title: Neighborhood-Level Drinking Norms and Alcohol Intervention Outcomes in HIV Patients Who Are Heavy Drinkers.
abstract: Heavy alcohol consumption can be harmful, particularly for individuals with HIV. There is substantial variability in response to interventions that aim to reduce drinking. Neighborhood drinking norms may explain some of this variability among HIV-infected patients. Therefore, we investigated whether neighborhood-level drinking norms modified response to alcohol intervention among HIV-infected heavy drinkers.
  
  
  
  Heavily-drinking HIV comprehensive care patients (n = 230) completed 1 of 3 brief alcohol interventions (an educational intervention, a motivational interviewing [MI] intervention, or an MI intervention with a technological enhancement called HealthCall). Drinking was reported at baseline and end of treatment (60 days). Neighborhood-level drinking norms were obtained from a separate general population study.
  
  
  
  Patients' reductions in drinks per drinking day in response to MI (as compared with the educational control) were more pronounced in neighborhoods with more permissive drinking norms. In contrast, patients' reductions in drinks per drinking day in response to MI plus HealthCall did not significantly vary between neighborhoods with different drinking norms. Norms did not evidence significant interactions with intervention condition for 3 other exploratory drinking outcomes (drinking frequency, binge frequency, and maximum quantity).
  
  
  
  Neighborhood-level drinking norms help explain differential response to an alcohol MI intervention among HIV-infected patients. This study suggests the utility of considering neighborhood context as an effect modifier of alcohol interventions.
authors.affiliation: New York State Psychiatric Institute , New York City, New York.|Department of Psychiatry , Columbia University Medical Center, New York City, New York.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Elliott
authors.affiliation: New York State Psychiatric Institute , New York City, New York.|San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Epidemiology) , San Diego, California.
authors.forename: Erin
authors.initials: E
authors.lastname: Delker
authors.affiliation: New York State Psychiatric Institute , New York City, New York.|Department of Psychiatry , Columbia University Medical Center, New York City, New York.|Department of Biostatistics , Mailman School of Public Health, Columbia University, New York City, New York.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: New York State Psychiatric Institute , New York City, New York.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Feng
authors.affiliation: New York State Psychiatric Institute , New York City, New York.|Department of Psychiatry , Columbia University Medical Center, New York City, New York.
authors.forename: Efrat
authors.initials: E
authors.lastname: Aharonovich
authors.affiliation: Department of Epidemiology and Biostatistics , School of Public Health, University at Albany, State University of New York, Rensselaer, New York.
authors.forename: Melissa
authors.initials: M
authors.lastname: Tracy
authors.affiliation: School of Public Health , Boston University, Boston, Massachusetts.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.affiliation: Division of Epidemiology , School of Public Health, University of California, Berkeley, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ahern
authors.affiliation: New York State Psychiatric Institute , New York City, New York.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Sarvet
authors.affiliation: New York State Psychiatric Institute , New York City, New York. dsh2@cumc.columbia.edu, deborah.hasin@gmail.com.|Department of Psychiatry , Columbia University Medical Center, New York City, New York. dsh2@cumc.columbia.edu, deborah.hasin@gmail.com.|Department of Epidemiology , Mailman School of Public Health, Columbia University, New York City, New York. dsh2@cumc.columbia.edu, deborah.hasin@gmail.com.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D012111:Residence Characteristics; D066262:Social Norms; D016896:Treatment Outcome
keywords: 
  HIV
  ; Alcohol; Intervention; Neighborhood; Norms