Table 3.
Predicted prevalence and prevalence ratioa of primary outcomes for transgender relative to non-transgender patients: Among all VA outpatients with unhealthy alcohol use use (AUDIT-C ≥ 5) and among VA outpatients with unhealthy alcohol use and a prior-year alcohol use disorder diagnosis
| Transgender | Non-Transgender | Prevalence Ratio (PR) for Transgender Relative to Non-Transgender | ||||||
|---|---|---|---|---|---|---|---|---|
| % | (95% CI) | % | (95% CI) | PR | (95% CI) | p-value | ||
| AMONG ALL VA OUTPATIENTS WITH UNHEALTHY ALCOHOL USE (N=1,405,734) | ||||||||
| Brief intervention within 14 days | ||||||||
| Model 1b | 74.2 | (70.9 – 77.4) | 74.8 | (73.0 – 76.5) | 0.99 | (0.96 – 1.03) | 0.655 | |
| Model 2c | 75.0 | (71.8 – 78.2) | 74.7 | (72.9 – 76.5) | 1.00 | (0.97 – 1.04) | 0.823 | |
| Model 3d | 75.4 | (72.2 – 78.5) | 74.6 | (72.9 – 76.4) | 1.01 | (0.98 – 1.04) | 0.574 | |
| AUD specialty addictions treatment | ||||||||
| Model 1b | 22.9 | (19.9 – 25.8) | 12.7 | (11.4 – 13.9) | 1.80 | (1.62 – 2.01) | <0.001 | |
| Model 2c | 18.8 | (16.4 – 21.2) | 12.7 | (11.4 – 14.1) | 1.48 | (1.33 – 1.64) | <0.001 | |
| Model 3d | 15.7 | (13.7 – 17.7) | 12.6 | (11.4 – 13.8) | 1.24 | (1.12 – 1.37) | <0.001 | |
| Any AUD medication | ||||||||
| Model 1b | 26.0 | (23.6 – 28.5) | 16.4 | (15.8 – 17.1) | 1.58 | (1.44 – 1.74) | <0.001 | |
| Model 2c | 21.9 | (19.9 – 23.9) | 16.4 | (15.9 – 16.9) | 1.33 | (1.22 – 1.46) | <0.001 | |
| Model 3d | 19.0 | (17.1 – 20.8) | 16.3 | (15.8 – 16.8) | 1.16 | (1.06 – 1.28) | 0.002 | |
| Any alcohol-related care | ||||||||
| Model 1b | 84.2 | (81.5 – 87.0) | 81.3 | (79.9 – 82.7) | 1.04 | (1.01 – 1.07) | 0.013 | |
| Model 2c | 83.8 | (81.0 – 86.6) | 81.3 | (79.9 – 82.7) | 1.03 | (1.00 – 1.06) | 0.040 | |
| Model 3d | 82.8 | (80.0 – 85.5) | 81.2 | (79.8 – 82.6) | 1.02 | (0.99 – 1.05) | 0.183 | |
| AMONG VA OUTPATIENTS WITH UNHEALTHY ALCOHOL USE AND A DOCUMENTED ALCOHOL USE DISORDER IN THE YEAR PRIOR TO POSITIVE ALCOHOL SCREENING (N=521,119) | ||||||||
| Brief intervention within 14 days | ||||||||
| Model 1b | 72.9 | (68.7 –77.1) | 75.1 | (73.2 – 77.0) | 0.97 | (0.92 – 1.02) | 0.233 | |
| Model 2c | 73.7 | (69.5 – 77.8) | 75.0 | (73.1 – 76.8) | 0.98 | (0.94 – 1.03) | 0.466 | |
| Model 3d | 74.8 | (70.7 – 78.9) | 75.0 | (73.1 – 76.8) | 1.00 | (0.95 – 1.05) | 0.937 | |
| AUD specialty addictions treatment | ||||||||
| Model 1b | 51.1 | (36.2 – 66.0) | 35.9 | (25.8 – 46.0) | 1.42 | (1.28 – 1.58) | <0.001 | |
| Model 2c | 40.0 | (31.5 – 48.4) | 31.4 | (25.2 – 37.5) | 1.28 | (1.16 – 1.40) | <0.001 | |
| Model 3d | 36.8 | (29.5 – 44.1) | 30.7 | (25.2 – 36.2) | 1.20 | (1.09 – 1.32) | <0.001 | |
| Any AUD medication | ||||||||
| Model 1b | 32.4 | (28.8 – 36.0) | 23.5 | (22.7 – 24.3) | 1.37 | (1.23 – 1.54) | <0.001 | |
| Model 2c | 28.8 | (25.6 – 31.9) | 23.5 | (22.8 – 24.3) | 1.22 | (1.09 – 1.36) | <0.001 | |
| Model 3d | 26.1 | (23.3 – 29.0) | 23.5 | (22.8 – 24.2) | 1.11 | (1.00 – 1.24) | 0.058 | |
| Any alcohol-related care | ||||||||
| Model 1b | 88.0 | (85.1 – 90.9) | 86.4 | (85.3 – 87.4) | 1.02 | (0.99 – 1.05) | 0.225 | |
| Model 2c | 87.5 | (84.6 – 90.3) | 86.4 | (85.3 – 87.4) | 1.01 | (0.98 – 1.04) | 0.422 | |
| Model 3d | 87.4 | (84.5 – 90.2) | 86.4 | (85.3 – 87.4) | 1.01 | (0.98 – 1.04) | 0.456 | |
AUD, alcohol use disorder; AUDIT-C, Alcohol Use Disorders Identification Consumption; PR, prevalence ratio; VA, Veterans Health Administration
From mixed-effects modified Poisson regression models with logarithm link and a random effect for VA facility, with robust standard errors
Adjusted for fiscal year in which AUDIT-C screen occurred
Adjusted for fiscal year in which AUDIT-C screen occurred, sex, age, race/ethnicity, VA copay status, and marital status
Adjusted for fiscal year in which AUDIT-C screen occurred, sex, age, race/ethnicity, VA copay status, marital status, smoking status, Hepatitis C, HIV, Charlson score without HIV (categories 0, 1, ≥2); any mental health conditions, any non-alcohol SUD