Alcohol use and depression: link with adherence and viral suppression in adult patients on antiretroviral therapy in rural Lesotho, Southern Africa: a cross-sectional study.
Depression and alcohol use disorder have been shown to be associated with poor adherence to antiretroviral therapy (ART). Studies examining their association with viral suppression in rural Africa are, however, scarce.



This study reports prevalence of depressive symptoms and alcohol use disorder, and their potential association with adherence and viral suppression in adult patients on ART in ten clinics in rural Lesotho, Southern Africa.



Among 1,388 adult patients (69 % women), 80.7 % were alcohol abstinent, 6.3 % were hazardous drinkers (men: 10.7 %, women: 4.4 %, p < 0.001). The prevalence of depressive symptoms was 28.8 % (men 20.2 %, women 32.7 %, p < 0.001). Both alcohol consumption (adjusted odds-ratio: 2.09, 95 % CI: 1.58-2.77) and alcohol use disorder (2.73, 95 % CI: 1.68-4.42) were significantly associated with poor adherence. There was, however, no significant association with viral suppression.



Whereas the results of this study confirm previously reported association of alcohol use disorder with adherence to ART, there was no association with viral suppression.



April 28th 2014; NCT02126696 .
Faculty of Medicine, University of Geneva, UDREM, 1 Rue Michel Servet, 1211, Geneva 4, Switzerland. bernard.cerutti@unige.ch.
Bernard
0000-0002-7929-3373
B
Cerutti
Dependencies Unit, Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland.
Barbara
B
Broers
SolidarMed, Swiss Organization for Health in Africa, Maseru, Lesotho.
Motlomelo
M
Masetsibi
SolidarMed, Swiss Organization for Health in Africa, Maseru, Lesotho.
Olatunbosun
O
Faturiyele
SolidarMed, Swiss Organization for Health in Africa, Maseru, Lesotho.
Likabelo
L
Toti-Mokoteli
SolidarMed, Swiss Organization for Health in Africa, Maseru, Lesotho.
Mokete
M
Motlatsi
Department of Biomedicine, University of Basel, Basel, Switzerland.
Joelle
J
Bader
Department of Biostatistics, Epidemiology and Public Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Thomas
T
Klimkait
Clinical Research Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Niklaus D
ND
Labhardt
D000328:Adult; D000349:Africa; D000353:Africa, Southern; D064829:Alcohol Abstinence / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000453:epidemiology*; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D007927:Lesotho / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012424:Rural Population; D016903:Drug Monitoring
D044966:Anti-Retroviral Agents
Africa; Alcohol; Depression; HIV, antiretroviral therapy; Medication adherence