Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania, Kenya, and Namibia.
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.
a Division of Global HIV/AIDS , U.S. Centers for Disease Control and Prevention , Atlanta , GA , USA.
Amy
A
Medley
Puja
P
Seth
Sonal
S
Pathak
Andrea A
AA
Howard
Nickolas
N
DeLuca
Eva
E
Matiko
Abubakari
A
Mwinyi
Frieda
F
Katuta
Mushin
M
Sheriff
Neema
N
Makyao
Lucy
L
Wanjiku
Carol
C
Ngare
Pamela
P
Bachanas
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control; D063425:Binge Drinking / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D017533:Marital Status; D009276:Namibia / Q000453:epidemiology; D016016:Proportional Hazards Models; D012309:Risk-Taking; D012737:Sex Factors; D012747:Sexual Partners / Q000145:classification; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D016903:Drug Monitoring
HIV risk behavior; HIV/AIDS; alcohol use; sub-Saharan Africa