A Latent Class Analysis of the Social Determinants of Health Impacting Heavy Alcohol Consumption Among Women Living with HIV in Canada: The Canadian HIV Women's Sexual and Reproductive Health Cohort Study

AIDS Behav. 2019 Dec;23(12):3226-3236. doi: 10.1007/s10461-019-02454-3.

Abstract

We used longitudinal data from the 2013-2017 Canadian HIV Women's Sexual and Reproductive Health Cohort Study (N = 1422) to assess the clustered impact of social determinants of health (SDoH) on hazardous drinking. Two measures of alcohol use were defined: (i) weekly alcohol use, with > 7 drinks/week as heavy drinking, and (ii) monthly binge drinking (≥ 6 drinks at one sitting), with ≥ 1/month as frequent binging. Twelve SDoH indicators were classified using latent class analysis: no/least adversities, discrimination/stigma, economic hardship, and most SDoH adversities. Inverse-probability weighted multinomial logistic regression was used to report relative-risk ratio (RRR). Women living with HIV (WLWH) in no/least adversity class had a substantially lower likelihood of both heavy weekly alcohol use and frequent binging than those in discrimination/stigma, economic hardship, and most SDoH adversities classes, with RRR estimates ranging from 0.02 to 0.18. Findings indicate the need to address SDoH to reduce hazardous drinking among WLWH.

Keywords: Alcohol drinking; CHIWOS; HIV; Social determinants; Women.

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / psychology
  • Anti-HIV Agents / therapeutic use
  • Canada / epidemiology
  • Cohort Studies
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / psychology*
  • Humans
  • Latent Class Analysis
  • Middle Aged
  • Reproductive Health
  • Residence Characteristics
  • Sexual Behavior
  • Sexual Health
  • Social Determinants of Health*
  • Social Stigma*
  • Women's Health

Substances

  • Anti-HIV Agents