Alcohol and HIV: a study among sexually active adults in rural southwest Uganda.
OBJECTIVE
To investigate the association between alcohol consumption and HIV sero-positivity in a rural Ugandan population.


METHODS
The adult population residing in a cluster of 15 neighbouring villages has been kept under epidemiological surveillance for HIV infection using annual censuses and sero-surveys since 1989. At the eighth annual survey all respondents were asked about their history of alcohol consumption, the sale of alcohol in their household, and other socio-demographic information. After informed consent, blood was drawn for HIV serology.


RESULTS
Of the total adult population 3279 (60%) were interviewed; 48% were males; 905 (27%) had not started sexual activity and were excluded from further analysis. Of the remaining 2374, 8% were HIV infected, 57% had ever drunk alcohol, and 4% lived in households where alcohol was sold. Living in a household where alcohol was sold was associated with a history of having ever drunk alcohol (OR 2.9, 95% CI : 1.7-4.8). HIV prevalence among adults living in households selling alcohol was 15% compared with 8% among those living in households not selling alcohol (OR 2.0, 95% CI : 1.1-3.6). Individuals who had ever drunk alcohol experienced an HIV prevalence twice that of those who had never drunk, 10% versus 5% (OR 2.0, 95% CI : 1.5-2.8). This association remained after adjusting for potential confounders including sale of alcohol in the household and Muslim religion (OR 1.8, 95% CI : 1.2-2.7). Only age, marital status and having ever drunk alcohol independently predicted HIV sero-positivity in a logistic regression model.


CONCLUSIONS
We have demonstrated an association between a history of alcohol consumption and being HIV sero-positive. This unexplored factor may explain in part the observed lower prevalence of HIV infection among Muslims. Public health campaigns need to stress the relationship between HIV and alcohol.
Mbulaiteye
S M
SM
Medical Research Council Programme on AIDS, Uganda Virus Research Institute, PO Box 49, Entebbe, Uganda. mrc@starcom.co.ug
Ruberantwari
A
A
Nakiyingi
J S
JS
Carpenter
L M
LM
Kamali
A
A
Whitworth
J A
JA
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D017280:Condoms / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D007514:Islam; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population; D014454:Uganda / Q000453:epidemiology