Hazardous and harmful use of alcohol and/or other drugs and health status among South African patients attending hiv clinics
Abstract
There is growing recognition of the influence of substance use, particularly alcohol use, on HIV disease progression. This study investigated how hazardous/harmful use of alcohol and drugs impacts the health status of 1503 patients attending HIV clinics. Of the sample, 37 % indicated hazardous/harmful drinking and 13 % indicated a drug problem. Hazardous/harmful use of alcohol and drugs was significantly related to health status, with participants using substances more likely to have TB-positive status (χ(2) = 4.30, p < 0.05), less likely to be on ARVs (χ(2) = 9.87, p < 0.05) and having lower CD4 counts (t = 4.01, p < 0.05). Structural equation modelling confirmed the centrality of hazardous/harmful use of alcohol as a direct and indirect determinant of disease progression. Based on these findings it is recommended that patients attending HIV clinics be routinely screened for problematic alcohol and/or drug use, with strong emphasis on ensuring ARV adherence in those with problematic alcohol use.
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Approximately one in five people attending health care facilities in sub-Saharan Africa meet the criteria for AUD.
“Studies conducted in sub-Saharan Africa (SSA) have shown that approximately one in five people attending health care facilities meet the criteria for AUD (3–7).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [6]
South African studies estimate that 40% to 63% of people living with HIV on ART who drink do so at hazardous or harmful levels.
“South African studies estimate that 40% to 63% of PLWH on ART who drink do so at hazardous or harmful levels [8–11].”
From Associations Between Patterns of Alcohol Use and Viral Load Suppression Amongst Women Living with HIV in South Africa (2021) · cites this paper as [8]
Comparable rates of heavy episodic drinking have been reported for women on ART, ranging between 30 and 75% of current drinkers.
“Comparable rates of HED have been reported for women on ART, ranging between 30 and 75% of current drinkers [8–10].”
From Associations Between Patterns of Alcohol Use and Viral Load Suppression Amongst Women Living with HIV in South Africa (2021) · cites this paper as [8]
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- Authors
- Kader, R., Seedat, S., Govender, R., Koch, J. R., & Parry, C. D.
- Corresponding author
- Kader, R.
- Venue
- AIDS and Behavior
- Published
- 2013-08-07
- Volume
- 18
- Issue
- 3
- Pages
- 525-534
- ISSN
- 1090-7165 (ISSN-L)
- 1573-3254
- OpenAlex
- W2055747888
- Cited by
- 83
- References
- 29
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 12 · 2023: 3 · 2022: 12 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 1
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- AIDS and Behavior (publishedVersion)
- PubMed (publishedVersion)
- Open University of Cape Town (University of Cape Town) (submittedVersion)
- Funders
- U.S. President’s Emergency Plan for AIDS Relief
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Centers for Disease Control and Prevention
- U.S. Public Health Service (5U2GPS001137)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- hazardous drinking, HIV, substance use, HIV disease progression, tuberculosis, antiretroviral therapy adherence, CD4 count, health status, screening, South Africa
- MeSH terms
- Adult, Aged, Alcohol Drinking, Alcoholism, Cross-Sectional Studies, Female, Health Status, Humans, Male, Regression Analysis, Risk, Socioeconomic Factors, South Africa, Urban Population, HIV Infections, Prevalence, CD4 Lymphocyte Count, Anti-HIV Agents, Viral Load, Substance-Related Disorders
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