High prevalence of binge drinking among people living with HIV in four African countries

• Published in: Journal of the International AIDS Society Vol. 21; no. 12; pp. e25202 - n/a
• Main Authors: Nouaman, Marcellin N, Vinikoor, Michael, Seydi, Moussa, Ekouevi, Didier K, Coffie, Patrick A, Mulenga, Lloyd, Tanon, Aristophane, Egger, Matthias, Dabis, François, Jaquet, Antoine, Wandeler, Gilles
• Format: Journal Article
• Language: English
• Published: Switzerland International AIDS Society 01-12-2018; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Acquired immune deficiency syndrome; Adult; Africa South of the Sahara - epidemiology; AIDS; alcohol; Alcohol use; Alcoholic beverages; Antiretroviral agents; Antiretroviral drugs; antiretroviral therapy; Beverages; binge drinking; Binge Drinking - epidemiology; Cross-Sectional Studies; Dosage and administration; Drinking (Alcoholic beverages); Drug therapy; Female; Health aspects; Hepatitis; HIV; HIV infections; HIV Infections - complications; Human immunodeficiency virus; Humans; Logistic Models; Male; Middle Aged; Population; Prevalence; Risk factors; Studies; sub‐Saharan Africa; Tobacco; viral hepatitis; Africa South of the Sahara; Sub-Saharan Africa; Zambia; Togo; United States > US; Senegal; Southern Africa; Africa; alcohol; viral hepatitis; sub-Saharan Africa; binge drinking; HIV; antiretroviral therapy
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1002/jia2.25202

Introduction
Excessive alcohol consumption leads to unfavourable outcomes in people living with HIV (PLHIV), including reduced adherence to antiretroviral therapy (ART) and engagement into care. However, there is limited information on alcohol consumption patterns among PLHIV in sub‐Saharan Africa.
Methods
Using a cross‐sectional approach, the Alcohol Use Disorders Identification Test (AUDIT‐C) was administered to PLHIV attending HIV clinics in Côte d'Ivoire, Togo, Senegal and Zambia (2013 to 2015). Hazardous drinking was defined as an AUDIT‐C score ≥4 for men or ≥3 for women, and binge drinking as ≥6 drinks at least once per month. The prevalence of binge drinking was compared to estimates from the general population using data from the World Health Organization. Factors associated with binge drinking among persons declaring any alcohol use in the past year were assessed using a logistic regression model to estimate odds ratio (OR) and their corresponding 95% confidence intervals (CI).
Results
Among 1824 PLHIV (median age 39 years, 62.8% female), the prevalence of hazardous alcohol use ranged from 0.9% in Senegal to 38.4% in Zambia. The prevalence of binge drinking ranged from 14.3% among drinkers in Senegal to 81.8% in Zambia, with higher estimates among PLHIV than in the general population. Male sex (OR 2.4, 95% CI 1.6 to 3.7), tobacco use (OR 1.7, 95% CI 1.0 to 2.9) and living in Zambia were associated with binge drinking.
Conclusions
Alcohol consumption patterns varied widely across settings and binge drinking was more frequent in HIV‐positive individuals compared to the general population. Interventions to reduce excessive alcohol use are urgently needed to optimize adherence in the era of universal ART.