Decreases in self-reported alcohol consumption following HIV counseling and testing at Mulago Hospital, Kampala, Uganda

BMC Infectious Diseases

Thomas J Coates¹  David R Bangsberg⁴  Moses R Kamya⁵  Steven Baveewo³  Rhoda K Wanyenze⁵  Robin Fatch²  Judith A Hahn² 

[1] University of California, Los Angeles, USA;University of California, San Francisco, Box 0886, San Francisco, CA 94143-0886, USA;Marie Stopes Uganda, Kampala, Uganda;Massachusetts General Hospital, Boston, MA, USA;Makerere University, Kampala, Uganda

关键词: Screening and brief intervention;    Antiretroviral therapy;    HIV counseling and testing;    HIV;    Africa;    Alcohol;   

Others  :  1127325
DOI  :  10.1186/1471-2334-14-403

 received in 2014-02-28, accepted in 2014-07-10,  发布年份 2014

【 摘 要 】

Background

Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT.

Methods

We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at baseline when they last consumed alcohol, and prior three month alcohol consumption was measured using the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) at baseline and quarterly for one year. Hazardous alcohol consumption was defined as scoring ≥3 or ≥4 for women and men, respectively. We examined correlates of alcohol use at baseline, and of hazardous and non-hazardous drinking during the year of follow-up using multinomial logistic regression, clustered at the participant level to account for repeated measurements.

Results

Prior to HCT, 30% were current drinkers (prior three months), 27% were past drinkers (>3 months ago), and 44% were lifetime abstainers. One-third (35%) of the current drinkers met criteria for hazardous drinking. Hazardous and non-hazardous self-reported alcohol consumption declined after HCT, with 16% of baseline current drinkers reporting hazardous alcohol use 3 months after HCT. Independent predictors (p < 0.05) of continuing non-hazardous and hazardous alcohol consumption after HCT were sex (male), alcohol consumption prior to HCT (hazardous), and HIV status (negative). Among those with HIV, non-hazardous drinking was less likely among those taking antiretroviral therapy (ART).

Conclusions

HCT may be an opportune time to intervene with alcohol consumption. Those with HIV experienced greater declines in alcohol consumption after HCT, and non-hazardous drinking decreased for those with HIV initiating ART. HCT and ART initiation may be ideal times to intervene with alcohol consumption. Screening and brief intervention (SBI) to reduce alcohol consumption should be considered for HCT and HIV treatment venues.

【 授权许可】

   
2014 Hahn et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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