Hazardous alcohol consumption and alcohol-related problems are associated with unknown and HIV-positive status in fishing communities in Uganda

ABSTRACT

In Uganda, alcohol consumption is associated with higher HIV prevalence. However, research is needed to better understand how different patterns of alcohol consumption and alcohol-related problems may drive this association. In this cross-sectional study, we examined how hazardous alcohol use and alcohol-related problems such as psychological, physical, and social harms are associated with HIV status in fishing communities in Uganda. 300 (132 male, 168 female) residents of fishing communities in Uganda (75 participants from each of the following occupational groups: fishmongers, alcohol sellers, commercial sex workers (CSW), and fishermen) completed an interviewer-assisted computerized interview. We captured information on sociodemographics and HIV testing history. Prior 12-month hazardous alcohol consumption patterns and alcohol-related problems were assessed with the AUDIT and AUDADIS. 19.7%, 58.0%, and 23.3% of the sample reported being HIV positive, being HIV negative from a test within the prior 12 months, and not knowing their HIV status respectively. 18.7% reported the co-occurrence of hazardous alcohol consumption patterns and alcohol-related problems. 7.7% reported either hazardous alcohol consumption patterns or alcohol-related problems. Compared to non-drinkers, those with co-occurring hazardous consumption and alcohol-related problems had greater odds of being HIV positive (adjOR 2.75, 95% CI 1.17–6.43) and of unknown HIV status (adjOR 3.35, 95% CI 1.52–7.42). Reporting only hazardous consumption levels, only alcohol-related problems, or low-risk drinking, did not increase the odds of being HIV positive or of unknown status. Among those not HIV positive, those with co-occurring hazardous consumption and alcohol-related problems had greater odds of never having had an HIV test (adjOR 3.78, 95% CI 1.63–8.68). The co-occurrence of hazardous alcohol use and alcohol related problems appears to be a prominent risk factor for HIV infection, not knowing one's HIV status, and never testing for HIV in this setting.

KEYWORDS:

• HIV
• alcohol dependence
• alcohol use disorders
• alcohol-related problems
• hazardous alcohol use
• sub-saharan Africa
• fishing communities
• HIV testing

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported the National Institute on Alcohol Abuse and Alcoholism (grant number P01 AA019072, PI: Peter M. Monti) through the Alcohol Research Center on HIV, Brown University. K. Sileo was supported by a T32 Predoctoral Fellowship Award on Substance Abuse, HIV, and Related Infections from the National Institute on Drug Abuse (grant number T32 DA023356, PI: Steffanie Strathdee).