Jennifer C Elliott1,2, Ahnalee M Brincks3,4, Daniel J Feaster3, Deborah S Hasin1,2,5, Carlos Del Rio6,7, Gregory M Lucas8, Allan E Rodriguez9, Ank E Nijhawan10, Lisa R Metsch11. 1. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA. 2. New York State Psychiatric Institute, New York, NY, USA. 3. Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA. 4. Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA. 5. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. 6. Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. 7. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 8. Johns Hopkins University School of Medicine, Baltimore, MD, USA. 9. Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA. 10. Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. 11. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
Abstract
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.
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.
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