Alcohol consumption among HIV-infected persons in a large urban HIV clinic in Kampala Uganda: a constellation of harmful behaviors
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INTRODUCTION: Alcohol use by persons living with HIV/AIDS (PLWHA) negatively impacts the public health benefits of antiretroviral therapy (ART). Using a standardized alcohol assessment tool, we estimate the prevalence of alcohol use, identify associated factors, and test the association of alcohol misuse with sexual risk behaviors among PLWHA in Uganda. METHODS: A cross-section of PLWHA in Kampala were interviewed regarding their sexual behavior and self-reported alcohol consumption in the previous 6 months. Alcohol use was assessed using the alcohol use disorders identification test (AUDIT). Gender-stratified log binomial regression analyses were used to identify independent factors associated with alcohol misuse and to test whether alcohol misuse was associated with risky sexual behaviors. RESULTS: Of the 725 subjects enrolled, 235 (33%) reported any alcohol use and 135 (18.6%) reported alcohol misuse, while 38 (5.2%) drank hazardous levels of alcohol. Alcohol misuse was more likely among subjects not yet on ART (adjusted prevalence ratio [aPR] was 1.65 p=0.043 for males and 1.79, p=0.019 for females) and those with self-reported poor adherence (aPR for males=1.56, p=0.052, and for females=1.93, p=0.0189). Belonging to Pentecostal or Muslim religious denominations was protective against alcohol misuse compared to belonging to Anglican and Catholic denominations in both sexes (aPR=0.11 for men, p<0.001, and aPR=0.32 for women, p=0.003). Alcohol misuse was independently associated with reporting risky sexual behaviors (aPR=1.67; 95% CI: 1.07-2.60, p=0.023) among males, but not significant among females (aPR=1.29; 95% CI: 0.95-1.74, p=0.098). Non-disclosure of HIV positive status to sexual partner was significantly associated with risky sex in both males (aPR=1.69; p=0.014) and females (aPR 2.45; p<0.001). CONCLUSION: Alcohol use among PLWHA was high, and was associated with self-reported medication non-adherence, non-disclosure of HIV positive status to sexual partner(s), and risky sexual behaviors among male subjects. Interventions targeting alcohol use and the associated negative behaviors should be tested in this setting.
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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 [21]
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- Authors
- Wandera, B., Tumwesigye, N. M., Nankabirwa, J. I., Kambugu, A. D., Parkes-Ratanshi, R., Mafigiri, D. K., Kapiga, S., & Sethi, A. K.
- Affiliations
- Infectious Diseases Institute (UG)
- Makerere University (UG)
- London School of Hygiene & Tropical Medicine (GB)
- University of Wisconsin–Madison (US)
- Corresponding author
- Wandera, Bonnie
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-05-11
- Volume
- 10
- Issue
- 5
- Pages
- e0126236
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4427399
- OpenAlex
- W329137226
- Cited by
- 72
- References
- 52
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 6 · 2023: 6 · 2022: 12 · 2021: 5 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 10 · 2016: 9 · 2015: 1
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Wellcome Trust (087540)
- 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
- alcohol abuse, HIV/AIDS, people living with HIV, sexual risk behavior, antiretroviral therapy adherence, religious affiliation, Pentecostalism, HIV status disclosure, hazardous drinking, alcohol use prevalence
- MeSH terms
- Adult, Alcohol Drinking, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Risk Factors, Sexual Behavior, Uganda, Urban Population, HIV Infections, Prevalence, Public Health Surveillance
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