Alcohol Use, Depressive Symptoms and the Receipt of Antiretroviral Therapy in Southwest Uganda

Abstract

Alcohol use and depressive symptoms are associated with reduced access to antiretroviral therapy (ART) in the developed world. Whether alcohol use and depressive symptoms limit access to ART in resource-limited settings is unknown. This cross-sectional study examined the association between alcohol use, depressive symptoms and the receipt of ART among randomly selected HIVpositive persons presenting for primary health care services at an outpatient HIV clinic in Uganda. Depressive symptoms were defined by the Hopkins Symptom Checklist and alcohol use was measured through frequency of consumption questions. Antiretroviral use was assessed using a standardized survey and confirmed by medical record review. Predictors of ART use were determined via logistic regression. Among 421 HIV-infected patients, factors associated with the receipt of ART were having at least primary education, having an opportunistic infection in the last 3 months, and not drinking within the last year.

Obstacles and Proposed Solutions to Effective Antiretroviral Therapy in Resource-Limited Settings

“…Thirty relevant studies were identified, of which 11 were in peerreviewed journals [15][16][17][18][19][20][21][22][23][24][25] and 19 were in conference abstracts. [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The earliest studies included in this review were from 2004, reflecting a greater emphasis on research in this field after major initiatives were undertaken (such as ''3 by 5'' by the WHO and the President's Emergency Plan for AIDS Relief [PEPFAR]) to increase ART access in resource-limited countries.…”

“…[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The earliest studies included in this review were from 2004, reflecting a greater emphasis on research in this field after major initiatives were undertaken (such as ''3 by 5'' by the WHO and the President's Emergency Plan for AIDS Relief [PEPFAR]) to increase ART access in resource-limited countries. Among the 30 studies, 21 were from Africa,* 6 from east/southeast Asia,The data collection methods described in the papers comprised mostly of interviews (22 studies), y surveys (7 studies), 16,27,29,34,39,40,42 review of clinical data (7 studies), 18,20,22,27,31,36,38 and focus-group discussions (6 studies). 21,23,28,32,42,43 Respondents included PLWHA with/without ART (22 studies), z noninfected people including elders, teenagers, and university students (11 studies), § health care workers including nurses, doctors, social workers, laboratory technologists (7 studies), 15,21,25,…”

“…Alcohol consumption. 20,21 9. Mental health problems such as depression, loss of hope arising due to stigma, and discrimination.…”

“…Alcohol consumption and depression have been shown to be related to not receiving treatment. 15,20,21 Some people were fearful of being used as ''guinea-pigs'' or ''subjects'' in medical experiments. 16 Universal and regional issues.…”

Perceived Social Support Among Clients Using Alcohol and Illicit Drugs at the Comprehensive Care Centre at the Coast General Hospital – Kenya: a Descriptive Cross-Sectional Study.

“…Studies carried out in Sub-Saharan Africa reflect a high prevalence. Closer home, a study at a Ugandan university teaching hospital found the prevalence of alcohol use disorders at 12% (Martinez P. et al, 2008) while one in Ethiopia found the prevalence at 32% (Soboka M. et al, 2014).…”