title: Self-reported alcohol abstinence associated with ART initiation among HIV-infected persons in rural Uganda.
abstract: BACKGROUND
  There is limited data on the impact of anti-retroviral treatment (ART) initiation on alcohol consumption. We characterized predictors of abstaining from alcohol among HIV-infected individuals following ART initiation.
  
  
  METHODS
  We analyzed data from a prospective cohort of HIV-infected adults in Mbarara, Uganda with quarterly measures of self-reported alcohol consumption, socio-demographics, health status, and blood draws. We used pooled logistic regression to evaluate predictors of becoming abstinent from alcohol for at least 90 days after baseline.
  
  
  RESULTS
  Among the 502 participants, 108 (21.5%) were current drinkers who consumed alcohol within 90 days of baseline, 206 (41.0%) were former drinkers, and 188 (37.5%) were lifetime abstainers at baseline. Among current drinkers, 67 (62.0%) drank at hazardous levels. 90 of current drinkers (83.3%) abstained from alcohol at least for 90 days over 3.6 median years of follow-up [IQR 2-4.8]; of those 69 (76.7%) remained abstinent for a median duration of follow-up of 3.25 years [1.6-4.5]. Becoming abstinent was independently associated with lower baseline AUDIT score (adjusted odds ratio [AOR] 0.95 [95%CI 0.91-0.99]), baseline physical health score (AOR 0.92 [0.87-0.97]), and decreases in physical health score at follow-up visits (AOR 0.92 [0.88-0.97)). Alcohol abstinence was most likely to start immediately after ART initiation (AORs for 6 month versus 3 month visit: 0.25 [0.10-0.61]; 9 month visit or later versus 3 month visit: 0.04 [0.02-0.09]).
  
  
  CONCLUSIONS
  We found that a large majority of drinkers starting ART reported that they became and remained abstinent from alcohol. ART initiation may be an opportune time to implement interventions for alcohol consumption and other health behaviors.
authors.affiliation: University of California, San Francisco, United States; San Francisco Department of Public Health, United States.
authors.forename: Glenn-Milo
authors.initials: GM
authors.lastname: Santos
authors.affiliation: University of California, San Francisco, United States.
authors.forename: Nneka I
authors.initials: NI
authors.lastname: Emenyonu
authors.affiliation: Mbarara University of Science and Technology, Uganda.
authors.forename: Francis
authors.initials: F
authors.lastname: Bajunirwe
authors.affiliation: University of California, San Francisco, United States.
authors.forename: A
authors.initials: A
authors.lastname: Rain Mocello
authors.affiliation: University of California, San Francisco, United States.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Martin
authors.affiliation: University of California, San Francisco, United States.
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.affiliation: Massachusetts General Hospital, United States.
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.affiliation: University of California, San Francisco, United States. Electronic address: Judy.hahn@ucsf.edu.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence / Q000523:psychology / Q000639:trends*; D000428:Alcohol Drinking / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012424:Rural Population / Q000639:trends*; D057566:Self Report; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology
keywords: ART-initiation; Africa; Alcohol; Alcohol abstinence; Antiretroviral treatment; HIV; Hazardous drinking; Uganda