Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania, Kenya, and Namibia

Abstract

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.

Sub-optimal adherence to combination anti-retroviral therapy and its associated factors according to self-report, clinician-recorded and pharmacy-refill assessment methods among HIV-infected adults in Addis Ababa

“…Drinking alcohol was significantly associated with sub-optimal adherence according to self-report. This is in agreement with previous study findings in both resource-limited and resourcerich settings (Conen et al, 2009;Medley et al, 2014), and it might be related to forgetfulness to take ARV drugs on time or inability to strictly follow the refill appointment schedules as a result of drinking. Therefore, interventions aimed at tackling sub-optimal adherence should consider improving social support and limiting alcohol intake as potential program targets.…”

Fatores associados ao uso inconsistente do preservativo entre pessoas vivendo com HIV/Aids

“…In another research conducted in sub-Saharan Africa, including Kenya, Tanzania and Namibia countries, the association between alcohol users and risky sexual behavior in people living with HIV was evaluated. The same highlights the need to integrate alcohol counseling in routine monitoring in people living with HIV/Aids (22) . Given the many intersections between alcohol and HIV, it is necessary the implementation of policies focusing on reducing alcohol consumption and risk behavior.…”

Associations with Unprotected Sexual Behavior Among HIV-Infected Drinkers in Western Kenya

“…They found that highest level of drinking, harmful/likely dependent, was associated with inconsistent condom use, and other high risk behaviors. Binge drinking was also associated with inconsistent condom use [13]. …”