HIV infection is a significant public health concern, particularly among young men who have sex with men (YMSM). Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV infection among YMSM when taken as prescribed. However, there may be unintended behavioral consequences associated with PrEP initiation, with previous studies finding associations between PrEP use and increased sexual risk behaviors such as condomless anal sex (CAS). Further, problematic alcohol use, to which YMSM are particularly vulnerable, may also play a role in increasing sexual risk as engaging in sexual behaviors while under the influence of alcohol has been associated with CAS and other sexual risk behaviors. Previous literature has proposed risk compensation theory as a basis for this change in sexual risk behaviors following PrEP initiation. However, results have been mixed, and fewer studies have examined risk compensation specifically among YMSM or explored the role of alcohol-related sexual behaviors in this relationship. The present study aims to examine risk compensation theory as a mechanism for the relationship between PrEP initiation and alcohol-related sexual behaviors among YMSM. We hypothesized that the trajectory of PrEP initiation would be positively associated with alcohol-related sexual behaviors across 18 months. Consistent with hypothesis, a combined latent difference score and latent trajectory model revealed a positive association between PrEP initiation and alcohol-related sexual behaviors between baseline and 18-month follow-up in a sample of YMSM. These results are consistent with previous research identifying a high-risk period following PrEP initiation among an already vulnerable group (YMSM), with implications for risk assessment and interventions targeting alcohol-related sexual behaviors among YMSM. This study also highlights the role of alcohol use in increasing sexual risk following PrEP initiation. Findings may aid in reducing adverse sexual outcomes among YMSM who initiate PrEP and ultimately contribute to the minimization of sexual health disparities among YMSM.

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Bakgrund Alkoholproblem kan leda till sjukdomar och höga samhällskostnader. Stigmatisering av personer med alkoholrelaterade problem ökar risken för diskriminering inom vården. Sjuksköterskor spelar en viktig roll i att vårda och främja hälsa hos personer med alkoholproblem. Syfte Att beskriva faktorer som påverkar sjuksköterskors attityder gentemot patienter med alkoholrelaterade problem. Metod En strukturerad litteraturöversikt med inslag av den metodik som tillämpas vid systematiska översikter. 15 artiklar både kvalitativa och kvantitativa från databaserna CINHAL och PubMed användes. Resultat Sjuksköterskor kan utveckla negativa attityder mot patienter med alkoholrelaterade problem på grund av rädsla, osäkerhet och brist på tid och kunskap. Stigmat kring alkoholism och bristande kunskap kan förstärka detta. Positiva attityder främjas av erfarenheter och utbildning inom beroendevård. Slutsats Sjuksköterskor känner ofta osäkerhet och rädsla när de vårdar patienter med alkoholrelaterade problem, särskilt i miljöer med olika patientgrupper. Denna osäkerhet och frustration leder till negativa attityder gentemot patienterna, som betraktas som svårhanterliga och ineffektiv användning av resurser. Genom att öka medvetenheten och erbjuda bättre utbildning och resurser kan det skapas en mer positiv vårdmiljö där patienternas behov kan bemötas på ett respektfullt och empatiskt sätt. / Background Alcohol problems can lead to diseases and high societal costs. Stigmatization of individuals with alcohol-related disorders increases the risk of discrimination within healthcare. Nurses play a crucial role in caring for and promoting the health of people with alcohol problems. Aim To describe factors influencing nurses’ attitudes towards patients with alcohol-related disorders. Method A structured literature review incorporating methodology similar to that used in systematic reviews. 15 articles from the CINHAL and PubMed databases were utilized, encompassing both qualitative and quantitative studies. Results Nurses may develop negative attitudes towards patients with alcohol-related problems due to fear, uncertainty, and lack of time and sufficient knowledge. Stigma surrounding alcoholism and lack of knowledge can exacerbate this. Positive attitudes are promoted by experiences and education in addiction care. Conclusions Nurses often experience insecurity and fear when caring for patients with alcohol-related disorders, especially in environments with various patient groups. This insecurity and frustration lead to negative attitudes towards the patients, who are seen as difficult to manage and an inefficient use of resources. By increasing awareness and providing better education and resources, a more positive care environment can be created where patients' needs are addressed respectfully and empathetically.

O presente trabalho consiste em um estudo epidemiológico, de corte transversal, sobre comportamentos de risco à saúde e sua associação com padrões de consumo de álcool, realizado entre a população de estudantes de graduação da Pontifícia Universidade Católica do Paraná. A pesquisa tem como objetivo descrever a prevalência de comportamentos de risco à saúde desses alunos e estudar a associação entre uso intenso de álcool e outros comportamentos de risco à saúde praticados por eles. O consumo intenso de álcool é definido neste trabalho como \"ter bebido cinco ou mais doses de álcool em, pelo menos, uma ocasião, nos últimos 30 dias\" e os comportamentos de risco considerados são aqueles monitorados pelo Centro de Controle e Prevenção de Doenças (CDC) dos EUA e com maior impacto na morbi-mortalidade do jovem contemporâneo. O recorte temporal (últimos 12 meses ou 30 dias) e de freqüência (1 vez, várias vezes, outros) variou dependendo do comportamento analisado. Os dados, obtidos por meio da aplicação de um questionário de autopreenchimento, anônimo, em uma amostra de estudantes sorteados (n= 1201), apontam que uma proporção elevada de estudantes se envolve em comportamentos de risco e a associação positiva entre consumo intenso de álcool e diversos desses comportamentos, apresentando variações de acordo com sexo e faixa etária. Os resultados permitem a constatação de que a ampla maioria dos bebedores intensos (77,7%) admite que seu padrão de consumo de álcool resultou em, pelo menos, 3 problemas, nos últimos 3 anos. Apesar das limitações próprias do estudo, seus resultados indicam a procedência do desenvolvimento de programas de promoção à saúde integral de universitários. / This paper presents a cross sectional study on health risk behaviors and their association with drinking patterns, among College students of the Catholic University of Paraná (Pontifícia Universidade Católica do Paraná) - PUCPR. Students were divided into 3 groups, according to their drinking patterns: binge drinkers, defined as having five or more drinks in at least, one single occasion during the last 30 days\", current drinkers (had some alcohol in the last 30 days but not reported a binge episode), and non drinkers (did not report alcohol use in the last 30 days). Risk behaviors considered in the study are those monitored by the Centers for Disease Control and Prevention (CDC) of USA and with greatest impact on the morbidity and mortality of the contemporary youth. The time periods (last 12 months or 30 days) and frequencies (once, many times, others) measured varied according to the behavior analyzed. Data obtained by means of an anonymous self completing questionnaire in a sample of randomized students (n=1201), documents that a great proportion of students get involved on risk behaviors and several of these behavior are positivetly associated with binge drinking. Results also lead to the conclusion that the majority of the binge drinkers (77,7%) admitted that their alcohol use behavior has resulted in, at least 3 problems during the last 3 years. Despite of study limitations, its results indicate the suitability of the development of programs for comprehensive student\'s health promotion.

<p>The relationship between alcohol consumption and alcohol-related violence has been firmly established in a wide array of studies concerning various forms of violence including intimate partner violence, domestic violence as well as sexual assault. One factor which has been highlighted as having a moderating effect on the relationship between alcohol consumption and alcohol-related aggression is the specific aggression-related alcohol expectancies concerning the effects of alcohol consumption on aggressive behaviour. In light of the prevalence of alcohol-related violence in South African communities it becomes important to examine the specific factors that moderate the relationship between alcohol consumption and alcohol-related aggression and violence. The aim of this study was to examine aggressionrelated alcohol expectancies as a moderating factor in the relationship between alcohol consumption and alcohol-related aggression and to examine the possible influence of exposure to community alcohol-related aggression in the formulation of aggression-related alcohol expectancies. The main objectives of this were to examine aggression-related alcohol expectancies as well as exposure to community alcohol-related aggression as domains for intervention to prevent alcohol-related violence.</p>

<p>The relationship between alcohol consumption and alcohol-related violence has been firmly established in a wide array of studies concerning various forms of violence including intimate partner violence, domestic violence as well as sexual assault. One factor which has been highlighted as having a moderating effect on the relationship between alcohol consumption and alcohol-related aggression is the specific aggression-related alcohol expectancies concerning the effects of alcohol consumption on aggressive behaviour. In light of the prevalence of alcohol-related violence in South African communities it becomes important to examine the specific factors that moderate the relationship between alcohol consumption and alcohol-related aggression and violence. The aim of this study was to examine aggressionrelated alcohol expectancies as a moderating factor in the relationship between alcohol consumption and alcohol-related aggression and to examine the possible influence of exposure to community alcohol-related aggression in the formulation of aggression-related alcohol expectancies. The main objectives of this were to examine aggression-related alcohol expectancies as well as exposure to community alcohol-related aggression as domains for intervention to prevent alcohol-related violence.</p>

O presente trabalho consiste em um estudo epidemiológico, de corte transversal, sobre comportamentos de risco à saúde e sua associação com padrões de consumo de álcool, realizado entre a população de estudantes de graduação da Pontifícia Universidade Católica do Paraná. A pesquisa tem como objetivo descrever a prevalência de comportamentos de risco à saúde desses alunos e estudar a associação entre uso intenso de álcool e outros comportamentos de risco à saúde praticados por eles. O consumo intenso de álcool é definido neste trabalho como \"ter bebido cinco ou mais doses de álcool em, pelo menos, uma ocasião, nos últimos 30 dias\" e os comportamentos de risco considerados são aqueles monitorados pelo Centro de Controle e Prevenção de Doenças (CDC) dos EUA e com maior impacto na morbi-mortalidade do jovem contemporâneo. O recorte temporal (últimos 12 meses ou 30 dias) e de freqüência (1 vez, várias vezes, outros) variou dependendo do comportamento analisado. Os dados, obtidos por meio da aplicação de um questionário de autopreenchimento, anônimo, em uma amostra de estudantes sorteados (n= 1201), apontam que uma proporção elevada de estudantes se envolve em comportamentos de risco e a associação positiva entre consumo intenso de álcool e diversos desses comportamentos, apresentando variações de acordo com sexo e faixa etária. Os resultados permitem a constatação de que a ampla maioria dos bebedores intensos (77,7%) admite que seu padrão de consumo de álcool resultou em, pelo menos, 3 problemas, nos últimos 3 anos. Apesar das limitações próprias do estudo, seus resultados indicam a procedência do desenvolvimento de programas de promoção à saúde integral de universitários. / This paper presents a cross sectional study on health risk behaviors and their association with drinking patterns, among College students of the Catholic University of Paraná (Pontifícia Universidade Católica do Paraná) - PUCPR. Students were divided into 3 groups, according to their drinking patterns: binge drinkers, defined as having five or more drinks in at least, one single occasion during the last 30 days\", current drinkers (had some alcohol in the last 30 days but not reported a binge episode), and non drinkers (did not report alcohol use in the last 30 days). Risk behaviors considered in the study are those monitored by the Centers for Disease Control and Prevention (CDC) of USA and with greatest impact on the morbidity and mortality of the contemporary youth. The time periods (last 12 months or 30 days) and frequencies (once, many times, others) measured varied according to the behavior analyzed. Data obtained by means of an anonymous self completing questionnaire in a sample of randomized students (n=1201), documents that a great proportion of students get involved on risk behaviors and several of these behavior are positivetly associated with binge drinking. Results also lead to the conclusion that the majority of the binge drinkers (77,7%) admitted that their alcohol use behavior has resulted in, at least 3 problems during the last 3 years. Despite of study limitations, its results indicate the suitability of the development of programs for comprehensive student\'s health promotion.

Os transtornos depressivos, a dependência de tabaco e os transtornos relacionados ao uso de álcool (TRUA) são altamente prevalentes e estão associados a diversas comorbidades. Todavia, permanecem subdiagnosticados e subtratados em diversos contextos de saúde. Dessa forma, o presente estudo teve por objetivos: a) avaliar parâmetros de fidedignidade e validade de instrumentos de rastreamento para transtornos depressivos (Patient Health Questionnaire - two itens [PHQ-2] e Well-Being Index - five itens [WHO-5]), dependência de tabaco (Fagerström Test for Nicotine Dependence [FTND] e Heaviness of Smoking Index [HSI]) e de álcool (Fast Alcohol Screening Test [FAST], CAGE, Alcohol Use Disorders Identification Test [AUDIT] e suas versões breves); b) realizar a análise fatorial do WHO-5, FTND e do AUDIT; c) avaliar a comorbidade entre os transtornos supracitados. Participaram dos estudos da fidedignidade teste-reteste 429 universitários e da fidedignidade interavaliadores 41 pacientes do Centro de Atenção Psicossocial - Álcool e Drogas (CAPS-AD). Os estudos da validade preditiva, consistência interna, comorbidade e análise fatorial utilizaram uma amostra de 530 pacientes do Pronto Socorro e do CAPS-AD. A fidedignidade foi estimada por meio do kappa e do coeficiente de correlação intraclasse (CCI). Nos estudos da validade preditiva, a SCID-CV foi a medida diagnóstica comparativa, sendo calculadas as áreas sob a curva ROC (ASC), sensibilidades, especificidades, acurácias, valores preditivos positivos e negativos dos instrumentos. A validade concorrente foi examinada pelo coeficiente de Spearman. O coeficiente alfa de cronbach foi utilizado para aferir a consistência interna. A análise fatorial exploratória foi realizada segundo os critérios de Kaiser. As comorbidades foram avaliadas por meio da regressão logística - odds ratios brutos e ajustados. O nível de significância foi de p<0,05, com intervalo de confiança de 95%. O PHQ-2 e do WHO-5 apresentaram altos índices de fidedignidade (>0,98). Exibiram, também, consistências internas elevadas (0,76 e 0,78, respectivamente). O WHO-5 obteve uma ASC de 0,89; sensibilidade de 0,85 e especificidade de 0,81 no ponto de corte nove. O PHQ-2 apresentou uma ASC de 0,86; sensibilidade de 0,74 e especificidade de 0,87 no ponto de corte três. O WHO-5 exibiu um único fator que explicou 51% da variância dos dados. Os estudos da fidedignidade do FTND resultaram em altos CCI (0,92 no teste-reteste e 0,99 no interavaliadores). Na análise fatorial, o FTND exibiu dois fatores. A consistência interna do FTND foi elevada (0,83), já a do HSI esteve abaixo do recomendado (0,56). O FTND e o HSI apresentaram elevados valores de sensibilidade, especificidade e acurácia. O AUDIT e suas versões abreviadas apresentaram consistências internas entre 0,83 e 0,94. No estudo da validade preditiva, esses instrumentos exibiram ASC entre 0,92 a 0,96, com índices de sensibilidade entre 0,84 e 0,93; e de especificidade de 0,83 a 0,94 para rastrear TRUA. A menor versão, o AUDIT-3 obteve excelentes resultados. No estudo da validade concorrente, observaram-se correlações expressivas entre as versões breves e o AUDIT (0,91 - 0,99). Em todas as avaliações o CAGE apresentou valores satisfatórios, porém inferiores aos das versões breves do AUDIT. Os resultados obtidos confirmam a validade e a confiabilidade das versões brasileiras do WHO-5, PHQ-2, FTND e do HSI, assim como, a eficácia de todas as versões breves do AUDIT, demonstrando que suas propriedades psicométricas são tão satisfatórias quanto às do instrumento completo e superiores as do CAGE. Portanto, o emprego desses instrumentos encontra apoio em sua viabilidade e sua validade, incentivando a sua utilização tanto na prática clínica diária como em pesquisas. Observou-se, neste estudo, que o tabagismo e o abuso e dependência do álcool são importantes preditores de transtornos depressivos e que os dependentes de álcool mostraram quatro vezes mais chance de serem tabagistas. / Depressive disorders, tobacco dependence, and alcohol-related disorders (ARD) are highly prevalent and are associated with several comorbidities. Nonetheless, they are still under-diagnosed and under-treated in many health settings. Therefore, this study was aimed at (1) assessing reliability and validity parameters of screening instruments for depressive disorders (Patient Health Questionnaire 2 [PHQ-2] and Well-Being Index 5 [WHO-5]), tobacco dependence (Fagerström Test for Nicotine Dependence [FTND] and Heaviness of Smoking Index [HSI]), and alcohol dependence (Fast Alcohol Screening Test [FAST], CAGE, Alcohol Use Disorders Identification Test [AUDIT] and their brief versions); (2) performing the factorial analysis of the WHO-5, FTND, and AUDIT; and (3) assessing the comorbidity between the above-mentioned disorders. The test-retest reliability study involved 429 university students and the inter-rater reliability study included 41 patients of a Center for Psychosocial Attention Alcohol and Drugs (CAPS-AD, in the Portuguese acronym). The assessment of the predictive validity, internal consistency, comorbidity, and factorial analysis involved a sample of 530 patients of an emergency unit and the CAPS-AD. Reliability was estimated by means of kappa and interclass correlation (ICC) coefficients. In the predictive validity studies, the SCID-CV was used as the comparison diagnostic measure, with calculation of the areas under the ROC curve (AUC), sensitivity, specificity, accuracy, and positive and negative predictive values of the instruments. Concurrent validity was assessed using Spearmans coefficient. Cronbachs alpha coefficient was used to assess internal consistency. The exploratory factorial analysis was conducted according to Kaisers criteria. Comorbidities were analyzed by logistic regression raw and adjusted odds ratio. The level of statistical significance was set at p < 0.05, with a 95% confidence interval. The PHQ-2 and WHO-5 had high levels of reliability (> 0.98) and internal consistency (0.76 and 0.78, respectively). The WHO-5 had an AUC of 0.89; sensitivity of 0.85; and specificity of 0.81 for a cut-off of 9. The PHQ-2 had an AUC of 0.86; sensitivity of 0.74; and specificity of 0.87 for a cut-off of 3. The WHO-5 yielded one single factor, which explained 51% of the data variance. The reliability study of the FTND provided high ICC coefficients (0.92 for test-retest and 0.99 for inter-rater). In the factorial analysis, the FTND yielded two factors. The internal consistency of the FTND was high (0.83), but that of the HIS was below recommended levels (0.56). The FTND and the HIS had high indices of sensitivity, specificity, and accuracy. The AUDIT and its brief versions had internal consistency values between 0.83 and 0.94. In the study of predictive validity, these instruments had AUC between 0.92 and 0.96, with sensitivity levels between 0.84 and 0.93 and specificity levels ranging from 0.83 and 0.94 for the screening of ARD. The shortest version of the AUDIT (AUDIT-3) had excellent results. In the assessment of concurrent validity, expressive correlations were found between the AUDIT and its brief versions (0.91-0.99). In all analyses, the CAGE had satisfactory results, although inferior to those of the brief versions of the AUDIT. The results confirm the validity and reliability of the Brazilian versions of the WHO-5, PHQ-2, FTND, and HIS, as well as the efficacy of all the brief versions of the AUDIT, demonstrating that their psychometric qualities are as satisfactory as those of the full version of the instrument and superior to those of the CAGE. Therefore, the use of these instruments is supported by their viability and validity, which encourage their use in routine clinical practice and research settings. The results also showed that smoking and alcohol abuse and dependence are important predictors of depressive disorders and that alcoholics had a fourfold higher chance of being smokers.