities exercised by women, there are indications that marriage, employment, and children have a good influence, discouraging alcohol use, while divorce, unemployment, and no children contribute to higher consumption. For both sexes, religion was a protective factor for alcohol use; acculturation was a strong influence in the pattern of alcohol use, and alcohol worsened the evolution of existing psychiatric disorders.

Culturally-sensitive complaints of depressions and anxieties in women.

BACKGROUND: Current classifications of Mental Disorders are centered on Westernized concepts and constructs. "Cross-cultural sensitivity" emphasizes culturally-appropriate translations of symptoms and questions, assuming that concepts and constructs are applicable. METHODS: Groups and individual psychiatrists from various cultures from Asia, Latin America, North Africa and Eastern Europe prepared descriptions of main symptoms and complaints of treatment-seeking women in their cultures, which are interpreted by clinicians as a manifestation of a clinically-relevant dysphoric disorder. They also transliterated the expressions of DSM IV criteria of main dysphoric disorders in their cultures. RESULTS: In many non-western cultures the symptoms and constructs that are interpreted and treated as dysphoric disorders are mostly somatic and are different from the Western-centered DSM or ICD systems. In many cases the DSM and ICD criteria of depression and anxieties are not even acknowledged by patients. LIMITATIONS: The descriptive approach reported here is a preliminary step which involved local but Westernized clinicians-investigators following a biomedical thinking. It should be followed by a more systematic-comprehensive surveys in each culture. CONCLUSIONS: Westernized concepts and constructs of mental order and disorders are not necessarily universally applicable. Culturally-sensitive phenomena, treatments and treatment responses may be diversified. Attempts at their cross-cultural harmonization should take into consideration complex interactional multi-dimensional processes.

Hazardous alcohol use among transwomen in a Brazilian city.

There is a lack of information about alcohol use by transgender women. We estimated the prevalence of dangerous alcohol use in the last 12 months by transgender women, who are known as travestis in Brazil, and we identified the associated risk factors. Three hundred travestis were recruited using Respondent Driving Sampling (RDS). We applied the Alcohol Use Disorders Identification Test (AUDIT). We controlled the sample by applying a weight to each interviewee. Three quarters (74.2%) of travestis were regular drinkers, half (48.7%) scored over eight in the AUDIT and 14.8% scored over 20. The risk factors for alcohol use were: aged over 24, low income and unprotected sex. The dangerous use of alcohol is prevalent among travestis. Given that this group has a greater risk of HIV infection and transmission, and that the dangerous use of alcohol was associated with unsafe sex, specific intervention strategies are required.

Efficacy of hormone therapy with and without methyltestosterone augmentation of venlafaxine in the treatment of postmenopausal depression: a double-blind controlled pilot study.

OBJECTIVE: This study evaluated the augmentation of venlafaxine with hormone therapy in the treatment of postmenopausal depression. The hormones evaluated were estrogen (0.625 mg) in combination with medroxyprogesterone acetate (2.5 mg) and methyltestosterone (2.5 mg). DESIGN: Seventy-two menopausal women (mean age: 53.6 +/- 4.27 years) diagnosed with depression (Montgomery-Asberg Depression Rating Scale [MADRS] scores > or = 20) were treated with venlafaxine and one of the following hormone therapy combinations, in a double-blind regimen: estrogen + medroxyprogesterone + methyltestosterone (group 1, n = 20); estrogen + medroxyprogesterone acetate (group 2, n = 20); methyltestosterone only (group 3, n = 16); and no hormone therapy (group 4, n = 16). Study duration was 24 weeks. Primary efficacy outcome was remission according to the MADRS, whereas secondary efficacy measures included the Clinical Global Impression (CGI), Blatt-Kupperman Index, and Women's Health Questionnaire (WHQ). RESULTS: Forty-eight patients completed the study. All groups showed significant improvement from baseline. Group 3 demonstrated significant improvement on the MADRS compared with placebo (group 4) at weeks 20 (P = 0.048) and 24 (P = 0.030); effect size 8.04 (0.83; 15.26) (P = 0.029), but also had the highest dropout rate. Groups 1 and 3 had significant CGI improvement rates compared with placebo: 42.23% (P = 0.012) and 44.45% (P = 0.08), respectively. There were no differences in the WHQ or BKI scores among the groups. CONCLUSIONS: Methyltestosterone 2.5 mg had the highest effect size compared with placebo, but the high dropout rate prevented its efficacy from being determined. Estrogen plus medroxyprogesterone, combined with methyltestosterone or otherwise, demonstrated a trend toward increased efficacy of venlafaxine. Further larger-scale clinical trials are needed to elucidate the findings of this pilot study.

[Psychiatric complications of alcoholism: alcohol withdrawal syndrome and other psychiatric disorders]. / Complicações psiquiátricas do uso crônico do álcool: síndrome de abstinência e outras doenças psiquiátricas.

Alcohol withdrawal syndrome is an acute condition secondary to total or partial reduction of alcohol consumption, characterized by self limited signs and symptoms and different degrees of severity. It can be complicated by several clinical and/or other psychiatric related problems. The objective of this article is to review the most important psychiatric complications to alcohol withdrawal syndrome as well as other psychiatric disorders associated with alcohol dependence as Wernicke Korsakoff and Marchiava Bignami syndromes. We aim to promote early diagnosis and treatment of these conditions, minimizing morbidity and mortality associated with them.

Psychiatric disorders and psychiatric consultation in a general hospital: a case- control study.

INTRODUCTION: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). METHODS: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD-10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. RESULTS: Behavioral alterations, either of elation or of depression, were the main for requesting a PC; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases), while anxiety, depressive and alcohol-related disorders were predominant in group II (controls). Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals). DISCUSSION: The SRQ and CAGE were quite useful in the screening of possible patients and might be important for medical students to learn and use as generalists. Further research is needed to verify if and how the newly-established service will improve the diagnostic and treatment skills of our students.

Validity of alcohol screening instruments in general population gender studies: an analytical review.

The present study is an analytical review of the methodology used in studies of efficacy of screening instruments to detect harmful use/ alcohol dependence according to the gender in population surveys. Systematic review of bibliography was done, using data from Web of Science, Pubmed and PsycInfo. Population studies were included without date range, in English, Spanish or Portuguese languages, with sample of adults, evaluating psychometric characteristics of any alcohol screening instrument, whereas studies in special population or under treatment as well as prevalence of alcohol consumption were excluded. Thirteen studies were selected to be included in the present review. According to the studies, the instruments that presented a better performance among men were AUDIT and its derivatives (6 studies) and CAGE (2 studies), whereas among women, AUDIT and its derivatives (7 studies), followed by CAGE (3 studies). The increase of consumption and problems related to alcohol use and its implications for public health indicate the need and urgency for adequacy of screening instruments to differences of gender in general population. The population surveys in the area are scarce. Furthermore, the found studies present heterogeneous methodology which makes accurate comparisons difficult.

[Alcohol consumption pattern and coronary heart disease risk in metropolitan São Paulo: analyses of GENACIS Project]. / Consumo de álcool e risco para doença coronariana na região metropolitana de São Paulo: uma análise do Projeto GENACIS.

OBJECTIVES: To examine the association between patterns of drinking and coronary heart disease (CHD) risk in a populational sample. METHODS: A population-based cross-sectional study carried out from January 2006 to June 2007, in Metropolitan São Paulo, Brazil, in conjunction with the international collaborative GENACIS project (Gender, Alcohol, and Culture: an International Study), with PAHO support. The subjects (1,501; 609 men, 892 women) of this study were residents of randomly chosen households aged 30 years and above who consented to provide information. The dependent variable was cardiac risk as assessed by the WHO Rose Angina Questionnaire. Logistic Regression analysis was used and the data were adjusted for Body Mass Index (BMI) and smoking. RESULTS: The response rate was 75%. Being female, older, African-American, a current smoker, and having a greater BMI were associated with higher risk of coronary heart disease. Lifetime abstainers (OR = 2.22) and former drinkers (OR = 2.42) had greater CHD risk than those who consumed up to 19g pure alcohol per day, with no binge. Among those who had binged weekly or more there was a tendency toward higher risk (OR = 3.95, p = .09). CONCLUSIONS: Our findings suggest a lower risk for CHD among moderate drinkers. It is important, in studies which were investigating cardiac risk, assess heavy alcohol use, since it can change that risk. Also, effective public policies are needed to reduce harmful drinking and related morbidity in Brazil.

Sexual abuse and alcohol use among women in metropolitan Sao Paulo, Brazil: a general population study.

OBJECTIVE: The present study aimed at estimating the prevalence of lifetime sexual abuse among women and at investigating its association with alcohol consumption. METHOD: Population-based survey conducted through a representative and stratified cluster sample of metropolitan São Paulo. GENACIS questionnaire was used. Sample unit was the home, and all residents aged 18 years and over were interviewed. The outcome was lifetime sexual abuse. The univariate statistical analysis used the Rao-Scott test. Logistic regression was used for the multivariate analysis. RESULTS: The final sample totalized 1,216 women aged 18 years and over; the response rate was 75.0%. Most women were married (56.6%) and had less than 12 years of formal education (59.0%); 46.2% were aged between 25 and 44 years, and 44.4% had a low income. Of the respondents, 7.5% reported having suffered lifetime sexual abuse. Multiple logistic regression model showed an association between lifetime sexual abuse and being a heavy drinker (OR = 4.97) and being a former drinker (OR = 2.04). CONCLUSIONS: There are few population studies in Brazil investigating sexual abuse and its relation to alcohol use. Although the prevalence of lifetime sexual abuse in the present study was smaller than that observed in other studies, it is a highly expressive percentage on account of its social and economic impact, as well as its potential effect on the health system.

[Positive expectations towards alcohol use and binge drinking: gender differences in a study from the GENACIS project, São Paulo, Brazil]. / Expectativas positivas com o uso de álcool e o beber se embriagando: diferenças de gênero em estudo do Projeto GENACIS, São Paulo, Brasil.

The objective was to investigate expectations towards alcohol use among men and women and the association between these expectations and binge drinking (or heavy episodic drinking). An epidemiological cross-sectional population-based household survey with a stratified probabilistic sample was conducted in Greater Metropolitan São Paulo, Brazil. Males and females were interviewed (n = 2,083) with the GENACIS questionnaire (Gender, Alcohol, and Culture: an International Study). The dependent variable was binge drinking, and logistic regression models were constructed for each gender, adjusting for age, schooling, and income. All expectations, with the exception of increased ease in talking with one's partner, were associated with binge drinking. The study shows that binge drinking can be associated with expectations towards alcohol use. Understanding such expectations can contribute to the design of effective polices to prevent binge drinking.

Relations between depression, alcohol and gender in the metropolitan region of São Paulo, Brazil.

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of São Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Hazardous alcohol use among transwomen in a Brazilian city / Consumo excessivo de álcool entre mulheres transgênero numa cidade brasileira / Consumo excesivo de alcohol entre mujeres transexuales en una ciudad brasileña

Abstract: There is a lack of information about alcohol use by transgender women. We estimated the prevalence of dangerous alcohol use in the last 12 months by transgender women, who are known as travestis in Brazil, and we identified the associated risk factors. Three hundred travestis were recruited using Respondent Driving Sampling (RDS). We applied the Alcohol Use Disorders Identification Test (AUDIT). We controlled the sample by applying a weight to each interviewee. Three quarters (74.2%) of travestis were regular drinkers, half (48.7%) scored over eight in the AUDIT and 14.8% scored over 20. The risk factors for alcohol use were: aged over 24, low income and unprotected sex. The dangerous use of alcohol is prevalent among travestis. Given that this group has a greater risk of HIV infection and transmission, and that the dangerous use of alcohol was associated with unsafe sex, specific intervention strategies are required.

Resumo: Informação sobre uso de álcool entre mulheres transgêneros são escassas. Estimamos a prevalência do uso perigoso de álcool nos últimos 12 meses entre mulheres transgêneros chamadas travestis no Brasil, e identificados os fatores de risco associados. Trezentas travestis foram recrutadas utilizando Respondent Driving Sampling (RDS). Aplicamos o Alcohol Use Disorders Identification Test (AUDIT). Controlamos a amostragem, com um peso aplicado a cada entrevistada. Três quartos (74,2%) das travestis eram bebedores regulares, metade (48,7%) obteve > 8 no AUDIT e 14,8% obtiveram > 20. Fatores de risco para o uso de risco de álcool foram: > 24 anos, baixa renda, raça negra, viver com a família, ter feito sexo por dinheiro, uso de drogas ilícitas nos últimos seis meses e sexo desprotegido. O uso perigoso de álcool é prevalente entre travestis. Tendo em vista que este grupo possui maior risco para a infecção e transmissão de HIV, e que o uso perigoso de álcool foi associado ao sexo inseguro, são necessárias estratégias de intervenção específicas.

Resumen: Existe falta de información sobre el consumo de alcohol por parte de mujeres transexuales. El estudio estimó la prevalencia de consumo excesivo de alcohol durante los últimos 12 meses por parte de mujeres transexuales, conocidas en Brasil como travestis, e identificó los factores de riesgo. Fueron reclutadas 300 travestis, utilizando la técnica de Respondent Driven Sampling (RDS). Aplicamos el Alcohol Use Disorders Identification Test (AUDIT). La muestra fue controlada, aplicando un peso a cada entrevistada. Tres cuartos (74,2%) de la muestra consumían alcohol regularmente, la mitad (48,7%) totalizó más de ocho puntos en el AUDIT y 14,8% sumaron más de 20 puntos. Los factores de riesgo para el consumo excesivo de alcohol fueron: edad por encima de 24 años, baja renta y sexo sin preservativo. El uso excesivo de alcohol es común entre las travestis. Debido a que el grupo presenta riesgo aumentado de transmisión del VIH, y que el uso excesivo de alcohol estuvo asociado al sexo inseguro, se necesitan estrategias específicas para mitigar los riesgos.

Alcohol screening instruments in elderly male: a population-based survey in metropolitan São Paulo, Brazil.

OBJECTIVE: This study compares the efficacy of the AUDIT (gold standard) with the more easily and quickly applied instruments CAGE, TWEAK, and T-ACE for men aged > 60 using data from a representative stratified sample of the general population of metropolitan São Paulo. METHOD: The GENACIS questionnaire was administered to a total sample of 2,083 people aged over 18, with a response rate of 74.5%. The elderly male sample consisted of 169 men. Sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve, and confidence intervals were calculated for each instrument (95% CI). RESULTS: Respondents were predominantly married (81.7%), had up to 11 years of education (61.3%) and a monthly per capita income of up to 300 US dollars. Current abstinence rate was high (61.6%) and 38% reported being former drinkers. There were no statistically significant differences among the instruments tested; however, the TWEAK had a higher area under the receiver operating characteristic curve (95% CI; 0.90-0.99). CONCLUSION: Research in the general population with screening instruments is scarce, especially among the elderly. However, it can provide specific information concerning this age group and be useful in the formulation of policies and prevention strategies.

Childhood trauma in substance use disorder and depression: an analysis by gender among a Brazilian clinical sample.

OBJECTIVE: In this study, we compared the frequency and intensity of childhood traumas in alcohol- or other drug-dependent patients, in patients with depression, and in a control group without psychiatric diagnoses. METHODS: The study had a retrospective design of a clinical sample of men and women from the groups listed above. They were evaluated by the same standardized instrument: the "Childhood Trauma Questionnaire." RESULTS: A higher frequency and intensity of emotional, physical, and sexual abuse were found in alcohol- and other drug-dependent patients than in patients with depression, who, in turn, presented significantly higher proportions than the control group. In all of the cases, the frequency was higher among women than men. CONCLUSION: Because of the high frequency and intensity of childhood traumas among alcohol- or other drug-dependent patients and depressed patients, the assessment of problems due to childhood traumas among these patients is essential to a better understanding of the etiology of those disorders and to their treatment.

[Violence between intimate partners and alcohol use: prevalence and associated factors]. / Violência entre parceiros íntimos e álcool: prevalência e fatores associados.

OBJECTIVE: To estimate physical violence between intimate partners and to examine the association between violence and sociodemographic variables, use of alcohol, and other related factors. METHOD: This epidemiologic survey included a stratified probabilistic sample representative of the population from the city of São Paulo in economic and educational terms. The Gender, Alcohol and Culture: An International Study (GENACIS) questionnaire was employed. The sampling unit was the home, where all individuals older than 18 years were candidates for interview. The final sample included 1 631 people. Statistical analysis employed the Rao Scott test and logistic regression. RESULTS: The response rate was 74.5%. Most participants were female (58.8%), younger than 40 years of age (52%), or had 5 to 12 years of schooling. Of the overall group, 5.4% reported having been victims of physical violence by an intimate partner and 5.4% declared having been aggressors of intimate partners in the past 2 years. Most men declared that none of those involved had ingested alcohol at the moment of aggression. Most women reported that nobody or only the man had drunk. Being a victim or an aggressor was associated with younger age and having a heavy-drinking partner. Women suffered more serious aggression, requiring medical care, and expressed more anger and disgust at aggression than men. CONCLUSIONS: The results underscore the importance of the association between alcohol use and risk of aggression between intimate partners, and may contribute to the design of public policies aimed to control this situation.