title: Alcohol Interactive Toxicity Beliefs and ART Non-adherence Among HIV-Infected Current Drinkers in Mbarara, Uganda.
abstract: Interactive toxicity beliefs regarding mixing alcohol and antiretroviral therapy (ART) may influence ART adherence. HIV-infected patients in Uganda completed quarterly visits for 1 year, or one visit at 6 months, depending on study randomization. Past month ART non-adherence was less than daily or <100 % on a visual analog scale. Participants were asked if people who take alcohol should stop taking their medications (belief) and whether they occasionally stopped taking their medications in anticipation of drinking (behavior). Visits with self-reported alcohol use and ART use for ≥30 days were included. We used logistic regression to examine correlates of the interactive toxicity belief and behavior, and to determine associations with ART non-adherence. 134 participants contributed 258 study visits. The toxicity belief was endorsed at 24 %, the behavior at 15 %, and any non-adherence at 35 % of visits. In multivariable analysis, the odds of non-adherence were higher for those endorsing the toxicity behavior [adjusted odds ratio (AOR) 2.06; 95 % confidence interval (CI) 0.97-4.36] but not the toxicity belief (AOR 0.63; 95 % CI 0.32-1.26). Clear messaging about maintaining adherence, even if drinking, could benefit patients.
authors.affiliation: Department of Medicine, University of California San Francisco, Box 1224, 550 16th Street, San Francisco, CA, 94158, USA. robin.fatch@ucsf.edu.
authors.forename: Robin
authors.initials: R
authors.lastname: Fatch
authors.affiliation: Department of Medicine, University of California San Francisco, Box 1224, 550 16th Street, San Francisco, CA, 94158, USA.
authors.forename: Nneka I
authors.initials: NI
authors.lastname: Emenyonu
authors.affiliation: Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Winnie
authors.initials: W
authors.lastname: Muyindike
authors.affiliation: Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Allen
authors.initials: A
authors.lastname: Kekibiina
authors.affiliation: Department of Medicine, University of California San Francisco, Box 1224, 550 16th Street, San Francisco, CA, 94158, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Woolf-King
authors.affiliation: Department of Medicine, University of California San Francisco, Box 1224, 550 16th Street, San Francisco, CA, 94158, USA.|Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D057566:Self Report; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: ART; Adherence; Africa; Alcohol; Interactive toxicity beliefs