ALCOHOL OUTLET DENSITY, HIV TREATMENT OUTCOMES, AND POLYSUBSTANCE USE AMONG WOMEN: A MIXED-METHODS APPROACH…

Assistance award details

Assistance award identifier

ASST_NON_R36DA061663_075

FAIN

R36DA061663

Recipient

TRUSTEES OF BOSTON UNIVERSITY

Awarding agency

Department of Health and Human Services

Funding agency

Department of Health and Human Services

Assistance listing (CFDA)

93.279

Total obligated

$49,150

Period

Aug 1, 2024 – Jul 31, 2025

Fiscal year

2024

Place of performance state

MA

Source file

FY2024_All_Assistance_Full_20261006.zip

Description

ALCOHOL OUTLET DENSITY, HIV TREATMENT OUTCOMES, AND POLYSUBSTANCE USE AMONG WOMEN: A MIXED-METHODS APPROACH - PROJECT SUMMARY THERE ARE 1.2 MILLION PEOPLE WITH HIV IN THE UNITED STATES, OF WHOM NEARLY ONE-FIFTH ARE WOMEN. NEARLY HALF OF WOMEN WITH HIV (WWH) CONSUMED ALCOHOL IN THE PAST MONTH, A PROPORTION TWO TO THREE TIMES GREATER THAN IN THE GENERAL FEMALE POPULATION. AMONG ADULTS, ALCOHOL CONSUMPTION IS INCREASING AMONG WOMEN BUT NOT MEN. DATA FROM THE WOMEN’S INTERAGENCY HIV STUDY INDICATE THAT BETWEEN 12-24% OF WWH REPORT UNHEALTHY ALCOHOL USE, DEFINED AS >7 DRINKS/WEEK OR >3 DRINKS/OCCASION. IN ADDITION, STUDIES HAVE DOCUMENTED THAT POLYSUBSTANCE USE—CONCURRENT USE OF ALCOHOL AND AT LEAST ONE OTHER SUBSTANCE (E.G., TOBACCO, STIMULANTS, COCAINE, OPIOIDS)—IS INCREASINGLY COMMON AMONG WWH. IT IS CRITICAL TO FOCUS ON WWH BECAUSE THE CONSEQUENCES OF ALCOHOL CONSUMPTION FOR WOMEN ARE GREATER THAN THOSE OF MEN AT LOWER LEVELS AND SHORTER DURATION OF ALCOHOL USE. WWH TEND TO HAVE POORER ART ADHERENCE AND VIRAL SUPPRESSION THAN MEN WITH HIV. AMONG WWH THAT RECEIVE ART, EXCESSIVE ALCOHOL USE HAS BEEN FOUND TO RESULT IN DECREASED ART ADHERENCE AND VIRAL LOAD INCREASES IN A DOSE-RESPONSE FASHION. AS A MODIFIABLE INFLUENCE ON HIV CARE CONTINUUM TARGETS, ALCOHOL AND POLYSUBSTANCE USE VULNERABILITY APPEARS TO HAVE GREATER IMPACTS ON HIV AND CLINICAL OUTCOMES AMONG WWH THAN AMONG MEN WITH HIV. THUS, TO ACHIEVE MORE SUSTAINABLE AND EQUITABLE REDUCTIONS IN EXCESSIVE ALCOHOL AND POLYSUBSTANCE USE, IT IS IMPORTANT TO IDENTIFY UPSTREAM FACTORS WITHIN NEIGHBORHOODS THAT CAN BE TARGETED TO ACHIEVE SIGNIFICANT POPULATION HEALTH GAINS AMONG WWH. RECENT RESEARCH HAS HIGHLIGHTED THE SIGNIFICANCE OF ENVIRONMENTAL FACTORS INFLUENCING SUBSTANCE USE AND HEALTH OUTCOMES FOR WWH. THEREFORE, IT IS IMPORTANT TO EXPLORE POTENTIAL COMMUNITY ENVIRONMENTAL FACTORS SUCH AS THE DENSITY OF ALCOHOL OUTLETS GIVEN THAT SOME OF THE MOST IMPORTANT DETERMINANTS OF ALCOHOL AND POLYSUBSTANCE USE ARE AT