Title

Prevalence and correlates of alcohol drinking among adults living with HIV: results from the Tanzania HIV Impact Survey 2016-2017

Presenter

Jennifer Imaa

Authors

J. Imaa¹, A. Ismail^1,2, A. Kailembo¹, C. Mahende¹, M. Amuri¹, N. Schaad¹, R. Laws³, W. Maokola⁴, H. Maruyama⁵, D. Hoos⁶, J. Francis⁷, B. Njiro⁷, M. Swaminathan¹, M.F. Jalloh¹, G.S. Mgomella¹

Institutions

¹US Centers for Disease Control and Prevention, Dar es Salaam, Tanzania, United Republic of, ²Integral Global Consulting, Tucker, United States, ³US Centers for Disease Control and Prevention, Atlanta, United States, ⁴National AIDS Control Programme, Dodoma, Tanzania, United Republic of, ⁵ICAP at Columbia University, Dar es Salaam, Tanzania, United Republic of, ⁶ICAP at Columbia University, New York, United States, ⁷University of the Witwatersrand, Department of Family Medicine and Primary Care, Johannesburg, South Africa

BACKGROUND: Alcohol consumption is associated with increased risk for HIV infection. Further, hazardous drinking has been linked to poor health outcomes among people living with HIV (PLHIV) including poor adherence to antiretroviral therapy (ART). In Tanzania, few studies have examined the potential effects of alcohol use on ART use and viral load suppression (VLS). We examined the prevalence and correlates of alcohol use among PLHIV in Tanzania.
METHODS: We used data from the Tanzania HIV Impact Survey 2016-2017, a cross-sectional household-based nationally representative survey. Consenting participants were interviewed and tested for HIV with return of results using the Tanzania national algorithm. HIV-positive results were laboratory confirmed and tested for viral load. VLS was defined as HIV RNA <1,000 copies/ml. Our analysis included laboratory confirmed PLHIV aged 15 years and older. We classified participants who responded to question on alcohol frequency in the past 12 months as non-drinkers or drinkers. We used AUDIT-C scores to determine hazardous drinking status. The primary outcome variable was self-reported alcohol consumption. Secondary outcomes included VLS and self-reported missing days of ART. Logistic regression models were used to assess correlates of overall drinking, ART and VLS. We estimated odds ratios (ORs) with their corresponding 95% confidence intervals (95% CI).
RESULTS: Among 1,812 PLHIV, 33.9% were classified as drinkers, with 246 (13.1%) being hazardous drinkers. Among males, 17.9% were considered hazardous drinkers compared to 11.8% of females. The odds of alcohol consumption were two times greater among males compared to females (aOR:2.31, 95% CI: 1.69-3.16) and almost three times greater among older adults, aged 50+ years compared to younger adults, aged 15-24 years (aOR: 2.91, 95% CI: 1.45-5.81). Further, drinkers had 75% greater odds of missing one or more days of ART in each month compared to non-drinkers (aOR: 1.75, 95% CI: 1.14-2.69). The association between VLS and alcohol consumption was not statistically significant in the multivariable model.
CONCLUSIONS: These findings highlight the sub-populations where alcohol use is most prevalent among PLHIV in Tanzania. Given alcohol use is associated with missing more days of ART, addressing alcohol use among PLHIV can aid in increasing ART adherence.

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