title: Qualitative study of changes in alcohol use among HIV-infected adults entering care and treatment for HIV/AIDS in rural southwest Uganda.
abstract: Alcohol has a substantial negative impact on the HIV epidemic in sub-Saharan Africa, particularly in Uganda, where heavy alcohol consumption is common. Using a content analytic approach, this qualitative study characterizes changes in alcohol use among 59 HIV-infected Ugandan adults (>18 years old), who reported any alcohol use in the previous year as they entered HIV care. Most participants reported attempting to cease or reduce alcohol intake over the study period. Reasons for decreased use included advice from clinicians, interference with social obligations, threats to financial security, and negative impact on social standing. Participants reported difficulty abstaining from alcohol, with incentives to continue drinking including desire for social inclusion, stress relief, and enjoyment of alcohol. These contrasting incentives created a moral quandary for some participants, who felt 'pulled' between 'good' and 'bad' influences. Results suggest brief interventions addressing self-identified obstacles to change may facilitate long-term reductions in drinking in this population.
authors.affiliation: Department of Emergency Medicine, University of California, San Diego, CA, USA, rsundararajan@ucsd.edu.
authors.forename: Radhika
authors.initials: R
authors.lastname: Sundararajan
authors.forename: Monique A
authors.initials: MA
authors.lastname: Wyatt
authors.forename: Sarah
authors.initials: S
authors.lastname: Woolf-King
authors.forename: Emily E
authors.initials: EE
authors.lastname: Pisarski
authors.forename: Nneka
authors.initials: N
authors.lastname: Emenyonu
authors.forename: Winnie R
authors.initials: WR
authors.lastname: Muyindike
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
authors.forename: Norma C
authors.initials: NC
authors.lastname: Ware
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence / Q000523:psychology* / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D023241:Antiretroviral Therapy, Highly Active; D063425:Binge Drinking / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D033182:Intention; D008297:Male; D036301:Qualitative Research; D012201:Reward; D012424:Rural Population; D014454:Uganda / Q000453:epidemiology