Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings

Kalichman, Seth C.; Simbayi, Leickness C.; Kaufman, Michelle R.; Cain, Demetria; Jooste, Sean

doi:10.1007/s11121-006-0061-2

Cited by 490 publications

(485 citation statements)

References 48 publications

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“…This association may have resulted, in part, from the causal impact of acute alcohol use on sexual decision‐making 107, resulting in condomless sex 105, 108, 109, 110, 111, 112, 113, 114. Alternatively, other variables could be causally responsible for the associations between alcohol use and HIV/AIDS, especially the effect of risk‐taking behaviours and other personality traits 96, 115.…”

Section: Resultsmentioning

confidence: 99%

The relationship between different dimensions of alcohol use and the burden of disease—an update

et al. 2017

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Background and aimsAlcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs).MethodsSystematic review of reviews and meta‐analyses on alcohol consumption and health outcomes attributable to alcohol use.For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others.ResultsIn total, 255 reviews and meta‐analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD‐10 three‐digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in‐depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently.ConclusionsResearch since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.

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Section: Resultsmentioning

confidence: 99%

The relationship between different dimensions of alcohol use and the burden of disease—an update

et al. 2017

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“…Men were more likely to have a lower QOL in respect to the psychological, level of independence, environment and spiritual domains. Compared to women, Nepalese HIV-positive men might have had problems with multiple substance use and poor engagement in HIV services as reported by the studies in South Africa, where men were more likely to engage in substance use that has negative effect on their use of continuum of care services [42]. …”

Section: Discussionmentioning

confidence: 99%

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Pokhrel

Pokhrel²,

Neupane³

et al. 2018

Global Health Action

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Background: People living with Human Immunodeficiency Virus (HIV) often suffer from alcohol-use disorders resulting in their poor health and treatment outcomes. Little is known about the association of harmful alcohol drinking with their adherence to anti-retroviral therapy (ART) and health-related quality of life (QOL) in low-resource settings. Objective: This study aimed to investigate associations between harmful alcohol drinking, adherence to ART and health-related QOL in HIV-positive people, stratified by gender, in Nepal. Methods: We conducted a cross-sectional study of 682 HIV-positive people on ART to measure their self-reported harmful alcohol drinking and non-adherence to ART in the previous month of data collection. We also measured health-related QOL using a WHOQOL-HIV BREF scale. The association between harmful alcohol drinking and non-adherence to ART was examined using multiple logistic regressions. Additionally, multiple linear regressions examined association between harmful alcohol drinking and QOL. Results: Harmful alcohol drinking was associated with non-adherence to ART among men (AOR: 2.48, 95% CI: 1.50, 4.11, p < 0.001) and women (AOR: 2.52, 95% CI: 1.32, 4.80, p = 0.005). Men were more likely to have lower score for the psychological (β = −0.55, p = 0.021) and level of independence (β = −0.68, p = 0.018) domains when they had harmful alcohol drinking. Moreover, women were more likely to have lower scores for the physical (β = −1.01, p = 0.015), social relations (β = −0.82, p = 0.033), environmental (β = −0.88, p = 0.011), and spiritual (β = −1.30, p = 0.005) domains of QOL when they had harmful alcohol drinking. Conclusions: Harmful alcohol drinking had a negative association with ART adherence and QOL in both HIV-positive men and women in Nepal. Screening for alcohol-use disorders and community-based counseling services should be provided while delivering ART services to improve treatment adherence and QOL.

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“…In the current example involving SABMiller, the world's second largest brewer by sales volume, a conflict of interest arises because of well-established links between alcohol use, violence (including sexual violence) and risky sexual behaviour, 2,3 making alcohol a risk factor in the spread of HIV infection. [4][5][6][7] Reducing alcohol use can therefore be seen as key to reducing HIV infection. [8][9][10] Yet this inevitably conflicts with SABMiller's underlying goal of maximizing profits from alcohol sales.…”

Section: Anna B Gilmore a And Gary Fooks Amentioning

confidence: 99%

Global Fund needs to address conflict of interest

Gilmore

Fooks

2012

Bull. World Health Organ.

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Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings

Cited by 490 publications

References 48 publications

The relationship between different dimensions of alcohol use and the burden of disease—an update

The relationship between different dimensions of alcohol use and the burden of disease—an update

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Global Fund needs to address conflict of interest

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