Decreases in self-reported alcohol consumption following HIV counseling and testing at Mulago Hospital, Kampala, Uganda.
Decreases in self-reported alcohol consumption following HIV counseling and testing at Mulago Hospital, Kampala, Uganda.
复制标题
DOI：
10.1186/1471-2334-14-403
复制
发表时间：
2014-07-20
影响因子：
3.7
通讯作者：
Coates TJ
中科院分区：
文献类型：
--
作者：
Hahn JA;Fatch R;Wanyenze RK;Baveewo S;Kamya MR;Bangsberg DR;Coates TJ
饮酒对艾滋病毒流行病有不利影响，特别是在撒哈拉以南非洲。HIV咨询和检测（HCT）可能提供接触机会，以干预危险的酒精使用;然而，对HCT后酒精消费量的变化知之甚少。我们利用了来自2056名参与者的随机对照试验的数据，该试验比较了在乌干达坎帕拉的Mulago医院进行的两种HCT方法及其与HIV护理的联系。那些以前没有检测出艾滋病毒呈阳性的人，以及最近一次艾滋病毒检测至少在过去一年的人，都有资格参加。参与者在基线时被问及他们最后一次饮酒的时间，并且在基线和一年内每季度使用酒精使用障碍识别测试-消费（AUDIT-C）测量前三个月的酒精消费量。女性和男性的危险饮酒定义为评分分别≥3或≥4。我们使用多项logistic回归分析研究了基线时饮酒的相关性，以及随访期间危险和非危险饮酒的相关性，并在参与者水平上进行聚类以解释重复测量。在HCT之前，30%是当前饮酒者（前三个月），27%是过去饮酒者（>3个月前），44%是终身戒酒者。三分之一（35%）的饮酒者符合危险饮酒的标准。危险和非危险自我报告的饮酒量在HCT后下降，16%的基线当前饮酒者在HCT后3个月报告危险饮酒。HCT后继续饮酒的独立预测因素（p < 0.05）为性别（男性）、HCT前饮酒（危险）和HIV状态（阴性）。在艾滋病毒感染者中，接受抗逆转录病毒治疗（ART）的人不太可能饮酒。HCT可能是干预饮酒的合适时机。HIV感染者在HCT后饮酒量下降幅度更大，HIV感染者开始ART后非危险性饮酒减少。HCT和ART开始可能是干预饮酒的理想时机。应考虑对HCT和HIV治疗场所进行筛查和简短干预（SBI），以减少饮酒量。
Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT. We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at baseline when they last consumed alcohol, and prior three month alcohol consumption was measured using the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) at baseline and quarterly for one year. Hazardous alcohol consumption was defined as scoring ≥3 or ≥4 for women and men, respectively. We examined correlates of alcohol use at baseline, and of hazardous and non-hazardous drinking during the year of follow-up using multinomial logistic regression, clustered at the participant level to account for repeated measurements. Prior to HCT, 30% were current drinkers (prior three months), 27% were past drinkers (>3 months ago), and 44% were lifetime abstainers. One-third (35%) of the current drinkers met criteria for hazardous drinking. Hazardous and non-hazardous self-reported alcohol consumption declined after HCT, with 16% of baseline current drinkers reporting hazardous alcohol use 3 months after HCT. Independent predictors (p < 0.05) of continuing non-hazardous and hazardous alcohol consumption after HCT were sex (male), alcohol consumption prior to HCT (hazardous), and HIV status (negative). Among those with HIV, non-hazardous drinking was less likely among those taking antiretroviral therapy (ART). HCT may be an opportune time to intervene with alcohol consumption. Those with HIV experienced greater declines in alcohol consumption after HCT, and non-hazardous drinking decreased for those with HIV initiating ART. HCT and ART initiation may be ideal times to intervene with alcohol consumption. Screening and brief intervention (SBI) to reduce alcohol consumption should be considered for HCT and HIV treatment venues.