Alcohol-Antiretroviral Therapy Interactive Toxicity Beliefs and Intentional Medication Nonadherence: Review of Research with Implications for Interventions

The successful treatment of HIV infection relies on adherence to antiretroviral therapy (ART). Alcohol use remains a threat to ART adherence, including the beliefs held by people who drink alcohol that it is harmful to take ART when consuming alcohol (i.e., alcohol-ART interactive toxicity beliefs, AA-ITB). We reviewed the current research that has investigated AA-ITB and their relationship to intentional ART nonadherence. The review of 17 published studies found that AA-ITB are prevalent among people receiving ART and that AA-ITB are directly associated with ART nonadherence and incomplete HIV suppression. Family, friends and healthcare providers are common sources and reinforcers of AA-ITB. Studies suggest that AA-ITB may best be explained by the Medication Necessity and Concerns Beliefs Model, treating AA-ITB as a specific circumstance of medication concerns. Interventions are needed to communicate the realities of potential medication interactions and dispel myths that it is harmful to mix alcohol with ART, while not inadvertently suggesting that it is safe to drink with all medications, which could undermine adherence to ART by increasing alcohol use.

Predicting self-reported drink driving among middle-aged women

A substantial and sustained increase in the proportion of drink drivers that is female is observed in many parts of the motorised world. Given this trend, a better understanding of the factors that influence drink driving among women is needed. The current study investigated drink driving among middle-aged women, a relatively under-researched group of female drink drivers. A total of 781 women (age; M=51.36, SD=4.29years) completed a cross-sectional survey measuring a number of alcohol beliefs and drink driving. Among the included alcohol beliefs, viewing alcohol as a form of social enhancement as well as higher perceived heavy episodic drinking among same-aged women and greater acceptability toward this consumption pattern significantly increased the likelihood of self-reported drink driving. However, after adjusting for harmful consumption patterns, only alcohol as form of social enhancement remained significant. These results indicate that middle-aged women who engage in harmful alcohol consumption are more likely to drink drive, but also that the social aspect of drinking is a risk factor. Targeting both harmful consumption patterns as well as alcohol beliefs that are held by middle-aged women may reduce the incidence of drink driving in this group.

Drinking games, tailgating, and pregaming: precollege predictors of risky college drinking

BACKGROUND

The transition from high school to college is a critical period for developing college drinking habits. Hazardous alcohol consumption increases during this period, as well as participation in drinking games, pregaming, and tailgating. All of these risky drinking practices are associated with higher levels of intoxication as well as an increased risk of alcohol-related problems.

OBJECTIVE

The current study aimed to evaluate pre-college predictors (personality, social norms, and beliefs reflecting the internalization of the college drinking culture [ICDC]) of estimated peak BAC (pBAC) reached during drinking games, pregaming, and tailgating, as well as pBAC and alcohol-related problems during the first 30 days of college.

METHODS

Participants (n = 936) were incoming freshmen at a large university who completed a baseline assessment prior to college matriculation and a follow-up assessment after they had been on campus for 30 days.

RESULTS

Using path analysis, ICDC was significantly associated with pBAC reached during the three risky drinking practices. ICDC had an indirect effect on both pBAC and alcohol-related problems via pBAC from drinking games, pregaming, and tailgating. Hopelessness and sensation seeking were significantly related to alcohol use outcomes.

CONCLUSION

Precollege perceptions of the college drinking culture are a stronger predictor of subsequent alcohol use than social norms. Interventions that target these beliefs may reduce peak intoxication and associated harms experienced during the first 30 days of college.

Personality and alcohol-related outcomes among mandated college students: descriptive norms, injunctive norms, and college-related alcohol beliefs as mediators

The present study examined three alcohol-perception variables (descriptive norms, injunctive norms, and college-related alcohol beliefs) as mediators of the predictive effects of four personality traits (impulsivity, sensation seeking, anxiety sensitivity, and hopelessness) on alcohol use and alcohol-related consequences in a sample of mandated college students (n=875). Our findings replicated several findings of a previous study of incoming freshman college students (Hustad et al., in press) in that impulsivity and hopelessness had direct effects on alcohol-related problems, sensation seeking and impulsivity had indirect effects on alcohol-related outcomes via college-related alcohol beliefs, and college-related alcohol beliefs predicted both alcohol use and alcohol-related problems. We discuss the implications of our findings for global college student interventions as well as personality-targeted interventions.

Impulsivity and alcohol-related risk among college students: examining urgency, sensation seeking and the moderating influence of beliefs about alcohol's role in the college experience

The personality trait of impulsivity is predictive of heavy drinking and consequences among college students. The current study examined how impulsivity-measured via positive urgency, negative urgency, and sensation seeking-and a person's beliefs about the role alcohol plays in the college experience relate to drinking and consequences in a sample of 470 college students (mean age=19 years, 61.3% female, 59.8% White). In support of the hypotheses, sensation seeking independently predicted greater drinking, and both positive urgency and negative urgency predicted greater experience of alcohol-related negative consequences after controlling for consumption level. Moreover, alcohol beliefs moderated the relationship between impulsivity types and alcohol outcomes. Among students high (versus low) in sensation seeking, strong beliefs about alcohol's role in college life were related to significantly greater drinking, and among students high (versus low) in negative urgency, endorsing strong beliefs about alcohol's role in college life were related to greater levels of alcohol-related negative consequences. Overall, findings inform college prevention efforts by highlighting the need to distinguish unique facets of impulsivity and examine how they intersect with students' beliefs about alcohol in college.