African-Americans are disproportionately impacted by HIV/AIDS and many contextual psychosocial issues complicate their experiences living with this disease, including high rates of heavy alcohol use, which has been linked to accelerated HIV disease progression, reduction in medication efficacy, poor adherence to medical regimens and risky sexual behaviors. The proposed study seeks to advance understanding of alcohol abuse and dependence among HIV positive African-Americans by testing models of the impact of key psychosocial variables on alcohol abuse and dependence in this population. As such, the specific aims of the study are to test the models that 1) Among HIV-positive African-Americans, gender moderates the influence of religiosity on alcohol abuse and dependence; 2) Gender moderates the influence of social support on alcohol abuse and dependence; 3) Social network composition mediates the influence of gender and religiosity on alcohol abuse and dependence; 4) Social network composition mediates the influence of gender and social support on alcohol abuse and dependence and 5) To illustrate and supplement these models with narratives of HIV-positive African-Americans about these issues. These goals will be achieved through secondary analysis of quantitative and qualitative data collected from 300 HIV-positive African-Americans in Los Angeles County. The proposed analysis will use logisitic regressions to assess the proposed moderation and mediated moderation models and content analysis of qualitative data to illustrate and supplement those models. Content analysis will also introduce consumer perspectives on the relationship between problem drinking and HIV-related self care as well as the genesis of and potential avenues for the cessation of problem drinking in the context of HIV. A dearth of information about this phenomenon and its underlying causes limits interventions efforts. Thus, the proposed development of a more clearly conceived culturally specific model for alcohol abuse and dependence among HIV-positive African-Americans holds potentially significant implications for public health. Because of the potential impact of alcohol abuse and dependence on both HIV treatment and prevention efforts with this population the results of this analysis may contribute to the development of interventions ranging from alcohol treatment for HIV-positive African-Americans to HIV-related supportive services, HIV medical treatment and HIV prevention strategies within the African-American community. ? ? ?
