Alcohol Use and HIV Prevention Among Personnel in the Belize Defence Force
Tóm tắt
To evaluate the effect of a peer-based risk reduction project on alcohol use and sexual behavior within Belize Defence Force personnel. We used a quasi-experimental, mixed quantitative and qualitative methods design to evaluate project outcomes. Two serial cross-sectional surveys were conducted [baseline (n = 126) and 6-month follow-up (n = 128)] using computer assisted self-interview. Semistructured interviews were collected from 12 peer counselors 3 months after the beginning of the project. The proportion of respondents screening positive for alcohol dependence decreased significantly from 80 % at preintervention to 66 % at postintervention (p = 0.045), and the percentage of respondents reporting that they normally drink alcohol before work decreased from 11 to 3 % (p = 0.013). Alcohol abuse and dependency scores correlated positively with the overall number of sexual partners in both male and female respondents. There was a slight decrease in the percentage of female respondents’ reporting inconsistent condom use for vaginal sex (baseline 100 %, follow-up 83 %, p = 0.088), but there was no appreciable change reported in condom use among male respondents. Qualitative findings suggest that techniques to reduce the quantity of alcohol consumed were a salient focus of peer counselors, and administrative barriers can readily mitigate implementation of such interventions. In this evaluation of a risk reduction program with the BDF, we found evidence of a reduction in types of alcohol use from baseline to follow-up. Alcohol-related risk reductions carry implications for reducing sexual risk behavior in military personnel. Future research with stronger experimental design strategies may better elucidate how substance use reduction is linked with sexual risk reduction in military personnel.
Tài liệu tham khảo
Anastario, M., et al. (2011). HIV infection, sexual risk behaviour and condom use in the Belize defense force. International Journal of STD & AIDS, 22(2), 73–79.
Bray, R. M., et al. (2009). 2008 Department of Defense survey of health related behaviors among active duty military personnel. RTI International: Research Triangle Park, NC.
Anastario, M. P., et al. (2013). Toward a social theory of sexual risk behavior among men in the Armed Services: Understanding the military occupational habitus. Culture, Medicine, and Psychiatry, 37(4), 737–755.
Tsuang, M.T., Tohen, M., & Zahner, G. E. P. (2002).Textbook in psychiatric epidemiology (2nd ed.). Hoboken, NJ: Wiley.
Bray, R. M., et al. (2010). Substance use and mental health trends among US military active duty personnel: Key findings from the 2008 DoD Health Behavior Survey. Military Medicine, 175(6), 390–399.
MacQueen, K.M., et al. (1996). Alcohol consumption, brothel attendance, and condom use: Normative expectations among Thai military conscripts. Medical Anthropology Quarterly, 10(3), 402–423.
Peterson, Z.D., Janssen, E., & Heiman, J.R. (2010). The association between sexual aggression and HIV risk behavior in heterosexual men. Journal of Interpersonal Violence, 25(3), 538–556.
Tavarez, M., Chun, H., & Anastario, M. P. (2010) Correlates of sexual risk behavior in sexually active male military personnel stationed along border-crossing zones in the Dominican Republic. American Journal of Men’s Health, 5(1), 65–77.
Hutton, H. E., et al. (2004) Depression and HIV risk behaviors among patients in a sexually transmitted disease clinic. American Journal of Psychiatry, 161(5), 912–914.
Mattson, M., & Basnyat, I. (2009) Infusing HIV test counseling practice with harm reduction theory: an integrated model for voluntary counseling and testing. In T. Edgar, S. M. Noar & V. S. Freimuth (Eds.), Communication perspectives on HIV/AIDS for the 21st century (137–167). New York, NY: Lawrence Erlbaum Associates.
Erbelding, E. J., et al. (2004) The prevalence of psychiatric disorders in sexually transmitted disease clinic patients and their association with sexually transmitted disease risk. Sexually Transmitted Diseases, 31(1), 8–12.
Marlatt, G. A., Larimer, M. E., & Witkiewitz, K. (Eds.).(2011). Harm reduction: Pragmatic strategies for managing high-risk behaviors (2nd ed.). New York, NY, Guilford Press.
Tatarsky, A., & Kellogg, S. (2010). Integrative harm reduction psychotherapy: A case of substance use, multiple trauma, and suicidality. Journal of Clinical Psychology, 66(2), 123–135.
National Institute on Drug Abuse, Questionnaire Risk Behavior Assessment, in Rockville, MD. 1993: National Institute on Drug Abuse: Community Research Branch, 16–44.
Cherpitel, C.J. (2002) Screening for alcohol problems in the US general population: Comparison of the CAGE, RAPS4, and RAPS4-QF by gender, ethnicity, and service utilization. Alcoholism: Clinical and Experimental Research, 26(11), 1686–1691.
StataCorp LP. (2013). Stata 13. College Station, TX: StataCorp LP.
ATLAS.ti. (2016). Qualitative analytic software, version 7.5.10. Berlin: Cincom Systems, Inc.
Charmaz, K. (2006). Constructing grounded theory: a practical guide through qualitative analysis (Introducing Qualitative Methods Series). Thousand Oaks, CA: SAGE Publications Inc.
Corbin, J., & Strauss, A. (2008) Basics of qualitative research 3e: Techniques and procedures for developing grounded theory. London, UK: SAGE Publications Ltd.
Webel, A. R., et al. (2010) A systematic review of the effectiveness of peer-based interventions on health-related behaviors in adults. American Journal of Public Health, 100(2), 247–253.
Thompson, J. C., Kao, T.-C., &, Thomas, R. J. (2005). The relationship between alcohol use and risk-taking sexual behaviors in a large behavioral study. Preventive Medicine, 41(1), 247–252.
Anastario, M. P., et al. (2013). Condom use following a pilot test of the popular opinion leader intervention in the Barbados Defence Force. Journal of Community Health, 38(1), 46–53.