“[Drinking is] Like a Rule That You Can't Break”: Perceived Barriers and Facilitators to Reduce Alcohol Use and Improve Antiretroviral Treatment Adherence among People Living with HIV and Alcohol Use Disorder in Vietnam

Hershow, Rebecca B.; Zuskov, Diana; Mai, Nguyen Vu Tuyet; Chander, Geetanjali; Hutton, Heidi E.; Latkin, Carl A.; Vượng, Nguyễn Đức; Sripaipan, Teerada; Lancaster, Kathryn E.; Ha, Tran Viet; Go, Vivian F.

doi:10.1080/10826084.2017.1392986

Cited by 21 publications

(33 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further, our results demonstrated a dose-response relationship between alcohol abstinence stigma and alcohol use disorder severity. Our findings align with previous qualitative findings that PWH in Thai Nguyen desire to reduce their alcohol consumption, but find it difficult due to stigma related to abstaining from alcohol in social, family, and work settings [6]. Most notably, PWH stated, "Drinking is like a rule you can't break [6]" in regards to social settings in Vietnam.…”

Section: Plos Onesupporting

confidence: 88%

“…therefore, PWH, especially those who are socially isolated, feel increased social pressure to drink to avoid disclosing their HIV status [6]. This potential dual stigma-HIV and alcohol abstinence-has not yet been addressed for PWH.…”

Section: Competing Interestsmentioning

confidence: 99%

“…The pressure to consume shots of liquor in unison and the phrases such as "not drunk, not going home," ensure intoxication among all present [12,19]. While men are expected to drink heavily and remain high-functioning, women are expected to drink less; however, rates of alcohol consumption among women are increasing which will likely impact current gender norms [6,12]. Although the high proportion of men in Vietnam living with AUD is well-known, the percentage of women with AUD is likely severely underestimated due to experienced stigma from gender norms and social pressure to conceal alcohol use [20].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Alcohol abstinence stigma and alcohol use among HIV patients in Thai Nguyen, Vietnam

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Hazardous alcohol use is prevalent among people living with HIV (PWH), leading to suboptimal HIV treatment outcomes. In Vietnam, alcohol use is highly normative making it socially challenging for PWH to reduce or abstain. We used mixed methods to develop a quantitative scale to assess alcohol abstinence stigma and examined the association between alcohol abstinence stigma with alcohol use among PWH in Vietnam. Methods We conducted qualitative interviews with 30 PWH with hazardous alcohol use from an antiretroviral therapy (ART) clinic in the Thai Nguyen to inform item development. Alcohol use was assessed using the Alcohol Use Disorders Identification Test. We tested items in a survey of 1,559 ART clinic patients to assess internal consistency and structural validity. We used log binomial modeling to estimate associations between any reported alcohol abstinence stigma and alcohol use. Results Using the results from the qualitative interview data, we developed the alcohol abstinence stigma scale with seven final items with scores ranging from 0 (no stigma) to 28 (high stigma). The scale had good internal consistency (α = 0.75). Exploratory factor analysis suggested the presence of three factors: internalized, experienced, and anticipated stigma that explained 56.9% of the total variance. The mean score was 2.74, (SD = 4.28) and 46% reported any alcohol abstinence stigma. We observed a dose-response relationship between alcohol abstinence stigma and alcohol use. PWH who reported any alcohol

show abstract

Section: Plos Onesupporting

confidence: 88%

Section: Competing Interestsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Alcohol abstinence stigma and alcohol use among HIV patients in Thai Nguyen, Vietnam

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Alcohol use, regardless of frequency, appeared protective against depressive symptoms, and no alcohol use was a strong predictor of depressive symptoms among our study’s participants. Our qualitative research in this population indicates that alcohol use may be a proxy for social support and participation in family and community gatherings, with no alcohol use corresponding to social isolation and loneliness [ 49 ]. We found support for a positive relationship between alcohol use and social support in our study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam

Levintow

Pence

et al. 2018

PLoS ONE

Self Cite

View full text Add to dashboard Cite

BackgroundHIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam.MethodsWe used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009–2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D≥23) with prevalence odds ratios (POR) and 95% confidence intervals (CI).ResultsThe prevalence of severe depressive symptoms (CES-D≥23) was 44%. 25% of participants had mild to moderate depressive symptoms (16≤CES-D<23), and 31% experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95% CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95% CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95% CI = 1.40, 3.47).ConclusionSevere depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.

show abstract

“…This framework recognizes the interplays among individual-level, social network, and environmental determinants (Sudhinaraset, Wigglesworth, & Takeuchi, 2016). Socioecological determinants, such as unprotected sex and living environment, have been well-established for alcohol use among non-FSW populations but are less understood for hazardous alcohol use specifically among venue-based FSW (Hershow et al, Submitted; Rhodes, 2009; Strathdee et al, 2010). Identifying socioecological factors that are associated with hazardous alcohol use can provide important insights for alcohol reduction and ultimately, HIV/STIs and violence prevention for FSW in these settings.…”

Section: Introductionmentioning

confidence: 99%

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

Lancaster

MacLean

Lungu

et al. 2017

Substance Use & Misuse

Self Cite

View full text Add to dashboard Cite

Background Alcohol use is pervasive among female sex workers (FSW) placing them at increased risk of violence and sexual risk behaviors. FSW often live and work where alcohol is highly normative. Objective To understand the socioecological influences on hazardous alcohol use among FSW in Malawi. Methods In 2014, 200 FSW identified through venue-based sampling in Lilongwe, Malawi, completed a quantitative behavioral survey, with a sub-sample participating in qualitative interviews. Multivariable log-binomial regression was used to identify associations between hazardous alcohol use (AUDIT score ≥ 7) and time in sex work, clients per week, unprotected sex, alcohol use with clients, and living environment. Qualitative interviews enhanced findings from quantitative data and identify emergent themes around socioecological influences on alcohol use. Results Over 50% reported hazardous alcohol use and lived in an alcohol-serving venue. Hazardous alcohol use was associated with sex work duration of ≥2 years (aPR: 1.30; 95%CI: 1.02,1.65) and alcohol use at last sex with a client (aPR: 1.29; 25%CI: 1.06,1.57). FSW perceived alcohol as a facilitator for sex work by reducing inhibitions and attracting clients, but acknowledged alcohol leads to violence and/or unprotected sex. Despite these risks and a motivation to reduce use, FSW feared that refusing to drink would be tantamount to turning away clients. Conclusions Although FSW recognized alcohol-related risks, the norms and power dynamics of sex work perpetuated hazardous alcohol use. Multilevel interventions are needed to collectively change norms around drinking and sex work that will enable FSW to reduce alcohol consumption when engaging in their work.

show abstract

“[Drinking is] Like a Rule That You Can't Break”: Perceived Barriers and Facilitators to Reduce Alcohol Use and Improve Antiretroviral Treatment Adherence among People Living with HIV and Alcohol Use Disorder in Vietnam

Abstract: It may be effective to introduce targeted alcohol reduction interventions in health care centers to address individual risk practices and microenvironmental social norms.

Cited by 21 publications

References 30 publications

Alcohol abstinence stigma and alcohol use among HIV patients in Thai Nguyen, Vietnam

Alcohol abstinence stigma and alcohol use among HIV patients in Thai Nguyen, Vietnam

Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

Contact Info

Product

Resources

About