ArticleJournal of the International Association of Providers of AIDS Care
Effect of Biomarker Confirmed Unhealthy Alcohol Use on Viral Suppression Among Adolescents and Young Adults With HIV in East Africa.
Article in Journal of the International Association of Providers of AIDS Care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BackgroundUnhealthy alcohol use is common among people affected by HIV and is associated with poor treatment outcomes, but its impact among adolescents and young adults living with HIV (AYAH) in Africa is rarely explored. This study aimed to estimate the prevalence of unhealthy alcohol use and examine its association with HIV viral suppression among AYAH in Uganda and Kenya.MethodsWe conducted a cross-sectional survey among AYAH enrolled in the intervention arm of the SEARCH Youth study, a life stage based trial evaluating an intervention to improve viral suppression among youth aged 15 to 24 years. At their 30 to 36 month follow-up visit, AYAH were interviewed for self-reported alcohol consumption using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C, modified to cover the last 3 months) and tested for phosphatidylethanol (PEth), a blood-based biomarker of prior month alcohol consumption. Unhealthy alcohol use was defined as AUDIT-C ≥ 3 for females, ≥4 for males or PEth≥50 ng/mL. We estimated underreporting of alcohol use among those with PEth ≥50 ng/mL and examined the association between unhealthy alcohol use and viral non suppression (≥400 copies/mL) using logistic regression, adjusting for gender, age, and country.ResultsUnhealthy alcohol use was assessed in 715 AYAH; 409 (57.0%) in Uganda and 309 (43.0%) in Kenya. Eighty percent were female, median age at the time of the survey was 24 years (interquartile range: 21-26), and 95.0% were virally suppressed. The prevalence of unhealthy alcohol use was 25% overall, higher among males than females, Ugandan than Kenyan AYAH and increased with age. Unhealthy alcohol use was associated with nearly 3-fold higher odds of viral nonsuppression (adjusted odds ratio = 2.80, 95% CI [1.19-6.58],
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