15 research outputs found
Descriptive systematic review of sub-Saharan African studies on the association between alcohol use and HIV infection
The purpose of this review was to identify and assess studies that have quantified the association between alcohol consumption and HIV infection in sub-Saharan Africa. PubMed, CAB Abstracts and article references were searched to identify studies published in English between 2000 and 2008 that reported relative measures of the association between alcohol use and HIV prevalence and/or seroconversion rates. Twenty-one eligible studies were described in detail and information on study characteristics extracted. All of the identified studies were conducted either in east or southern Africa, and varied substantially regarding study population andalcohol use definitions. Overall, users of alcohol and especially problem drinkers were more likely to be HIV seropositive (HIV+) than non-users, frequency or quantity of alcohol use was positively associated with HIV prevalence, and the association varied by gender. The use of alcohol in sexual contexts was significantly associated with an increased risk of HIV acquisition and prevalence. The findings of this review of sub-Saharan African research strongly support an association between alcohol consumption and HIV infection. Although a causal relationship could not be established with certainty from the mainly cross-sectional studies, the negative consequences of such an association have profound implications for the burden of disease in this region. To confirm causality, futureresearch should use prospective study designs, use clearly definedĀ standardised measures of alcohol use (and problematic drinking)and an āevent-specificā approach to examine the situational links between alcohol use and HIV acquisition. Keywords: Alcohol, HIV, sexual risk, Africa
Prevalence and correlates of alcohol dependence disorder among TB and HIV infected patients in Zambia.
OBJECTIVES: To determine the prevalence and correlates of alcohol dependence disorders in persons receiving treatment for HIV and Tuberculosis (TB) at 16 Primary Health Care centres (PHC) across Zambia. METHODS: 649 adult patients receiving treatment for HIV and/or TB at PHCs in Zambia (363 males, 286 females) were recruited between 1st December 2009 and 31st January 2010. Data on socio-demographic variables, clinical disease features (TB and HIV), and psychopathological status were collected. The Mini International Neuropsychiatric Interview (MINI) was used to diagnose alcohol dependence disorder. Correlates of alcohol dependence were analyzed for men only, due to low prevalence in women. Univariable and multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using general estimating equations to allow for within-PHC clustering. RESULTS: The prevalence of alcohol dependence was 27.2% (95%CI: 17.7-39.5%) for men and 3.9% (95%CI: 1.4-0.1%) for women. Factors associated with alcohol dependence disorder in men included being single, divorced or widowed compared with married (adjusted OR = 1.47, 95%CI: 1.00-2.14) and being unemployed (adjusted OR=1.30, 95%CI: 1.01-1.67). The highest prevalence of alcohol dependence was among HIV-test unknown TB patients (34.7%), and lowest was among HIV positive patients on treatment but without TB (14.1%), although the difference was not statistically significant (p=0.38). CONCLUSIONS: Male TB/HIV patients in this population have high prevalence of alcohol dependence disorder, and prevalence differs by HIV/TB status. Further work is needed to explore interventions to reduce harmful drinking in this population
Implementing Evidence-Based Alcohol Interventions in a Resource-Limited Setting: Novel Delivery Strategies in Tomsk, Russia
Effective implementation of evidence-based interventions in āreal-worldā settings can be challenging. Interventions based on externally valid trial findings can be even more difficult to apply in resource-limited settings, given marked differencesāin provider experience, patient population, and health systemsābetween those settings and the typical clinical trial environment. Under the auspices of the Integrated Management of Physician-Delivered Alcohol Care for Tuberculosis Patients (IMPACT) study, a randomized, controlled effectiveness trial, and as an integrated component of tuberculosis treatment in Tomsk, Russia, we adapted two proven alcohol interventions to the delivery of care to 200 patients with alcohol use disorders. Tuberculosis providers performed screening for alcohol use disorders and also delivered naltrexone (with medical management) or a brief counseling intervention either independently or in combination as a seamless part of routine care. We report the innovations and challenges to intervention design, training, and delivery of both pharmacologic and behavioral alcohol interventions within programmatic tuberculosis treatment services. We also discuss the implications of these lessons learned within the context of meeting the challenge of providing evidence-based care in resource-limited settings. (Harv Rev Psychiatry 2012;20:58ā67.
Determinants of HIV infection among adolescent girls and young women aged 15ā24Ā years in South Africa: a 2012 population-based national household survey
Romantic relationships, college student alcohol use, and negative consequences of drinking
J Int AIDS Soc
INTRODUCTION: Excessive alcohol consumption leads to unfavourable outcomes in people living with HIV (PLHIV), including reduced adherence to antiretroviral therapy (ART) and engagement into care. However, there is limited information on alcohol consumption patterns among PLHIV in sub-Saharan Africa. METHODS: Using a cross-sectional approach, the Alcohol Use Disorders Identification Test (AUDIT-C) was administered to PLHIV attending HIV clinics in Cote d'Ivoire, Togo, Senegal and Zambia (2013 to 2015). Hazardous drinking was defined as an AUDIT-C score >/=4 for men or >/=3 for women, and binge drinking as >/=6 drinks at least once per month. The prevalence of binge drinking was compared to estimates from the general population using data from the World Health Organization. Factors associated with binge drinking among persons declaring any alcohol use in the past year were assessed using a logistic regression model to estimate odds ratio (OR) and their corresponding 95% confidence intervals (CI). RESULTS: Among 1824 PLHIV (median age 39 years, 62.8% female), the prevalence of hazardous alcohol use ranged from 0.9% in Senegal to 38.4% in Zambia. The prevalence of binge drinking ranged from 14.3% among drinkers in Senegal to 81.8% in Zambia, with higher estimates among PLHIV than in the general population. Male sex (OR 2.4, 95% CI 1.6 to 3.7), tobacco use (OR 1.7, 95% CI 1.0 to 2.9) and living in Zambia were associated with binge drinking. CONCLUSIONS: Alcohol consumption patterns varied widely across settings and binge drinking was more frequent in HIV-positive individuals compared to the general population. Interventions to reduce excessive alcohol use are urgently needed to optimize adherence in the era of universal ART
Epi-Criminological Responses to Human Trafficking of Young Women and Girls for Involuntary Prostitution in South Africa
This is a scholarly analysis of
the epidemiological criminology
measures applied by South Africa
to combat human trafficking of
women and girls for involuntary
prostitution. It comprises a
description of the range of services
provided by South African and
international organizations and
institutions responding to human
trafficking of women and girls for
involuntary prostitution. Firstly, the
sources of information collected
to assemble this paper are
described. Secondly, the theoretical
framework of epi-criminology and
the conceptual framework of
human trafficking for involuntary
prostitution are explained. Thirdly,
criminological and public health
challenges facing South Africa are
discussed briefly as factors giving
rise to human trafficking of young
women and girls for involuntary
prostitution. The fourth aspects
discussed are epi-criminological
responses, and challenges facing
South Africa when responding to
human trafficking of women and
girls are described. Although
victims of human trafficking would
still remain hidden with legislation,
in the absence of the Human
Trafficking Law South Africa
cannot determine the extent of the
crime. In addition, an ambiguous
approach to prostitution prevails
in communities and among
South African Police Service (SAPS)
officers. Furthermore, it is possible
that poverty alleviation programmes
aimed at mediating poverty
and unemployment challenges may
not be reaching the targeted
populations. To conclude, an
emphasis on a multi-faceted
approach to address human
trafficking of women and girls is
advised. South Africa is currently
applying a prevention, protection of
victims, and prosecution of
traffickers approach to respond to
human trafficking of girls for
involuntary prostitution.http://www.tandfonline.com/loi/scri2