Alcohol Use and HIV Disease Progression in an Antiretroviral Naive Cohort

Hahn, Judith A.; Cheng, Debbie M.; Emenyonu, Nneka; Lloyd‐Travaglini, Christine; Fatch, Robin; Shade, Starley B.; Ngabirano, Christine; Adong, Julian; Bryant, Kendall; Muyindike, Winnie; Samet, Jeffrey H.

doi:10.1097/qai.0000000000001624

Cited by 33 publications

(33 citation statements)

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“…For this analysis, we analyzed baseline data from 2 longitudinal cohorts of adults living with HIV recruited from the Mbarara Regional Referral Hospital's (MRRH) Immune Suppression Syndrome (ISS) clinic in southwestern Uganda. The studies are part of the Uganda–Russia–Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium and are described in detail elsewhere (Hahn et al., , ). ISS clinic patients were eligible for the Alcohol Drinking Effects Prior to Treatment (ADEPT) study from 2011 through 2014 if they were ≥18 years, fluent in English or Runyankole (the local language), lived within 60 km of the clinic, and were not yet eligible to initiate HAART.…”

Section: Methodsmentioning

confidence: 99%

“…ISS clinic patients were eligible for the Alcohol Drinking Effects Prior to Treatment (ADEPT) study from 2011 through 2014 if they were ≥18 years, fluent in English or Runyankole (the local language), lived within 60 km of the clinic, and were not yet eligible to initiate HAART. Recruitment was targeted to include approximately 50% unhealthy drinkers (defined after study enrollment as Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) score of ≥3 for women and ≥4 for men, or PEth value ≥50 ng/ml; Hahn et al., ). The Biomarker Research on Ethanol Among Those with HIV (BREATH) study was a cohort study examining changes in alcohol use during the first year of HIV/AIDS care at the MRRH ISS Clinic, conducted from 2011 to 2014.…”

Section: Methodsmentioning

confidence: 99%

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Social Desirability Bias Impacts Self‐Reported Alcohol Use Among Persons With HIV in Uganda

Adong

Fatch

Emenyonu

et al. 2019

Alcoholism Clin & Exp Res

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Background: Self-report is widely used to assess alcohol use in research and clinical practice, but may be subject to social desirability bias. We aimed to determine if social desirability impacts self-reported alcohol use.Methods: Among 751 human immunodeficiency virus (HIV)-infected patients from a clinic in southwestern Uganda, we measured social desirability using the Marlowe-Crowne Social Desirability Scale (SDS) Short Form C, self-reported alcohol use (prior 3 months) Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and phosphatidylethanol (PEth), a biomarker of prior 3 weeks' drinking. We conducted multiple regression analyses to assess the relationship between SDS score (low, medium, and high levels) and (i) any self-reported recent alcohol use, among those who were PEth-positive (≥8 ng/ml), and (ii) continuous AUDIT-C score, among those reporting any recent alcohol use. We controlled for PEth level, age, gender, education, economic assets, marital status, religion, spirituality/religiosity, social support, and study cohort.Results: Of 751 participants, 59% were women; the median age was 31 years (interquartile range [IQR]: 26 to 39). Median SDS score was 9 (IQR: 4 to 10). Two-thirds (62%) self-reported any recent alcohol use; median AUDIT-C was 1 (IQR: 0 to 4). Among those who were PEth-positive (57%), 13% reported no recent alcohol use. Those with the highest SDS tertile had decreased odds of reporting any recent alcohol use compared to the lowest tertile, but the association did not reach statistical significance in multivariable analyses (adjusted odds ratio 0.55 [95% confidence interval (CI): 0.25, 1.23]). Among participants self-reporting recent alcohol use, SDS level was negatively associated with AUDIT-C scores (adjusted b: À0.70 [95% CI: À1.19, À0.21] for medium vs. low SDS and À1.42 [95% CI: À2.05, À0.78] for high vs. low SDS).Conclusions: While use of objective measures (e.g., alcohol biomarkers) is desirable for measuring alcohol use, SDS scores may be used to adjust self-reported drinking levels by participants' level of social desirability in HIV research studies.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Social Desirability Bias Impacts Self‐Reported Alcohol Use Among Persons With HIV in Uganda

Adong

Fatch

Emenyonu

et al. 2019

Alcoholism Clin & Exp Res

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“…The primary aim of the ADEPTT study is to estimate the rate of hepatotoxicity to isoniazid (6 months INH) treatment among adults (> = 18 years) who are HIV/LTBI co-infected and are current (prior 3 months) alcohol drinkers and to compare that rate to hepatotoxicity among non-drinkers (abstaining at least one year). We screened PLWH who participated in prior URBAN ARCH studies of alcohol use in the Immune Suppression Syndrome (ISS) clinic of Mbarara Regional Referral Hospital (MRRH) in south-western Uganda from 2010-2017 [25,26]. Eligibility criteria was based on the main ADEPTT study and included: 1) age � 18 years, 2) fluency in English or Runyakole (the local language), 3) HIV-infected on a non-nevirapine containing ART regimen for at least six months, 4) living within 2 hours travel time from the clinic with no plans to move, 5) no evidence of active TB infection based on WHO symptoms criteria, 6) no prior use of TB medicines for treatment and/or prevention of TB, 7) being either a self-reported current (prior 3 month) drinker or abstainer (at least one year since drinking), 8) having alanine aminotransferase [ALT] and aspartate aminotransferase [AST] � 2x of the upper limit of normal (ULN), 9) women who were pregnant.…”

Section: Study Setting and Populationmentioning

confidence: 99%

Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda

et al. 2020

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Background Tuberculosis (TB) is the leading cause of death among people living with HIV (PLWH), and current evidence suggests that heavy alcohol users have an increased risk of developing TB disease compared to non-drinkers. Not known is whether the increased risk for TB disease among alcohol users may reflect higher rates of latent TB infection (LTBI) among this population. We assessed the latent TB infection prevalence based on tuberculin skin testing (TST) and examined association with current alcohol use among HIV-infected persons on antiretroviral therapy (ART) in southwestern Uganda. Methods We included PLWH at the Mbarara Regional Hospital HIV clinic, who were either current alcohol consumers (prior 3 months) or past year abstainers (2:1 enrolment ratio). Participants were recruited for a study of isoniazid preventive therapy for LTBI. TST was performed using 5 tuberculin units of purified protein derivative. The primary outcome was a positive TST reading (�5mm induration), reflecting LTBI. We used logistic regression analyses to assess the cross-sectional association between self-reported current alcohol use and a positive TST. Results Of the 295 of 312 (95%) who returned for TST reading, 63% were females and 63% were current alcohol drinkers. The TST positive prevalence was 27.5% (95% confidence interval [CI]: 22.6%-32.9%). The odds of a positive TST for current alcohol users compared to

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“…A systematic review and meta-analysis study by Duko et al 2019 [7] showed that the average worldwide prevalence of AUD among patients with HIV/AIDS was found to be 29.8%. Other earlier studies in Africa reported that the prevalence of AUD ranges from 17 to 39.4% in Nigeria [8][9][10], 1.4 to 33% in Uganda [11][12][13][14], 6.6 to 48.5% in South Africa [15][16][17][18], 5.4 to 33% in Kenya [19][20][21][22], and 14.8% in Zambia [23]. There exists a scarcity of average data on alcohol use disorders in people with HIV in other African countries despite the high disease burden with people living with HIV (PLWHA) [24].…”

Section: Introductionmentioning

confidence: 99%

The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis

Necho

Belete

Getachew

2020

Subst Abuse Treat Prev Policy

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Background: Alcohol use disorder (AUD) in HIV/AIDS patient's decreases adherence and effectiveness of medications and help-seeking to HIV/AIDS care and treatment. This study, therefore, assessed the average 1 year prevalence and associated factors of alcohol use disorder in HIV/AIDS patients. Methods: We did an electronic data search on PubMed, Scopus, EMBASE, Psych-INFO libraries, African index Medicus and African Journals Online (AJOL). Google scholar was also investigated for non-published articles. The reference lists of published articles were also reviewed. The stata-11meta-prop package was employed. Subgroup and sensitivity analyses were done. Cochran's Q-statistics and the Higgs I 2 test were used to check heterogeneity. Publication bias was evaluated with Egger's test and funnel plots. Results: Of 1362 articles identified using the search strategies; only 22 studies were included in the final analysis. The average 1 year prevalence of AUD was 22.03% (95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). The prevalence of AUD in studies published before 2011, 2011-2015, and after 2015 was found to be 13.47, 24.93, and 22.88% respectively. The average prevalence of AUD among studies with a sample size > 450 was 16.71% whereas it was 26.46% among studies with a sample size < 450. Furthermore, the average prevalence of hazardous, harmful, and dependent drinking was 10.87, 8.1, and 3.12% respectively. Our narrative analysis showed that male sex, cigarette smoking, family history of alcohol use, missing ART medication, mental distress, khat chewing, low CD4 count, and low income were among the associated factors for AUD in people with HIV AIDS. On quantitative meta-analysis for associated factors of AUD, the AOR of being male, Cigarette smoking and khat chewing were 5.5, 3.95, and 3.34 respectively. Conclusion: The average 1 year prevalence of AUD in HIV/AIDs patients was high and qualitatively factors such as being Male, cigarette smoking, and khat chewing were associated with it. Therefore, clinical services for people living with HIV/AIDS should integrate this public health problem. Policymakers should also develop guidelines and implementation strategies for addressing this problem.

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Alcohol Use and HIV Disease Progression in an Antiretroviral Naive Cohort

Cited by 33 publications

References 48 publications

Social Desirability Bias Impacts Self‐Reported Alcohol Use Among Persons With HIV in Uganda

Social Desirability Bias Impacts Self‐Reported Alcohol Use Among Persons With HIV in Uganda

Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda

The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis

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