Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017
Abstract Introduction Hazardous alcohol use (HAU), defined as a pattern of alcohol consumption that increases the risk of harmful consequences for the user or others, is associated with an elevated risk of human immunodeficiency virus (HIV) infection and poor health outcomes. We describe the associa...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-11-01
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| Series: | Journal of the International AIDS Society |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jia2.26029 |
| _version_ | 1811188111334440960 |
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| author | Gregory C. Chang Christine A. West Evelyn Kim Andrea J. Low Kathryn E. Lancaster Stephanie S. Behel Steven Y. Hong Leigh Ann Miller Rachel Silver George S. Mgomella Jennifer Imaa Werner M. Maokola Thomas Carpino Gili Hrusa Rachel M. Bray Annie Mwila Godfrey Musuka Christopher O'Connell Stephen McCracken Andrew C. Voetsch |
| author_facet | Gregory C. Chang Christine A. West Evelyn Kim Andrea J. Low Kathryn E. Lancaster Stephanie S. Behel Steven Y. Hong Leigh Ann Miller Rachel Silver George S. Mgomella Jennifer Imaa Werner M. Maokola Thomas Carpino Gili Hrusa Rachel M. Bray Annie Mwila Godfrey Musuka Christopher O'Connell Stephen McCracken Andrew C. Voetsch |
| author_sort | Gregory C. Chang |
| collection | DOAJ |
| description | Abstract Introduction Hazardous alcohol use (HAU), defined as a pattern of alcohol consumption that increases the risk of harmful consequences for the user or others, is associated with an elevated risk of human immunodeficiency virus (HIV) infection and poor health outcomes. We describe the association between people living with HIV (PLHIV) who report HAU and key HIV indicators. Gaps in current literature in estimating HAU on HIV outcomes at the regional level of Eastern and Southern Africa still exist and our analysis aims to address this issue. Methods We used weighted pooled data (2015–2017) from the nationally representative Population‐based HIV Impact Assessments among adults who provided written consent aged 18–59 years from Eswatini, Malawi, Namibia, Tanzania, Zambia and Zimbabwe. We estimated differences in the prevalence of HIV infection and The Joint United Nations Programme on HIV and AIDS (UNAIDS) 90‐90‐90 indicators between PLHIV by HAU status using log‐binomial regression, stratified by sex. HAU was determined using the Alcohol Use Identification Test—Consumption. Results Among the 9755 women and 4444 men who tested HIV positive, 6.6% of women and 21.8% of men engaged in HAU. Women who reported HAU were more likely to be HIV positive (adjusted prevalence ratio [aPR] = 1.31, 95% CI: 1.18–1.46) compared to those who did not report HAU. For the UNAIDS 90‐90‐90 targets, women who engaged in HAU were more likely to be unaware of their HIV‐positive status (aPR = 1.22, 95% CI: 1.01–1.47) and not on antiretroviral therapy (ART) (aPR = 1.73, 95% CI: 1.26–2.37). Men who engaged in HAU were more likely to be unaware of their HIV‐positive status (aPR = 1.56, 95% CI 1.39–1.76) and not on ART (aPR = 1.72, 95% CI: 1.30–2.29). No difference in viral load suppression, defined as <1000 copies/ml of HIV RNA, was seen by sex. Conclusions PLHIV who engage in HAU were more likely to have suboptimal outcomes along the HIV care continuum when compared to those who did not engage in HAU. Targeted interventions, such as alcohol screening for HAU in HIV testing and treatment settings and HIV prevention efforts in alcohol‐based venues, may help countries reach HIV epidemic control by 2030. |
| first_indexed | 2024-04-11T14:13:53Z |
| format | Article |
| id | doaj.art-bc77696e3ccb4968bbbf7cce8c6574ec |
| institution | Directory Open Access Journal |
| issn | 1758-2652 |
| language | English |
| last_indexed | 2024-04-11T14:13:53Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj.art-bc77696e3ccb4968bbbf7cce8c6574ec2022-12-22T04:19:36ZengWileyJournal of the International AIDS Society1758-26522022-11-012511n/an/a10.1002/jia2.26029Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017Gregory C. Chang0Christine A. West1Evelyn Kim2Andrea J. Low3Kathryn E. Lancaster4Stephanie S. Behel5Steven Y. Hong6Leigh Ann Miller7Rachel Silver8George S. Mgomella9Jennifer Imaa10Werner M. Maokola11Thomas Carpino12Gili Hrusa13Rachel M. Bray14Annie Mwila15Godfrey Musuka16Christopher O'Connell17Stephen McCracken18Andrew C. Voetsch19Division of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Lilongwe MalawiICAP at Columbia University New York New York USADivision of EpidemiologyCollege of Public HealthThe Ohio State University Columbus Ohio USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Windhoek NamibiaDivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Dar es Salaam TanzaniaDivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Dar es Salaam TanzaniaNational AIDS Control Programme Ministry of Health Community Development Gender Elderly and Children Dar es Salaam TanzaniaICAP at Columbia University New York New York USAICAP at Columbia University New York New York USAICAP at Columbia University New York New York USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Lusaka ZambiaICAP at Columbia University Harare ZimbabweCenter for Substance Abuse PreventionSubstance Abuse and Mental Health Services Administration Rockville Maryland USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USADivision of Global HIV and TB Center for Global Health US Centers for Disease Control and Prevention Atlanta Georgia USAAbstract Introduction Hazardous alcohol use (HAU), defined as a pattern of alcohol consumption that increases the risk of harmful consequences for the user or others, is associated with an elevated risk of human immunodeficiency virus (HIV) infection and poor health outcomes. We describe the association between people living with HIV (PLHIV) who report HAU and key HIV indicators. Gaps in current literature in estimating HAU on HIV outcomes at the regional level of Eastern and Southern Africa still exist and our analysis aims to address this issue. Methods We used weighted pooled data (2015–2017) from the nationally representative Population‐based HIV Impact Assessments among adults who provided written consent aged 18–59 years from Eswatini, Malawi, Namibia, Tanzania, Zambia and Zimbabwe. We estimated differences in the prevalence of HIV infection and The Joint United Nations Programme on HIV and AIDS (UNAIDS) 90‐90‐90 indicators between PLHIV by HAU status using log‐binomial regression, stratified by sex. HAU was determined using the Alcohol Use Identification Test—Consumption. Results Among the 9755 women and 4444 men who tested HIV positive, 6.6% of women and 21.8% of men engaged in HAU. Women who reported HAU were more likely to be HIV positive (adjusted prevalence ratio [aPR] = 1.31, 95% CI: 1.18–1.46) compared to those who did not report HAU. For the UNAIDS 90‐90‐90 targets, women who engaged in HAU were more likely to be unaware of their HIV‐positive status (aPR = 1.22, 95% CI: 1.01–1.47) and not on antiretroviral therapy (ART) (aPR = 1.73, 95% CI: 1.26–2.37). Men who engaged in HAU were more likely to be unaware of their HIV‐positive status (aPR = 1.56, 95% CI 1.39–1.76) and not on ART (aPR = 1.72, 95% CI: 1.30–2.29). No difference in viral load suppression, defined as <1000 copies/ml of HIV RNA, was seen by sex. Conclusions PLHIV who engage in HAU were more likely to have suboptimal outcomes along the HIV care continuum when compared to those who did not engage in HAU. Targeted interventions, such as alcohol screening for HAU in HIV testing and treatment settings and HIV prevention efforts in alcohol‐based venues, may help countries reach HIV epidemic control by 2030.https://doi.org/10.1002/jia2.26029HIV care continuumPHIAhazardous alcohol usehazardous drinkingUNAIDS 90‐90‐90HIV epidemiology |
| spellingShingle | Gregory C. Chang Christine A. West Evelyn Kim Andrea J. Low Kathryn E. Lancaster Stephanie S. Behel Steven Y. Hong Leigh Ann Miller Rachel Silver George S. Mgomella Jennifer Imaa Werner M. Maokola Thomas Carpino Gili Hrusa Rachel M. Bray Annie Mwila Godfrey Musuka Christopher O'Connell Stephen McCracken Andrew C. Voetsch Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017 Journal of the International AIDS Society HIV care continuum PHIA hazardous alcohol use hazardous drinking UNAIDS 90‐90‐90 HIV epidemiology |
| title | Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017 |
| title_full | Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017 |
| title_fullStr | Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017 |
| title_full_unstemmed | Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017 |
| title_short | Hazardous alcohol use and HIV indicators in six African countries: results from the Population‐based HIV Impact Assessments, 2015–2017 |
| title_sort | hazardous alcohol use and hiv indicators in six african countries results from the population based hiv impact assessments 2015 2017 |
| topic | HIV care continuum PHIA hazardous alcohol use hazardous drinking UNAIDS 90‐90‐90 HIV epidemiology |
| url | https://doi.org/10.1002/jia2.26029 |
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