A Longitudinal Study of Alcohol Use and Intimate Partner Violence among Men with HIV and Hazardous Alcohol Use in Vietnam

Background: Intimate partner violence (IPV) is an urgent global health problem that is associated with HIV. Alcohol use may lead to male-perpetrated IPV, although little is known about the alcohol-IPV relationship among men with HIV and hazardous alcohol use, a group at high risk for IPV perpetration and forward HIV transmission. Methods: I conducted three studies using data from a randomized controlled trial in Thai Nguyen, Vietnam. The parent trial evaluated the effects of two alcohol reduction interventions (two-session Brief Intervention [BI]; six-session Combined Intervention [CoI]) on alcohol use as compared to the standard of care (SOC) among antiretroviral treatment patients with hazardous alcohol use. In Study 1, I examined the longitudinal effects of alcohol use (proportion of days alcohol abstinent, heavy drinking, and alcohol use disorder [AUD]) on IPV perpetration among male participants who were married or cohabitating (N=313) using multilevel modeling. In Study 2, I tested whether depressive symptoms moderated the alcohol-IPV relationship. In Study 3, I tested the effects of the BI and CoI on IPV perpetration and alcohol use as a mediator among male participants (N=426) using path analyses. Results: In Study 1, reporting higher levels of alcohol use on average increased odds of IPV perpetration for all alcohol measures. Time-varying effects of alcohol use on IPV perpetration were observed for proportion of days alcohol abstinent and AUD. In Study 2, depressive symptoms weakened the time-varying effects of proportion of days alcohol abstinent and heavy drinking on IPV perpetration. Depressive symptoms did not moderate the relationship between AUD and IPV perpetration; a main effect of depressive symptoms on IPV perpetration was observed. In Study 3, the BI and CoI reduced IPV perpetration at three months as compared to the SOC, although effects were not sustained at six and 12 months. Alcohol use was not a mediator. Conclusions: Alcohol use is a risk factor for IPV perpetration among Vietnamese men with HIV and hazardous alcohol use. Depressive symptoms and alcohol use may not interact to exacerbate IPV perpetration. Enhanced alcohol reduction interventions addressing IPV and depression should be tested to improve and sustain effects on IPV perpetration.Doctor of Philosoph