Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania, Kenya, and Namibia
Open accessAbstract
This article describes the frequency of alcohol use among HIV-positive patients attending clinical care in sub-Saharan Africa and explores the association between alcohol use, medication adherence, and sexual risk behavior. Data from 3538 patients attending an HIV clinic in Kenya, Tanzania, or Namibia were captured through interview and medical record abstraction. Participants were categorized into three drinking categories: nondrinkers, nonharmful drinkers, and harmful/likely dependent drinkers. A proportional odds model was used to identify correlates associated with categories of alcohol use. Overall, 20% of participants reported alcohol use in the past 6 months; 15% were categorized as nonharmful drinkers and 5% as harmful/likely dependent drinkers. Participants who reported missing a dose of their HIV medications [adjusted odds ratio (AOR): 2.04, 95% confidence interval (CI): 1.67, 2.49]; inconsistent condom use (AOR: 1.49, 95% CI: 1.23, 1.79); exchanging sex for food, money, gifts, or a place to stay (AOR: 1.57, 95% CI: 1.06, 2.32); and having a sexually transmitted infection symptom (AOR: 1.40, 95% CI: 1.10, 1.77) were more likely to be categorized in the higher risk drinking categories. This research highlights the need to integrate alcohol screening and counseling into the adherence and risk reduction counseling offered to HIV-positive patients as part of their routine care. Moreover, given the numerous intersections between alcohol and HIV, policies that focus on reducing alcohol consumption and alcohol-related risk behavior should be integrated into HIV prevention, care, and treatment strategies.
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Interventions for AUD have been reported in various general health care settings in sub-Saharan Africa, including HIV or sexually transmitted disease services, antenatal and postnatal care, tuberculosis care, and inpatient and outpatient care.
“In SSA, interventions for AUD have been reported in various general health care settings (3, 17–27), including services for people with HIV or other sexually transmitted diseases (9, 10, 13–16, 18, 21), antenatal and postnatal care (19, 27–29), care for people with tuberculosis (30, 31), inpatient and outpatient care (20, 26, 32–35).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [22]
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References 50 · Cited by 41
Research works printed but not linked: 7
- Chander G Lau B Moore RD 2006 Hazardous alcohol use: A risk factor for non-adherence and lack of suppression in HIV infection Journal of Acquired Immune Deficiency Syndromes 43 411 417 17099312 PMC2704473
- Kidder DP Bachanas P Medley A Pals S Nuwagaba-Biribonwoha H Ackers M Somi G 2013 HIV prevention in care and treatment settings: Baseline risk behaviors among HIV patients in Kenya, Namibia, and Tanzania PLoS One 8 e57215 10.1371/journal.pone.0057215.s002 23459196 PMC3581447 · DOI
- Luchters S Geibel S Syengo M Lango D King’ola N Temmerman M Chersich MF 2011 Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya BMC Public Health 11 384 392 10.1016/S0140-6736(10)60884-7 21609499 PMC3128017 · DOI
- Peltzer K Ramlagan S 2009 Alcohol use trends in South Africa Journal of Social Sciences 18 1 12
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- Shacham E Agbebi A Stamm K Overton ET 2011 Alcohol consumption is associated with poor health in HIV clinic patient population: A behavioral surveillance study AIDS and Behavior 15 209 213 10.1007/s10461-009-9652-9 20013042 PMC3621137 · DOI
- Woolf-King S Maisto S 2011 Alcohol use and high-risk sexual behavior in sub-Saharan Africa: A narrative review Archives of Sexual Behavior 40 17 42 10.1007/s10508-009-9516-4 19705274 · DOI
- Authors
- Medley, A., Seth, P., Pathak, S., Howard, A. A., DeLuca, N., Matiko, E., Mwinyi, A., Katuta, F., Sheriff, M., Makyao, N., Wanjiku, L., Ngare, C., & Bachanas, P.
- Affiliations
- Centers for Disease Control and Prevention (US)
- ICF International (United States) (US)
- ICAP Global Health (US)
- Ministry of Health and Social Services (NA)
- Ministry of Health and Social Welfare (TZ)
- Corresponding author
- Medley, Amy
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2014-04-29
- Volume
- 26
- Issue
- 10
- Pages
- 1288-1297
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- PMC
- PMC4664067
- OpenAlex
- W2015676769
- Cited by
- 41
- References
- 50
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 4
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcohol consumption, HIV, HIV risk behavior, medication adherence, sexual risk behavior, hazardous drinking, alcoholism, condom use, sex work, sexually transmitted infections, sub-Saharan Africa
- MeSH terms
- Assessment of Medication Adherence, Adult, Alcohol Drinking, Alcoholism, Female, Humans, Kenya, Male, Namibia, Risk-Taking, Sex Factors, Sexual Partners, Socioeconomic Factors, Tanzania, HIV Infections, Proportional Hazards Models, Drug Monitoring, Condoms, Marital Status, Medication Adherence, Binge Drinking
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