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

Abstract

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.

<p>Health-Related Quality of Life and Associated Factors Among Adult HIV Mono-Infected and TB/HIV Co-Infected Patients in Public Health Facilities in Northeast Ethiopia: A Comparative Cross-Sectional Study</p>

“…Various evidences showed that socio-demographic, clinical, psychological and behavioral factors, immunological status, presence of symptoms, depression, stigma, and social support (Figure 1) are the most frequently and consistently reported factors associated with HRQOL among HIV mono-infected and TB/HIV co-infected people. 7,11,[15][16][17][18][19][20][21][22][23][24] TB/HIV co-infection places a massive burden on health-care systems, particularly in highly affected countries such as Ethiopia.…”

Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross- sectional study

“…The prevalence of this study was in-line with the other studies in Ethiopia which was 32.6% [9] , 30.7% in Togo [10] , 25.7% in Nepal [29] , 28.6% in Brazil [30] and 27% in USA [31] . On the other hand, the prevalence of AUD is lower than the studies in China which is 42.8% [11] and higher than the studies from Ethiopia which is 14.2% [23] and 14 in Nigeria [32] . The difference in prevalence of alcohol use disorder could be due to the variation in the study setting, data collection instrument and the cutoff point of the instrument which was used to assess alcohol use disorder and the sample size in the study.…”

“…A study conducted on drug and alcohol abuse in Ethiopia revealed that the prevalence of hazardous alcohol use and alcohol dependence was 3 and 1.5% in general population respectively [8] . Different studies showed that higher prevalence of AUD among HIV patients; 32% in Ethiopia [9] , 38.4% in four African country [10] , 42% in Nepal [11] , 39.4% in Nigeria [12] and 74.3% in New York, USA [13] .…”

The Quality of Life of Patients with HIV/AIDS Undergoing Antiretroviral Therapy: A Systematic Review

“…Quality of Life There is ART failure Compliance with treatment Decreasing the virus load (Torres, Harrison, La Rosa, Cardoso, et al, 2018) Descriptive 512 clients with HIV QoL Based Quality of life can be improved (Pokhrel, Gaulee Pokhrel, Neupane, & Sharma, 2018) Descriptive 682 clients using ART…”