Dataset Information

Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature.

ABSTRACT: Alcohol is associated with HIV and other sexually transmitted infections through increased sexual risk-taking behavior. Establishing a causal link between alcohol and sexual behavior has been challenging due to methodological limitations (e.g., reliance on cross-sectional designs). Experimental methods can be used to establish causality. The purpose of this meta-analysis was to evaluate the effects of alcohol consumption on unprotected sex intentions. We searched electronic bibliographic databases for records with relevant keywords; 26 manuscripts (k = 30 studies) met inclusion criteria. Results indicate that alcohol consumption is associated with greater intentions to engage in unprotected sex (d +s = 0.24, 0.35). The effect of alcohol on unprotected sex intentions was greater when sexual arousal was heightened. Alcohol consumption is causally linked to theoretical antecedents of sexual risk behavior, consistent with the alcohol myopia model. Addressing alcohol consumption as a determinant of unprotected sex intentions may lead to more effective HIV interventions.

SUBMITTER: Scott-Sheldon LA

PROVIDER: S-EPMC4683116 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Publications

Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature.

Scott-Sheldon Lori A J LA Carey Kate B KB Cunningham Karlene K Johnson Blair T BT Carey Michael P MP

AIDS and behavior 20160101

Alcohol is associated with HIV and other sexually transmitted infections through increased sexual risk-taking behavior. Establishing a causal link between alcohol and sexual behavior has been challenging due to methodological limitations (e.g., reliance on cross-sectional designs). Experimental methods can be used to establish causality. The purpose of this meta-analysis was to evaluate the effects of alcohol consumption on unprotected sex intentions. We searched electronic bibliographic databas ...[more]

PMID: 26080689

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Project description:BackgroundShared Decision Making (SDM) as means to the involvement of patients in medical decision making is increasingly demanded by treatment guidelines and legislation. Also, matching of patients' preferences to treatments has been shown to be effective regarding symptom reduction. Despite promising results for patients with substance use disorders (SUD) no systematic evaluation of the literature has been provided. The aim is therefore to give a systematic overview of the literature of patient preferences and SDM in the treatment of patients with SUD.MethodsAn electronic literature search of the databases Medline, Embase, Psyndex and Clinical Trials Register was performed. Variations of the search terms substance use disorders, patient preferences and SDM were used. For data synthesis the populations, interventions and outcomes were summarized and described according to the PRISMA statement. Methodological quality of the included articles was assessed with the Mixed Methods Appraisal Tool.ResultsN = 25 trials were included in this review. These were conducted between 1986 and 2014 with altogether n = 8.729 patients. Two studies found that patients with SUD preferred to be actively involved in treatment decisions. Treatment preferences were assessed in n = 18 studies, where the majority of patients preferred outpatient compared with inpatient treatment. Matching patients to preferences resulted in a reduction on substance use (n = 3 studies), but the majority of studies found no significant effect. Interventions for SDM differed across patient populations and optional therapeutic techniques.DiscussionPatients with substance use disorders should be involved in medical treatment decisions, as patients with other health conditions. A suitable approach is Shared Decision Making, emphasizing the patients' preferences. However, due to the heterogeneity of the included studies, results should be interpreted with caution. Further research is needed regarding SDM interventions in patient populations with substance use disorders.

Project description:Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely.

Dataset Information

Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature.

Publications

Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature.

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