Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research.

Abstract

There is now conclusive evidence of a causal linkage between heavy drinking patterns and/or alcohol use disorders and the worsening of the disease course for HIV. However, while alcohol usage is consistently associated with the prevalence and incidence of HIV, further research is needed to substantiate causality in terms of the acquisition of this disease. The burden attributable to alcohol use in South Africa in 2004 has been estimated to be 1.3 million years in terms of years lost though premature death caused by alcohol and years lived with an alcohol-related disability (or just over 6% of all years lost from all causes). Of all years lost through death and disability that can be attributed to alcohol, 10% for men and 28% for women can be directly attributed to alcohol's impact on the progression of HIV in infected individuals. The implications of the above will be discussed in terms of research gaps that need to be addressed and broader policy responses that are needed in the health and social services sectors. In addition, emphasis will be given to specific practices that should be considered for rollout by agencies involved in substance abuse and HIV/AIDS treatment and prevention.

Fresh Perspectives on the Alcohol and HIV Nexus: A Call for Action in an Era of Increased Opportunities and Challenges

“…What is also needed is more advocacy to ensure uptake of knowledge into action [33]. This could happen via publishing articles on these topics in publications with a broader readership like general nursing, medical and public health journals, but also through presentations (particularly keynote presentations, panel/discussion sessions and other oral presentations) at international conferences.…”

Alcohol consumption and HIV/AIDS: the neglected interface

“…Alcohol use might also influence uptake of HIV testing and HIV care [14]. Health personnel in HIV, tuberculosis (TB) and sexually transmitted infection (STI) clinics should screen patients for alcohol problems and manage them accordingly [10]. Standard screening, for example the Alcohol Use Disorders Identification Test, can ascertain which individuals require interventions, such as brief interventions.…”

Addressing the intersection between alcohol consumption and antiretroviral treatment: needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa

“…An important finding was that interventions to improve the mental health of HIV-positive individuals and to support ART adherence are urgently needed. In particular, to improve the integration of substance abuse services, and HIV and AIDS prevention and treatment, Parry et al [33] stress the importance of reducing the vertical nature of HIV and AIDS and alcohol programmes. Staff require cross training at HIV and AIDS and alcohol facilities, with a focus on facilitating behaviour change, i.e.…”