Decreases in self-reported alcohol consumption following HIV counseling and testing at Mulago Hospital, Kampala, Uganda
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BACKGROUND: Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT. METHODS: We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at baseline when they last consumed alcohol, and prior three month alcohol consumption was measured using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) at baseline and quarterly for one year. Hazardous alcohol consumption was defined as scoring ≥3 or ≥4 for women and men, respectively. We examined correlates of alcohol use at baseline, and of hazardous and non-hazardous drinking during the year of follow-up using multinomial logistic regression, clustered at the participant level to account for repeated measurements. RESULTS: Prior to HCT, 30% were current drinkers (prior three months), 27% were past drinkers (>3 months ago), and 44% were lifetime abstainers. One-third (35%) of the current drinkers met criteria for hazardous drinking. Hazardous and non-hazardous self-reported alcohol consumption declined after HCT, with 16% of baseline current drinkers reporting hazardous alcohol use 3 months after HCT. Independent predictors (p < 0.05) of continuing non-hazardous and hazardous alcohol consumption after HCT were sex (male), alcohol consumption prior to HCT (hazardous), and HIV status (negative). Among those with HIV, non-hazardous drinking was less likely among those taking antiretroviral therapy (ART). CONCLUSIONS: HCT may be an opportune time to intervene with alcohol consumption. Those with HIV experienced greater declines in alcohol consumption after HCT, and non-hazardous drinking decreased for those with HIV initiating ART. HCT and ART initiation may be ideal times to intervene with alcohol consumption. Screening and brief intervention (SBI) to reduce alcohol consumption should be considered for HCT and HIV treatment venues.
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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 [24]
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Illness Experiences of People Living with HIV in Kenya: A Case Study of Kisumu County
Owino, G. (2015) · PUB – Publications at Bielefeld University (Bielefeld University) · doi:10.13140/rg.2.1.1545.9049
Sundararajan, R. L., Wyatt, M. A., Ware, P. N. C., Woolf‐King, S. E., Emenyonu, N. I., Hahn, J. A., & Muyindike, W. R. (2014)
Self-citationKalichman, S. C., Banas, E., Shkembi, B., Kalichman, M. O., & Mathews, C. (2023) · Journal of Behavioral Medicine · doi:10.1007/s10865-023-00438-2
KALICHMAN, S., Mathews, C., Kalichman, M. O., Banas, E., & Shkembi, B. (2026) · International Journal of Behavioral Medicine · doi:10.1007/s12529-026-10494-y
- Authors
- Hahn, J. A., Fatch, R., Wanyenze, R. K., Baveewo, S., Kamya, M. R., Bangsberg, D. R., & Coates, T. J.
- Affiliations
- University of California, San Francisco (US)
- Makerere University (UG)
- Massachusetts General Hospital (US)
- University of California, Los Angeles (US)
- Corresponding author
- Hahn, Judith A
- Venue
- BMC Infectious Diseases
- Published
- 2014-07-20
- Volume
- 14
- Issue
- 1
- Pages
- 403-403
- ISSN
- 1471-2334 (ISSN-L)
- PMC
- PMC4223423
- OpenAlex
- W1996206248
- Cited by
- 39
- References
- 58
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 6 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 8 · 2015: 5 · 2014: 2
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Infectious Diseases (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PDXScholar (Portland State University) (submittedVersion, cc-by)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (NIH K24, and K24, NIH-R01)
- National Institute on Alcohol Abuse and Alcoholism (U01AA020776, R01AA018631, K24AA022586)
- National Institute of Mental Health (R01MH077512, K24MH087227)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV counseling and testing, alcohol consumption, hazardous drinking, HIV, antiretroviral therapy, screening and brief intervention, alcohol screening, AUDIT-C, linkage to HIV care
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Alcoholism, Counseling, Female, Humans, Male, Middle Aged, Uganda, HIV Infections, Young Adult, Self Report
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