Alcohol use and non‐adherence to antiretroviral therapy in HIV‐infected patients in West Africa

Abstract

AIM To investigate the association between alcohol use and adherence to Highly Active Antiretroviral Treatment (HAART) among HIV-infected patients in sub-Saharan Africa. DESIGN and MEASURES Cross sectional survey conducted in eight adult HIV treatment centers from Benin, Côte d’Ivoire and Mali. During a four-week period, health workers administered the Alcohol Use Disorders Identification Test to HAART-treated patients and assessed treatment adherence using the AIDS Clinical Trials Group follow-up questionnaire. RESULTS A total of 2920 patients were enrolled with a median age of 38 years (IQR 32–45 years) and a median duration on HAART of 3 years (IQR 1–4 years). Overall, 91.8% of patients were identified as adherent to HAART. Non-adherence was associated with current drinking (OR 1.4; 95% CI 1.1–2.0), hazardous drinking (OR 4.7; 95% CI 2.6–8.6) and was inversely associated with a history of counseling on adherence (OR 0.7; 95% CI 0.5–0.9). CONCLUSION Alcohol consumption and hazardous drinking is associated with non-adherence to HAART among HIV-infected patients from West Africa. thus providing a framework for developing and reinforcing the necessary prevention and intervention strategies.

Alcohol and drug use outcomes among vulnerable women living with HIV: results from the Western Cape Women's Health CoOp

“…Alcohol and other drug use is a major problem among PLWHA (Bhat et al, 2010; Bryant, 2006; Kalichman et al, 2013; Rosen et al, 2013) because of its impact on HIV treatment adherence (Azar et al, 2010; Jaquet et al, 2010; Van geertruyden et al, 2010), disease progression, and treatment outcomes (Baum et al, 2010; Samet et al, 2007). Reducing alcohol and other drug use among PLWHA may hold many personal and public health benefits.…”

“…Alcohol and other drug use have been linked to poor adherence to antiretroviral therapy (ART), (Azar, Springer, Meyer, & Altice, 2010; Grodensky, Golin, Ochtera, & Turner, 2012; Jaquet et al, 2010; Van geertruyden, Woelk, Mukumbi, Ryder, & Colebunders, 2010) more rapid HIV disease progression (Baum et al, 2010; Samet et al, 2007) and poorer HIV treatment outcomes among people living with HIV/AIDS (PLWHA) (Azar et al, 2010). The success of ART in reducing HIV incidence in serodiscordant couples (Cohen et al, 2011) generated hope that HIV epidemics could be controlled and reversed through the use of HIV treatment as prevention (Branson, Viall, & Marum, 2013; Granich, Williams, & Montaner, 2013).…”

Substance Use: Impact on Adherence and HIV Medical Treatment

“…Moreover, low levels of alcohol use are related to better HIV appointment adherence over time, specifically among minority youth with HIV [48]. Finally, recent international studies consistently highlight a significant association between alcohol use and medication nonadherence [49][50][51][52][53][54][55].…”

Adding Fuel to the Fire: Alcohol’s Effect on the HIV Epidemic in Sub-Saharan Africa

“…However, none of the 40 studies in the meta-analysis were conducted in SSA [39]. Several recent quantitative and qualitative studies conducted in SSA have reported associations between alcohol consumption and ART adherence [39][40][41][42][43][44][45][46][47][48][49][50], while a few studies have found no association [51,52] or did not measure or report on alcohol consumption [53,54]. We echo the opinion that research focused on the effect of alcohol consumption on ART adherence specifically in SSA is needed [39], and note that careful consideration must be paid to methods of measuring alcohol consumption in this setting because under-report is likely [9].…”