High Levels of Persistent Problem Drinking in Women at High Risk for HIV in Kampala, Uganda: A Prospective Cohort Study

Abstract

The aim of this study was to describe the epidemiology of problem drinking in a cohort of women at high-risk of HIV in Kampala, Uganda. Overall, 1027 women at high risk of HIV infection were followed from 2008 to 2013. The CAGE and AUDIT questionnaires were used to identify problem drinkers in the cohort. Interviewer-administered questionnaires were used to ascertain socio-demographic and behavioural factors. Blood and genital samples were tested for HIV and other sexually transmitted infections. At enrollment, most women (71%) reported using alcohol at least weekly and about a third reported having drunk alcohol daily for at least 2 weeks during the past 3 months. Over half (56%) were problem drinkers by CAGE at enrollment, and this was independently associated with vulnerability (being divorced/separated/widowed, less education, recruiting clients at bars/clubs, and forced sex at first sexual experience). Factors associated with problem drinking during follow-up included younger age, meeting clients in bars/clubs, number of clients, using drugs and HSV-2 infection. HIV prevalence was associated with drinking at enrollment, but not during follow-up. This longitudinal study found high levels of persistent problem drinking. Further research is needed to adapt and implement alcohol-focused interventions in vulnerable key populations in sub-Saharan Africa.

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

“…Previously, we have seen how adherence changes over time (Mbonye, Nakamanya, Birungi, et al, 2013;; this may also be the case with this group, especially given the fact many start treatment without the strong motivation of those who started when they were already very ill or were aware that they had failing health. Although women, like those attending the clinic in Kampala, have been shown to be capable of adhering at comparable levels with other women in the general population (Mountain et al, 2014), barriers to adherence such as alcohol use, partner change, high mobility, stigma and poor disclosure are important factors in their lives that may affect their future on ART (Weiss et al, 2016).…”

Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

“…For instance, globally, the prevalence of current drinking increases from 26.5% among [15][16][17][18][19] year olds to 40.7% among [20][21][22][23][24] year olds, while the prevalence of heavy episodic drinking increases from 13.6% to 21.8% [1]. An estimated 14% of all deaths among [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] year olds are attributable to alcohol [4].…”

Prevalence of HSV1 and HSV2 among HIV Patients in Northern South Africa as Determined by Real Time PCR in Urine Samples

“…Infections caused by Herpes Simplex Virus type 1 and 2 (HSV-1 and HSV-2) are associated with substantial morbidity, transmission and acquisition of the Human Immunodeficiency Virus (HIV) (Weiss et al, 2016). Over two-thirds of individuals infected are unaware of their infections and the majority of infections are transmitted by these individuals (Schulte et al, 2016).…”

“…Most studies conducted on the prevalence of HSV1 and 2, have used serum samples (Wang et al, 2016;Weiss et al, 2016). Although this can show that the study subjects have been in contact with the virus, it does not determine if these individuals are currently carrying the virus and are therefore capable of transmitting it.…”