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

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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.

Resumen

La atención temprana para el VIH y el TARV es esencial para mejorar los resultados de tratamientos, pero esto primero depende de las pruebas del VIH. El consumo pesado de alcohol es común en África subsahariana, lo cual es una barrera para la adhesión al TARV y una barrera potencial para el cuidado del VIH. Conducimos un estudio poblacional de 2,516 adultos en el sudoeste de Uganda de noviembre-diciembre del 2007, y estimamos el riesgo relativo de nunca haberse hecho la prueba del VIH, usando modelos Poisson clasificados por género. Más hombres (63.9 %) que mujeres (56.9 %) nunca se habían hecho la prueba. En un análisis multivariable, a comparación con mujeres que no habían consumido el alcohol durante al menos 5 años, mujeres que eran bebedoras empedernidas actuales y mujeres que habían tomado el alcohol por última vez hace 1-5 años fueron más probables a nunca haberse hecho la prueba. El uso del alcohol no se relacionó con pruebas anteriores del VIH entre los hombres. Puede entonces que las estrategias de pruebas del VIH tengan que concentrarse específicamente hacia mujeres que toman el alcohol.

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Acknowledgments

Ben Bellows received funding from the German Development Bank (KFW) and University of California Berkeley for this project. Judith A. Hahn received support from the Liver Center (P30 DK026743)

Conflict of interest

The authors have no known conflicts of interest.

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Authors and Affiliations

  1. Department of Medicine, University of California San Francisco (UCSF), Box 0886, San Francisco, CA, 94143-0886, US

    Robin Fatch, Sheri Weiser & Judith A. Hahn

  2. Population Council, Nairobi, Kenya

    Ben Bellows

  3. Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda

    Fred Bagenda & Edgar Mulogo

Authors
  1. Robin Fatch
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  2. Ben Bellows
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  3. Fred Bagenda
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  4. Edgar Mulogo
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  5. Sheri Weiser
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  6. Judith A. Hahn
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Correspondence to Judith A. Hahn.

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Fatch, R., Bellows, B., Bagenda, F. et al. Alcohol Consumption as a Barrier to Prior HIV Testing in a Population-Based Study in Rural Uganda. AIDS Behav 17, 1713–1723 (2013). https://doi.org/10.1007/s10461-012-0282-2

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