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AIDS and Behavior
Published in: AIDS and Behavior 5/2013

01-06-2013 | Original Paper

Alcohol Consumption as a Barrier to Prior HIV Testing in a Population-Based Study in Rural Uganda

Authors: Robin Fatch, Ben Bellows, Fred Bagenda, Edgar Mulogo, Sheri Weiser, Judith A. Hahn

Published in: AIDS and Behavior | Issue 5/2013

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Abstract

Early receipt of HIV care and ART is essential for improving treatment outcomes, but is dependent first upon HIV testing. Heavy alcohol consumption is common in sub-Saharan Africa, a barrier to ART adherence, and a potential barrier to HIV care. We conducted a population-based study of 2,516 adults in southwestern Uganda from November–December 2007, and estimated the relative risk of having never been tested for HIV using sex-stratified Poisson models. More men (63.9 %) than women (56.9 %) had never been tested. In multivariable analysis, compared to women who had not consumed alcohol for at least 5 years, women who were current heavy drinkers and women who last drank alcohol 1–5 years prior, were more likely to have never been tested. Alcohol use was not associated with prior HIV testing among men. HIV testing strategies may thus need to specifically target women who drink alcohol.
Literature
1.
Global Report: UNAIDS report on the global AIDS epidemic 2010: UNAIDS; 2010.
2.
Global Report Fact Sheet: Sub-Saharan Africa: UNAIDS; 2009.
3.
Sterne JA, May M, Costagliola D, et al. Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies. Lancet. 2009;373(9672):1352–63.PubMedCrossRef
4.
Lawn SD, Harries AD, Anglaret X, Myer L, Wood R. Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa. AIDS. 2008;22(15):1897–908.PubMedCrossRef
5.
Lanoy E, Mary-Krause M, Tattevin P, et al. Frequency, determinants and consequences of delayed access to care for HIV infection in France. Antivir Ther. 2007;12(1):89–96.PubMed
6.
Egger M, May M, Chene G, et al. Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet. 2002;360(9327):119–29.PubMedCrossRef
7.
Sabin CA, Smith CJ, Gumley H, et al. Late presenters in the era of highly active antiretroviral therapy: uptake of and responses to antiretroviral therapy. AIDS. 2004;18(16):2145–51.PubMedCrossRef
8.
Krentz HB, Auld MC, Gill MJ. The high cost of medical care for patients who present late (CD4 < 200 cells/microL) with HIV infection. HIV Med. 2004;5(2):93–8.PubMedCrossRef
9.
Attia S, Egger M, Muller M, Zwahlen M, Low N. Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis. AIDS. 2009;23(11):1397–404.PubMedCrossRef
10.
Donnell D, Baeten JM, Kiarie J, et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375(9731):2092–8.PubMedCrossRef
11.
Giordano TP, Suarez-Almazor ME, Grimes RM. The population effectiveness of highly active antiretroviral therapy: are good drugs good enough? Curr HIV/AIDS Rep. 2005;2(4):177–83.PubMedCrossRef
12.
Uganda National Policy Guidelines for HIV Counselling and Testing: Uganda Ministry of Health; 2005.
13.
Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report 2009: World Health Organization; 2009.
14.
Powers KA, Ghani AC, Miller WC, et al. The role of acute and early HIV infection in the spread of HIV and implications for transmission prevention strategies in Lilongwe, Malawi: a modelling study. Lancet. 2011;378(9787):256–68.PubMedCrossRef
15.
Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800.PubMedCrossRef
16.
17.
Parry CD, Bhana A, Myers B, et al. Alcohol use in South Africa: findings from the South African Community Epidemiology Network on Drug use (SACENDU) Project. J Stud Alcohol. 2002;63(4):430–5.PubMed
18.
Obot IS. Substance abuse, health and social welfare in Africa: an analysis of the Nigerian experience. Soc Sci Med. 1990;31(6):699–704.PubMedCrossRef
19.
Gillis LS, Stone GL. The fate of drinkers: a six-year follow-up study of a community survey. S Afr Med J. 1977;51(22):789–91.PubMed
20.
21.
Omoluabi PF. A review of the incidence of nonprescription psychoactive substance use/misuse in Nigeria. Int J Addict. 1995;30(4):445–58.PubMed
22.
Acuda SW, Sebit MB. Prevalence of psychoactive substance use among psychiatric in-patients in Harare, Zimbabwe. Cent Afr J Med. 1997;43(8):226–9.PubMed
23.
Global Status Report on Alcohol and Health: World Health Organization; 2011.
24.
Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007;97(10):1762–74.PubMedCrossRef
25.
Gage AJ, Ali D. Factors associated with self-reported HIV testing among men in Uganda. AIDS Care. 2005;17(2):153–65.PubMedCrossRef
26.
Siziya S, Muula AS, Rudatsikira E, Mataya RH. Correlates of HIV testing among women in Malawi: results from the 2006 Multiple Indicator Cluster Survey. Trop Med Int Health. 2008;13(11):1351–6.PubMedCrossRef
27.
Sambisa W, Curtis S, Mishra V. AIDS stigma as an obstacle to uptake of HIV testing: evidence from a Zimbabwean national population-based survey. AIDS Care. 2010;22(2):170–86.PubMedCrossRef
28.
Venkatesh KK, Madiba P, De Bruyn G, Lurie MN, Coates TJ, Gray GE. Who gets tested for HIV in a South African urban township? Implications for test and treat and gender-based prevention interventions. J Acquir Immune Defic Syndr. 2011;56(2):151–65.PubMedCrossRef
29.
Mitchell S, Cockcroft A, Lamothe G, Andersson N. Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries. BMC Int Health Hum Rights. 2010;10(23):23.PubMedCrossRef
30.
Bwambale FM, Ssali SN, Byaruhanga S, Kalyango JN, Karamagi CA. Voluntary HIV counselling and testing among men in rural western Uganda: implications for HIV prevention. BMC Public Health. 2008;8(263):263.PubMedCrossRef
31.
MacPhail C, Pettifor A, Moyo W, Rees H. Factors associated with HIV testing among sexually active South African youth aged 15–24 years. AIDS Care. 2009;21(4):456–67.PubMedCrossRef
32.
Peltzer K, Matseke G, Mzolo T, Majaja M. Determinants of knowledge of HIV status in South Africa: results from a population-based HIV survey. BMC Public Health. 2009;9(174):174.PubMedCrossRef
33.
Sherr L, Lopman B, Kakowa M, et al. Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort. AIDS. 2007;21(7):851–60.PubMedCrossRef
34.
Fylkesnes K, Siziya S. A randomized trial on acceptability of voluntary HIV counselling and testing. Trop Med Int Health. 2004;9(5):566–72.PubMedCrossRef
35.
Matovu JK, Gray RH, Makumbi F, et al. Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda. AIDS. 2005;19(5):503–11.PubMedCrossRef
36.
Wringe A, Isingo R, Urassa M, et al. Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment. Trop Med Int Health. 2008;13(3):319–27.PubMedCrossRef
37.
Neale J, Tompkins C, Sheard L. Barriers to accessing generic health and social care services: a qualitative study of injecting drug users. Health Soc Care Community. 2008;16(2):147–54.PubMedCrossRef
38.
Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci. 2007;8(2):141–51.PubMedCrossRef
39.
Woolf-King SE, Maisto SA. Alcohol use and high-risk sexual behavior in Sub-Saharan Africa: a narrative review. Arch Sex Behav. 2011;40(1):17–42.PubMedCrossRef
40.
Lewis JJ, Garnett GP, Mhlanga S, Nyamukapa CA, Donnelly CA, Gregson S. Beer halls as a focus for HIV prevention activities in rural Zimbabwe. Sex Transm Dis. 2005;32(6):364–9.PubMedCrossRef
41.
Fritz K, Woelk G, Bassett M, et al. The association between alcohol use, sexual risk behavior, and HIV infection among men attending beerhalls in Harare, Zimbabwe. AIDS Behav. 2002;6(3):221–8.CrossRef
42.
Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004;59(8):1581–92.PubMedCrossRef
43.
Fisher JC, Bang H, Kapiga SH. The association between HIV infection and alcohol use: a systematic review and meta-analysis of African studies. Sex Transm Dis. 2007;34(11):856–63.PubMedCrossRef
44.
Peltzer K, Mlambo G, Phaweni K. Factors determining prenatal HIV testing for prevention of mother to child transmission of HIV in Mpumalanga, South Africa. AIDS Behav. 2010;14(5):1115–23.PubMedCrossRef
45.
Luseno WK, Wechsberg WM. Correlates of HIV testing among South African women with high sexual and substance-use risk behaviours. AIDS Care. 2009;21(2):178–84.PubMedCrossRef
46.
Msuya SE, Mbizvo E, Uriyo J, Stray-Pedersen B, Sam NE, Hussain A. Predictors of failure to return for HIV test results among pregnant women in Moshi, Tanzania. J Acquir Immune Defic Syndr. 2006;43(1):85–90.PubMedCrossRef
47.
Bellows B, Hamilton M. Vouchers for health: increasing utilization of facility-based STI and safe motherhood services in Uganda. Health Systems 20/20 project. Bethesda, MD: Abt Associates Inc.; 2009.
48.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–95.PubMedCrossRef
49.
Papas RK, Sidle JE, Wamalwa ES, et al. Estimating alcohol content of traditional brew in Western Kenya using culturally relevant methods: the case for cost over volume. AIDS Behav. 2010;14(4):836–44.PubMedCrossRef
50.
Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21(6):459–68.PubMedCrossRef
51.
Filmer D, Pritchett LH. Estimating wealth effects without expenditure data-or tears: an application to educational enrollments in states of India. Demography. 2001;38(1):115–32.PubMed
52.
Coates J, Swindale A, Bilinsky P. Household food insecurity access scale (HFIAS) for measurement of household food access: indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development; 2006.
53.
Deddens JA, Petersen MR. Approaches for estimating prevalence ratios. Occup Environ Med. 2008;65(7):481, 501-6.
54.
Ostermann J, Kumar V, Pence BW, Whetten K. Trends in HIV testing and differences between planned and actual testing in the United States, 2000–2005. Arch Intern Med. 2007;167(19):2128–35.PubMedCrossRef
55.
Nabyonga J, Desmet M, Karamagi H, Kadama PY, Omaswa FG, Walker O. Abolition of cost-sharing is pro-poor: evidence from Uganda. Health Policy Plan. 2005;20(2):100–8.PubMedCrossRef
56.
Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3(21):21.PubMedCrossRef
57.
Sterne JA, White IR, Carlin JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.PubMedCrossRef
58.
Weiser SD, Tsai AC, Gupta R, et al. Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting. AIDS. 2012;26(1):67–75.
59.
60.
Hahn JA, Woolf-King SE, Muyindike W. Adding fuel to the fire: alcohol’s effect on the HIV epidemic in Sub-Saharan Africa. Curr HIV/AIDS Rep. 2011;8(3):172–80.PubMedCrossRef
61.
Fritz K, Morojele N, Kalichman S. Alcohol: the forgotten drug in HIV/AIDS. Lancet. 2010;376(9739):398–400.PubMedCrossRef
Metadata
Title
Alcohol Consumption as a Barrier to Prior HIV Testing in a Population-Based Study in Rural Uganda
Authors
Robin Fatch
Ben Bellows
Fred Bagenda
Edgar Mulogo
Sheri Weiser
Judith A. Hahn
Publication date
01-06-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 5/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-012-0282-2

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