Brian Houle, Nicole Angotti, F Xavier Gómez-Olivé, Samuel J Clark
{"title":"Fieldworker effects on substance use reporting in a rural South African setting.","authors":"Brian Houle, Nicole Angotti, F Xavier Gómez-Olivé, Samuel J Clark","doi":"10.7895/ijadr.246","DOIUrl":"https://doi.org/10.7895/ijadr.246","url":null,"abstract":"Aims\u0000Fieldworkers capturing reports of sensitive behaviors, such as substance use, may influence survey responses and represent an important factor in response validity. We explored the effects and interaction of fieldworker and respondent characteristics (age and gender) in substance (tobacco and alcohol) use reporting. We aim to further the literature on conditional social attribution effects on substance use reporting in the context of South Africa, where accurate estimates of modifiable risk factors are critical for medical and public health practitioners and policy-makers in efforts to reduce chronic disease burden and mortality.\u0000\u0000\u0000Design\u0000We modeled substance use reporting using binary logistic regression. We also tested if fieldworker effects remained, allowing for correlation in reporting for respondents with the same fieldworker using multi-level logistic regression.\u0000\u0000\u0000Setting\u0000Agincourt Health and Socio-Demographic Surveillance System site, rural South Africa.\u0000\u0000\u0000Participants\u0000We used data from a 2010-2011 study on HIV and cardiometabolic risk, ages 15+ (N = 4,684).\u0000\u0000\u0000Measures\u0000Lifetime and current alcohol and tobacco use.\u0000\u0000\u0000Findings\u0000Respondents reported higher lifetime smoking use to older fieldworkers. Male respondents reported higher lifetime alcohol use to older fieldworkers. No fieldworker effects were significant on reports of current smoking. An older, male fieldworker increased the probability of reports of current alcohol use. Adjusting for intra-fieldworker correlation explained many of the observed fieldworker effects.\u0000\u0000\u0000Conclusions\u0000Our results highlight the importance of adjusting for interviewer characteristics to improve the accuracy of chronic disease risk factor estimates and validity of inferred associations. We recommend that surveys collecting information that may be subject to response bias routinely include anonymized fieldworker identifiers and demographic information. Analysts can then use these additional fieldworker data as a tool in evaluating probable bias in respondent reporting.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561499/pdf/nihms-1028905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37325512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard W Wilsnack, Arlinda F Kristjanson, Sharon C Wilsnack, Kim Bloomfield, Ulrike Grittner, Ross D Crosby
{"title":"The Harms That Drinkers Cause: Regional Variations Within Countries.","authors":"Richard W Wilsnack, Arlinda F Kristjanson, Sharon C Wilsnack, Kim Bloomfield, Ulrike Grittner, Ross D Crosby","doi":"10.7895/ijadr.254","DOIUrl":"10.7895/ijadr.254","url":null,"abstract":"<p><strong>Aims: </strong>Multinational studies of drinking and the harms it may cause typically treat countries as homogeneous. Neglecting variation within countries may lead to inaccurate conclusions about drinking behavior, and particularly about harms drinking causes for people other than the drinkers. This study is the first to examine whether drinkers' self-reported harms to others from drinking vary regionally within multiple countries.</p><p><strong>Design setting and participants: </strong>Analyses draw on survey data from 12,356 drinkers in 46 regions (governmental subunits) within 10 countries, collected as part of the GENACIS project (Wilsnack et al., 2009).</p><p><strong>Measures: </strong>Drinkers reported on eight harms they may have caused others in the past 12 months because of their drinking. The likelihood of reporting one or more of these eight harms was evaluated by multilevel modeling (respondents nested within regions nested within countries), estimating random effects of country and region and fixed effects of gender, age, and regional prevalence of drinking.</p><p><strong>Findings: </strong>Reports of causing one or more drinking-related harms to others differed significantly by gender and age (but not by regional prevalence of drinking), but also differed significantly by regions within countries.</p><p><strong>Conclusions: </strong>National and multinational evaluations of adverse effects of drinking on persons other than the drinkers should give more attention to how those effects may vary regionally within countries.</p>","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366667/pdf/nihms-988598.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36949411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Newman, Ling Qian, N. Tamrakar, Yonghua Feng, Ganrong Xu
{"title":"Chemical content of unrecorded distilled alcohol (bai jiu) from rural central China: Analysis and public health risk","authors":"I. Newman, Ling Qian, N. Tamrakar, Yonghua Feng, Ganrong Xu","doi":"10.7895/IJADR.V6I1.236","DOIUrl":"https://doi.org/10.7895/IJADR.V6I1.236","url":null,"abstract":"Newman, I., Qian, L., Tamrakar, N., Feng, Y., & Xu, G. (2017). Chemical content of unrecorded distilled alcohol (bai jiu) from rural central China: Analysis and public health risk. The International Journal Of Alcohol And Drug Research, 6(1), 59-67. doi:http://dx.doi.org/10.7895/ijadr.v6i1.236Aims: To test 47 samples of locally distilled unrecorded beverage alcohol (bai jiu) obtained in rural central China.Methods: Alcohol samples purchased from home-based makers or from small village shops were analyzed for ethanol, methanol, acetaldehyde, ethyl acetate, six higher alcohols, arsenic, cadmium, and lead. Results were judged against the standards for these compounds set by the AMPHORA Project.Findings: Ethanol concentrations ranged from 38.7% to 63.7% (mean 50.4%). Methanol and methyl acetate detected in all samples did not exceed the Alcohol Measures for Public Health Research Alliance (AMPHORA) limits. Acetaldehyde was present in all samples, with three samples exceeding the AMPHORA limit by a small amount. Lead was found in 57.4% of the samples with one sample exceeding the AMPHORA limit; cadmium was found in 89.4% of the samples with two exceeding the AMPHORA limit. Arsenic was found in 46.8% of the samples with none exceeding the AMPHORA limit.Conclusions: The three samples that exceeded AMPHORA limits for cadmium or lead are of concern in terms of the potential of long-term exposure for local people who regularly consume locally made bai jiu. The main health concern from bai jiu appears to be the risk associated with high ethanol concentration—the same health concern as for recorded, commercially produced spirits.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47844355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Halfway there – The evolution of local alcohol control in California. Part I: The system as it has developed","authors":"Friedner D. Wittman","doi":"10.7895/ijadr.v5i2.228","DOIUrl":"https://doi.org/10.7895/ijadr.v5i2.228","url":null,"abstract":"Wittman, F. (2016). Halfway there – The evolution of local alcohol control in California. Part I: The system as it has developed. The International Journal Of Alcohol And Drug Research, 5(3), 101-107. doi:http://dx.doi.org/10.7895/ijadr.v5i3.228Local control over retail alcohol sales in California cities provides substantial capacity to reduce and prevent alcohol-related harm. This paper shows how local control works in California to prevent harm at retail alcohol outlets. Prior to issuing a retail license to an outlet operator, the state Alcoholic Beverage Control Department (ABC) waits until the local jurisdiction (city or county) issues a land-use permit (also called a zoning permit or use permit). Localities have discretionary authority to impose preventive “conditions” on the use permit to protect public health and safety by imposing restrictions on setting design, operation, and hours of operation for the retail alcohol outlet. Within the state/local control system, city options include Level 1 permissive zoning (no restrictions), Level 2 problem-solving zoning (restrictions on new/expanded outlets), and Level 3 community oversight (restrictions on existing and new outlets). Since 1980 the scope of local control has progressed from nil (Level 1 permissive zoning) to Level 3 preventive surveillance for all outlets. Higher-level zoning requires local politics in which the ABC is not involved. A companion article (Wittman, 2016) describes the evolution of local control for retail alcohol availability in California’s local jurisdictions from 1980 to 2015.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138543644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Public space and alcohol advertising: Exploratory study of the role of local government","authors":"G. Swensen","doi":"10.7895/IJADR.V5I3.224","DOIUrl":"https://doi.org/10.7895/IJADR.V5I3.224","url":null,"abstract":"Swensen, G. (2016). Public space and alcohol advertising: Exploratory study of the role of local government. The International Journal Of Alcohol And Drug Research, 5(3), 117-123. doi:http://dx.doi.org/10.7895/ijadr.v5i3.224The paper argues that local government bodies in Western Australia, which have a long-standing key role in overseeing public health standards and regulating business activities, potentially have a major, but under-recognized, capability to regulate the promotion and advertising of alcohol in public places overseen by them. It is contended that because local government bodies already possess extensive statutory powers to undertake this function, there is a compelling case for them to actively regulate alcohol advertising as they “own” most of the public space in Australian cities and towns.As the proposition would involve the prohibition of alcohol advertising, this could mean that local authorities may balk at assuming this responsibility due to a possible loss of revenue if they have already issued licenses to companies to construct and maintain key parts of the public infrastructure, like bus shelters, seating, and other street furniture, in return for being able to charge fees for advertising on these facilities.It is contended that local government authorities would ably perform a front-line role in regulating alcohol advertising in public places because of their reliance on community-based processes of consultation and decision-making for planning, in addition to understanding this role as an extension of a long standing role concerned with the advancement of public health and traffic safety.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71358975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol’s harm to others: An international collaborative project","authors":"Sarah Callinan,Anne-Marie Laslett,Dag Rekve,Robin Room,Orratai Waleewong,Vivek Benegal,Sally Casswell,Ramon Florenzano,Hoang Thi My Hanh,Vu Thi Minh Hanh,Siri Hettige,Taisia Huckle,Akanidomo Ibanga,Isidore Obot,Girish Rao,Latsamy Siengsounthone,Georgia Rankin,Thaksaphon Thamarangsi","doi":"10.7895/ijadr.v0i0.218","DOIUrl":"https://doi.org/10.7895/ijadr.v0i0.218","url":null,"abstract":"Callinan, S., Laslett, A., Rekve, D., Room, R., Waleewong, O., Benegal, V., Casswell, S., Florenzano, R., Hanh, H., Hanh, V., Hettige, S., Huckle, T., Ibanga, A., Obot, I., Rao, G., Siengsounthone, L., Rankin, G., & Thamarangsi, T. (2016). Alcohol’s harm to others: An international collaborative project. The International Journal Of Alcohol And Drug Research, 5(2), 25-32. doi:http://dx.doi.org/10.7895/ijadr.v5i2.218Aims: This paper outlines the methods of a collaborative population survey project measuring the range and magnitude of alcohol’s harm to others internationally.Setting: Seven countries participating in the World Health Organization (WHO) and ThaiHealth Promotion Foundation (ThaiHealth) research project titled “The Harm to Others from Drinking,” along with two other countries with similar studies, will form the core of a database which will incorporate data from other countries in the future.Measures: The WHO-ThaiHealth research project developed two comparable versions of a survey instrument, both measuring harm from others’ drinking to the respondent and the respondent’s children.Design: Surveys were administered via face-to-face methods in seven countries, while similar surveys were administered via computer-assisted telephone interviews in two additional countries. Responses from all surveys will be compiled in an international database for the purpose of international comparisons.Discussion: Harms from the alcohol consumption of others are intertwined with the cultural norms where consumption occurs. The development of this database will make it possible to look beyond reports and analyses at national levels, and illuminate the relationships between consumption, harms, and culture.Conclusions: This database will facilitate work describing the prevalence, patterning, and predictors of personal reports of harm from others’ drinking cross-nationally.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol’s harm to others: An international collaborative project","authors":"Sarah Callinan,Anne-Marie Laslett,Dag Rekve,Robin Room,Orratai Waleewong,Vivek Benegal,Sally Casswell,Ramon Florenzano,Hoang Thi My Hanh,Vu Thi Minh Hanh,Siri Hettige,Taisia Huckle,Akanidomo Ibanga,Isidore Obot,Girish Rao,Latsamy Siengsounthone,Georgia Rankin,Thaksaphon Thamarangsi","doi":"10.7895/ijadr.vxiy.218","DOIUrl":"https://doi.org/10.7895/ijadr.vxiy.218","url":null,"abstract":"Callinan, S., Laslett, A., Rekve, D., Room, R., Waleewong, O., Benegal, V., Casswell, S., Florenzano, R., Hanh, H., Hanh, V., Hettige, S., Huckle, T., Ibanga, A., Obot, I., Rao, G., Siengsounthone, L., Rankin, G., & Thamarangsi, T. (2016). Alcohol’s harm to others: An international collaborative project. The International Journal Of Alcohol And Drug Research, 5(2), 25-32. doi:http://dx.doi.org/10.7895/ijadr.v5i2.218Aims: This paper outlines the methods of a collaborative population survey project measuring the range and magnitude of alcohol’s harm to others internationally.Setting: Seven countries participating in the World Health Organization (WHO) and ThaiHealth Promotion Foundation (ThaiHealth) research project titled “The Harm to Others from Drinking,” along with two other countries with similar studies, will form the core of a database which will incorporate data from other countries in the future.Measures: The WHO-ThaiHealth research project developed two comparable versions of a survey instrument, both measuring harm from others’ drinking to the respondent and the respondent’s children.Design: Surveys were administered via face-to-face methods in seven countries, while similar surveys were administered via computer-assisted telephone interviews in two additional countries. Responses from all surveys will be compiled in an international database for the purpose of international comparisons.Discussion: Harms from the alcohol consumption of others are intertwined with the cultural norms where consumption occurs. The development of this database will make it possible to look beyond reports and analyses at national levels, and illuminate the relationships between consumption, harms, and culture.Conclusions: This database will facilitate work describing the prevalence, patterning, and predictors of personal reports of harm from others’ drinking cross-nationally.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Alcohol Use Disorders Identification Test (AUDIT): A review of graded severity algorithms and national adaptations","authors":"T. Babor, Katherine Robaina","doi":"10.7895/IJADR.V5I2.222","DOIUrl":"https://doi.org/10.7895/IJADR.V5I2.222","url":null,"abstract":"Babor, T., & Robaina, K. (2016). The Alcohol Use Disorders Identification Test (AUDIT): A review of graded severity algorithms and national adaptations. The International Journal Of Alcohol And Drug Research, 5(2), 17-24. doi:http://dx.doi.org/10.7895/ijadr.v5i2.222Aims: Since it was first released in 1989, the Alcohol Use Disorders Identification Test (AUDIT) has generated a large amount of research to evaluate its psychometric properties. The purpose of this review is to critically evaluate the literature relevant to applications of the AUDIT in screening, brief intervention, and treatment referral programs, and identify national adaptations of the AUDIT to country-specific health, education, and reimbursement needs.Methods: Methods comprised a search of the world literature published since 2004, combined with review articles published since 1997.Findings: We identified 431 studies of the AUDIT, including 386 articles, 26 review papers, and 11 book chapters since 2004, with a six-fold increase in the last decade. The factor structure of the AUDIT items remains unclear, but the weight of evidence supports a two-factor model. Despite the translation of the AUDIT into numerous languages, the alcohol consumption questions were rarely adapted to suit cultural or national conditions. Although numerous studies have supported the recommended cutoff thresholds for a possible alcohol use disorder, only three studies evaluated the classification accuracy of the AUDIT’s graded severity system.Conclusions: Further development of the AUDIT score’s severity zones is needed to guide intervention selection in clinical settings.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71358970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Alcohol Use Disorders Identification Test (AUDIT): A review of graded severity algorithms and national adaptations","authors":"Thomas F. Babor,Katherine Robaina","doi":"10.7895/ijadr.v0i0.222.","DOIUrl":"https://doi.org/10.7895/ijadr.v0i0.222.","url":null,"abstract":"Babor, T., & Robaina, K. (2016). The Alcohol Use Disorders Identification Test (AUDIT): A review of graded severity algorithms and national adaptations. The International Journal Of Alcohol And Drug Research, 5(2), 17-24. doi:http://dx.doi.org/10.7895/ijadr.v5i2.222Aims: Since it was first released in 1989, the Alcohol Use Disorders Identification Test (AUDIT) has generated a large amount of research to evaluate its psychometric properties. The purpose of this review is to critically evaluate the literature relevant to applications of the AUDIT in screening, brief intervention, and treatment referral programs, and identify national adaptations of the AUDIT to country-specific health, education, and reimbursement needs.Methods: Methods comprised a search of the world literature published since 2004, combined with review articles published since 1997.Findings: We identified 431 studies of the AUDIT, including 386 articles, 26 review papers, and 11 book chapters since 2004, with a six-fold increase in the last decade. The factor structure of the AUDIT items remains unclear, but the weight of evidence supports a two-factor model. Despite the translation of the AUDIT into numerous languages, the alcohol consumption questions were rarely adapted to suit cultural or national conditions. Although numerous studies have supported the recommended cutoff thresholds for a possible alcohol use disorder, only three studies evaluated the classification accuracy of the AUDIT’s graded severity system.Conclusions: Further development of the AUDIT score’s severity zones is needed to guide intervention selection in clinical settings.","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan P Lindsay, Scott C Roesch, Steffanie A Strathdee, M Gudelia Rangel, Hugo S Staines-Orozco, Daniela Abramovitz, Monica D Ulibarri, Melanie L A Rusch
{"title":"Correlates of unprotected sex by client type among female sex workers that inject drugs in Tijuana and Ciudad Juarez, Mexico.","authors":"Ryan P Lindsay, Scott C Roesch, Steffanie A Strathdee, M Gudelia Rangel, Hugo S Staines-Orozco, Daniela Abramovitz, Monica D Ulibarri, Melanie L A Rusch","doi":"10.7895/ijadr.v4i2.208","DOIUrl":"https://doi.org/10.7895/ijadr.v4i2.208","url":null,"abstract":"<p><strong>Aims: </strong>Risk environment factors may influence unprotected sex between female sex workers who are also injection drug users (FSW-IDUs) and their regular and non-regular clients differently. Our objective is to identify correlates of unprotected vaginal sex in the context of client type.</p><p><strong>Methods: </strong>A cross-sectional survey of 583 FSW-IDUs in Tijuana and Ciudad Juarez, Mexico, was analyzed using negative binomial regression to determine physical, social, economic, and policy risk-environment factors that affect the frequency of unprotected sex with regular and non-regular clients.</p><p><strong>Results: </strong>Median number of unprotected vaginal sex acts in the past month among FSW-IDUs and their regular and non-regular clients was 11 (IQR 3-30) and 13 (IQR 5-30), respectively. Correlates differed by site and client type and were most closely associated with the risk environment. In Tijuana, social factors (e.g., injecting drugs with clients) were independently associated with more unprotected sex. Factors independently associated with less unprotected sex across client type and site included social and economic risk environment factors (e.g., receiving more money for unprotected sex). In the policy risk environment, always having free access to condoms was independently associated with less unprotected sex among non-regular clients in Tijuana (Risk rate ratio = 0.64; 95% confidence interval 0.43-0.97).</p><p><strong>Conclusions: </strong>Primarily physical, social, and economic risk-environment factors were associated with unprotected vaginal sex between FSW-IDUs and both client types, suggesting potential avenues for intervention.</p>","PeriodicalId":73420,"journal":{"name":"International journal of alcohol and drug research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442543/pdf/nihms-1680472.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39425408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}