1
|
Ojeaburu SO, Dorward J, Violette LR, Gibbs A, Shozi H, Sookrajh Y, Mhlongo T, Ngobese H, Garrett N, Drain PK. Intimate Partner Violence and HIV Outcomes Among Women Living with HIV in Durban, South Africa. AIDS Behav 2024; 28:2247-2257. [PMID: 38869756 PMCID: PMC11199217 DOI: 10.1007/s10461-024-04318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 06/14/2024]
Abstract
We examined the impact of past-year intimate partner violence (IPV) on HIV outcomes among women living with HIV (WLHIV) in Durban, South Africa. We assessed past-year IPV using the WHO Violence Against Women Questionnaire. We conducted logistic regression to assess associations between demographic variables and IPV at baseline, and between IPV at baseline and longitudinal HIV outcomes. Among 235 WLHIV, 17% reported past-year emotional, physical, or sexual IPV. At baseline, HIV-disclosure to partner was associated with 4.35-fold odds of past-year IPV (95% CI 1.17-16.10) after controlling for children, education, and harmful alcohol use. In the prospective analysis, IPV was associated with not achieving the co-primary outcome of retention in care and viral suppression in univariate (OR = 2.32, 95% CI 1.04-5.18), but not in the multivariate model. In the context of rapid treatment scale-up, the high burden of IPV among WLHIV needs to be prioritized, with an emphasis on disclosure support.
Collapse
Affiliation(s)
- Sheila O Ojeaburu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
- Department of Medicine, University of California at San Francisco, San Francisco, CA, USA.
| | - Jienchi Dorward
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lauren R Violette
- Department of Allergy & Infectious Diseases, School of Medicine, University of Washington, Seattle, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Andrew Gibbs
- South African Medical Research Council, Gender and Health Research Unit, Durban, South Africa
- Centre for Rural Health School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Institute for Global Health, University College, London, UK
| | - Hlengiwe Shozi
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Yukteshwar Sookrajh
- Centre for Rural Health School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Thobile Mhlongo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Hope Ngobese
- Prince Cyril Zulu Communicable Disease Centre, eThekwini Municipality, Durban, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Paul K Drain
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
- Department of Global Health, School of Public Health, University of Washington, Seattle, USA
- Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, USA
| |
Collapse
|
2
|
Oguen-Alon T, Bilder L, Giladi HZ, Gutmacher Z, Mayer Y. Analyzing Oral Health Conditions in Sex Workers-A Comparative Retrospective Clinical and Radiographic Study. Dent J (Basel) 2024; 12:110. [PMID: 38668022 PMCID: PMC11048831 DOI: 10.3390/dj12040110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
This study highlights the oral health condition of female sex workers (SWs), who face increased risks associated with habits such as excessive alcohol and tobacco use. These behaviors heighten the likelihood of issues like oral cancer and dental diseases, underscoring the need for targeted health interventions. The study examines the oral health disparities between SWs and the general population (GP). A retrospective study analyzed the health records of 40 SWs and 40 controls matched by age and gender who were examined between 1 January 2020 and 30 May 2023. Intra-oral and panoramic radiographs, alongside clinical examination, were used to evaluate missing teeth, periodontal bone support, and caries. T-tests and chi-square tests were used to compare dental health indicators. A comparative analysis of these 80 patients revealed significant disparities: SWs had a higher incidence of missing teeth (5.8 ± 7.3 vs. 0.7 ± 1.4, p < 0.01) and caries (6.1 ± 6.2 vs. 0.8 ± 1.2, p < 0.05) compared to the GP. The DMFT (Decayed, Missing, and Filled Teeth) index was notably higher in SWs (16.1 ± 8.09) than in the GP (7.95 ± 5.48, p < 0.001). Additionally, 12% of SWs used removable dentures, unlike the GP. This study underscores significant oral health challenges in SWs, emphasizing the need for targeted healthcare strategies to improve their health conditions.
Collapse
Affiliation(s)
- Tahel Oguen-Alon
- Department of Prosthodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa 3525408, Israel
| | - Leon Bilder
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa 3525408, Israel
| | - Hadar Zigdon Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa 3525408, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Zvi Gutmacher
- Department of Prosthodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa 3525408, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa 3525408, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| |
Collapse
|
3
|
Nguyen CT, Nguyen HT, Vu TMT, Le Vu MN, Vu GT, Latkin CA, Ho CSH, Ho RCM. Mapping Studies of Alcohol Use Among People Living with HIV/AIDS During 1990-2019 (GAPRESEARCH). AIDS Behav 2023; 27:3981-3991. [PMID: 37338623 DOI: 10.1007/s10461-023-04112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Alcohol drinking has long been reported to be common in people living with HIV/AIDS, having biological and behavioral impacts on the transmission, progression, and prevention of HIV/AIDS. A total of 7059 eligible articles and reviews published in English from 1990 to 2019 were extracted from the WOS. Results show an increase in publication volume, while citations peak for papers published in 2006. Content analysis reveals a wide-ranging coverage of topics, with the most popular being effects of alcohol consumption on ART adherence and outcomes, alcohol-related sexual behaviors, TB co-infection, and psycho-socio-cultural considerations in examining and designing measures targeting alcohol use and interventions to reduce alcohol dependence in PLWHA. This calls for more active engagement of governments in research and in designing and implementing interventions, as well as collaborations and knowledge transfer from high-income countries to developing counterparts, to effectively address alcohol use-related issues in PLWHA, moving toward the HIV/AIDS eradication target.
Collapse
Affiliation(s)
- Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Thuc Minh Thi Vu
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Minh Ngoc Le Vu
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 700000, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119077, Singapore
| |
Collapse
|
4
|
Qiao S, Garrett CM, Addo PNO, Adeagbo O, Moore DM, Muttau N, Sharma A, Lwatula C, Ngosa L, Kabwe M, Manasyan A, Menon JA, Weissman S, Li X, Harper GW. The Impacts of Stigma Against Sexual Minority Men Within and Between Various Socioecological Levels: Breaking the Vicious Cycle in Zambia. Am J Mens Health 2023; 17:15579883231209190. [PMID: 37909703 PMCID: PMC10621297 DOI: 10.1177/15579883231209190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 11/03/2023] Open
Abstract
Sexual minority men (SMM) face persistent stigma in Zambia. From a holistic perspective, we aim to explore its impacts within and between multiple socioecological levels, demonstrating how their interactions create a vicious cycle of barriers to the well-being of SMM. In-depth interviews were conducted with 20 purposively recruited SMM from Lusaka, Zambia. All interviews were audio-recorded, after written consent, transcribed verbatim, and iteratively coded employing inductive (i.e., data-driven) approaches for thematic analysis using NVivo. Results suggest three key themes: (1) interpersonal socially perpetuated sexual minority stigma (SMS); (2) multidirectional interactions between psychosocial well-being and risk-taking behaviors; and (3) institutionally perpetuated SMS as a barrier to seeking and receiving health care. SMS permeates across all levels of the socioecological model to negatively impact the psychosocial well-being of SMM while acting also as a barrier to accessing HIV prevention and care. Our study necessitates structural public health intervention to decrease stigma and discrimination against SMM in Zambia, in efforts to increase their psychosocial well-being as well as their access to and utilization of HIV care by breaking the vicious cycle of SMS that pervades through the intrapersonal, interpersonal, and institutional levels of the socioecological model.
Collapse
Affiliation(s)
- Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Camryn M. Garrett
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Prince N. O. Addo
- Department of Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Oluwafemi Adeagbo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Darius M. Moore
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nobutu Muttau
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Anjali Sharma
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Levy Ngosa
- Dignitate Zambia Limited (DZL), Lusaka, Zambia
| | | | - Albert Manasyan
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Sharon Weissman
- Department of Internal Medicine, School of Medicine Columbia, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Gary W. Harper
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
5
|
Gagnon KW, Levy S, Figge C, Wolford Clevenger C, Murray L, Kane JC, Bosomprah S, Sharma A, Nghiem VTH, Chitambi C, Vinikoor M, Eaton E, Cropsey K. Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol. Contemp Clin Trials Commun 2023; 33:101123. [PMID: 37063165 PMCID: PMC10090240 DOI: 10.1016/j.conctc.2023.101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
Background Unhealthy alcohol use is an unaddressed barrier to achieving and maintaining control of the human immunodeficiency virus (HIV) epidemic. Integrated screening, treatment of common behavioral and mental health comorbidities, and telemedicine can improve alcohol treatment and HIV clinical and quality of life outcomes for rural and underserved populations. Objective In a randomized controlled clinical trial, we will evaluate the effectiveness and implementation of telephone-delivered Common Elements Treatment Approach (T-CETA), a transdiagnostic cognitive behavioral therapy protocol, on unhealthy alcohol use, HIV, other substance use and mental health outcomes among predominantly rural adults with HIV receiving care at community clinics in Alabama. Methods Adults with HIV receiving care at four selected community clinics in Alabama will receive a telephone-delivered alcohol brief intervention (BI), and then be assigned at random (stratified by clinic and sex) to no further intervention or T-CETA. Participants will be recruited after screening positively for unhealthy alcohol use or when referred by a provider. The target sample size is 308. The primary outcome will be change in the Alcohol Use Disorder Identification Test (AUDIT) at six- and 12-months post-enrollment. Additional outcomes include HIV (retention in care and viral suppression), patient-reported mental health (anxiety, depression, posttraumatic stress), and quality of life. A range of implementation measures be evaluated including T-CETA provider and client acceptability, feasibility, cost and cost-effectiveness. Conclusions This trial will inform alcohol treatment within HIV care programs, including the need to consider comorbidities, and the potential impact of alcohol interventions on HIV and quality of life outcomes.
Collapse
|
6
|
Mandlate FM, Greene MC, Pereira LF, Gouveia ML, Mari JJ, Cournos F, Duarte CS, Oquendo MA, Mello MF, Wainberg ML. Association between mental disorders and adherence to antiretroviral treatment in health facilities in two Mozambican provinces in 2018: a cross-sectional study. BMC Psychiatry 2023; 23:274. [PMID: 37081470 PMCID: PMC10116733 DOI: 10.1186/s12888-023-04782-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/13/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Lower adherence to antiretroviral treatment (ART) has been found among people with HIV (PWH) who have comorbid mental disorders like depression and alcohol use in Sub-Saharan African. However, there has been less exploration with regards to other mental disorders. METHODS This study assessed the association of multiple mental disorders and adherence to ART based on the data from primary/tertiary health care facilities in Maputo and Nampula, Mozambique. We administered a sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI) Plus 4.0.0 adapted for use in Mozambique to assess mental conditions, and a 3-item self-report to measure ART adherence. RESULTS 395 HIV-positive (self-report) participants on ART, with an average age of 36.7 years (SD = 9.8), and 30.4% were male. The most common mental disorders were major depressive disorder (27.34%) followed by psychosis (22.03%), suicidal ideation/behavior (15.44%), and alcohol-use disorder (8.35%). Higher odds of missing at least one dose in the last 30 days (OR = 1.45, 95% CI: 1.01, 2.10) were found in participants with any mental disorder compared to those without a mental disorder. The highest levels of non-adherence were observed among those with drug use disorders and panic disorder. CONCLUSIONS In Mozambique, PWH with any co-occurring mental conditions had a lower probability of ART adherence. Integrating comprehensive mental health assessment and treatment and ART adherence interventions tailored to PWH with co-occurring mental disorders is necessary to attain optimal ART adherence and reach the UNAIDS ART target.
Collapse
Affiliation(s)
- Flavio M. Mandlate
- Department of Mental Health, Ministry of Health, Eduardo Mondlane Avenue, nr 1008, Postal Code 264 Maputo, Mozambique
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - M. Claire Greene
- Program on Forced Migration and Health, Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, USA
| | - Luis F. Pereira
- New York State Psychiatric Institute, Columbia University, New York, USA
| | - Maria Lidia Gouveia
- Department of Mental Health, Ministry of Health, Eduardo Mondlane Avenue, nr 1008, Postal Code 264 Maputo, Mozambique
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Jair Jesus Mari
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Francine Cournos
- New York State Psychiatric Institute, Columbia University, New York, USA
| | | | - Maria A. Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Marcelo Feijó Mello
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Milton L. Wainberg
- New York State Psychiatric Institute, Columbia University, New York, USA
| |
Collapse
|
7
|
Regan T, Gette J, McAfee N, Parker J. Substance use disparities by age, race, sex, and sexual orientation among persons living with HIV in the Southern U.S. Int J STD AIDS 2023:9564624231162150. [PMID: 36919911 DOI: 10.1177/09564624231162150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Alcohol and drug use is overrepresented among individuals living with Human Immunodeficiency Virus (HIV) and is associated with poor health outcomes. Determining the extent to which substance use differs between demographic profiles of people living with HIV (PLWH) would determine at-risk groups that would benefit from intervention. METHODS Cross-sectional screening data (N = 1307, Mage = 42.7 years, 66% male, 86% African American, 39% sexual minority) was examined from an HIV clinic in the southern U.S. largely treating underserved and low-income patients. Age, gender, race/ethnicity, sexual orientation, and their interactions were entered as predictors of substance use and related impairment in a series of zero-inflated negative binomial regressions. RESULTS African Americans reported more drug use (p = 0.004) and drug-related negative consequences (p = 0.003). Notably, alcohol-related negative consequences of African American heterosexuals were much higher at younger ages, compared to sexual minorities (regardless of race) and White heterosexuals of all age groups (p = 0.04). CONCLUSIONS Among PLWH in the U.S. South, African Americans may be uniquely at-risk with for problems related to drug-related functional impairment. Specifically, young heterosexual African Americans are at high risk for alcohol-related impairment. Implications are discussed.
Collapse
Affiliation(s)
- Timothy Regan
- Department of Mental Health, RinggoldID:25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jordan Gette
- Center of Alcohol and Substance Use Studies, RinggoldID:242612Rutgers University, Piscataway, NJ, USA
| | - Nicholas McAfee
- Department of Psychiatry and Human Behavior, RinggoldID:12276University of Mississippi Medical Center, Jackson, MI, USA
| | - Jefferson Parker
- Department of Psychiatry and Human Behavior, RinggoldID:12276University of Mississippi Medical Center, Jackson, MI, USA
| |
Collapse
|
8
|
Lewis-Kulzer J, Mburu M, Obatsa S, Cheruiyot J, Kiprono L, Brown S, Apaka C, Koros H, Muyindike W, Kwobah EK, Diero L, Aluda M, Wools-Kaloustian K, Goodrich S. Patient perceptions of facilitators and barriers to reducing hazardous alcohol use among people living with HIV in East Africa. Subst Abuse Treat Prev Policy 2023; 18:8. [PMID: 36737735 PMCID: PMC9896687 DOI: 10.1186/s13011-023-00520-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hazardous alcohol use among people living with HIV is associated with poor outcomes and increased morbidity and mortality. Understanding the hazardous drinking experiences of people living with HIV is needed to reduce their alcohol use. METHODS We conducted 60 interviews among people living with HIV in East Africa with hazardous drinking histories. Interviews and Alcohol Use Disorder Identification Test (AUDIT) scores were conducted 41 - 60 months after their baseline assessment of alcohol use to identify facilitators and barriers to reduced alcohol use over time. RESULTS People living with HIV who stopped or reduced hazardous drinking were primarily motivated by their HIV condition and desire for longevity. Facilitators of reduced drinking included health care workers' recommendations to reduce drinking (despite little counseling and no referrals) and social support. In those continuing to drink at hazardous levels, barriers to reduced drinking were stress, social environment, alcohol accessibility and alcohol dependency. CONCLUSIONS Interventions that capacity-build professional and lay health care workers with the skills and resources to decrease problematic alcohol use, along with alcohol cessation in peer support structures, should be explored.
Collapse
Affiliation(s)
- Jayne Lewis-Kulzer
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 550 16TH Street, 3rd Floor, San Francisco, CA, USA.
| | - Margaret Mburu
- Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Sarah Obatsa
- Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Julius Cheruiyot
- Academic Model Providing Access to Health Care (AMPATH), P.O. Box 4606-30100, Eldoret, Kenya
| | - Lorna Kiprono
- Academic Model Providing Access to Health Care (AMPATH), P.O. Box 4606-30100, Eldoret, Kenya
| | - Steve Brown
- Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, 410 W. 10th Street, HITS 3000, Indianapolis, IN, USA
| | - Cosmas Apaka
- Academic Model Providing Access to Health Care (AMPATH), P.O. Box 4606-30100, Eldoret, Kenya
| | - Hillary Koros
- Academic Model Providing Access to Health Care (AMPATH), P.O. Box 4606-30100, Eldoret, Kenya
| | - Winnie Muyindike
- The Immune Suppression Syndrome Clinic, Mbarara University of Science and Technology, P.O. Box 40, Mbarara, Uganda
| | - Edith Kamaru Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, P.O. Box 3-30100, Eldoret, Kenya
| | - Lameck Diero
- Department of Medicine, Moi University School of Medicine, P.O. Box 4606-30100, Eldoret, Kenya
| | - Maurice Aluda
- Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Kara Wools-Kaloustian
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Indiana University, 545 Barnhill Drive, Indianapolis, IN, USA
| | - Suzanne Goodrich
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Indiana University, 545 Barnhill Drive, Indianapolis, IN, USA
| |
Collapse
|
9
|
Integration of Common Elements Treatment Approach (CETA) into public sector HIV clinics for unhealthy alcohol use in urban Zambia: Qualitative evaluation on acceptability and feasibility. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
|
10
|
Simegnew D, Di Q, Turi E, Fekadu G, Feyisa BR, Temesgen S, Bikila H, Bayisa L, Shibiru T, Ahinkorah BO, Seidu AA. Psychoactive substance uses among people living with HIV/AIDS in Western Ethiopia: a multi-centered facility-based cross-sectional study. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2120428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Dawit Simegnew
- Department of Pharmacy, College of Health and Medical Sciences, Bule Hora University, Bule Hora, Ethiopia
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, China
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria
| | - Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Bikila Regassa Feyisa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Sidise Temesgen
- Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Haile Bikila
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lami Bayisa
- Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Services, James Cook University, Australia
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
| |
Collapse
|
11
|
Kim TW, Heeren TC, Samet JH, Bertholet N, Lloyd-Travaglini C, Winter MR, Magane KM, Gnatienko N, Bryant K, Rateau LJ, Muyindike WR, Hahn JA, Blokhina E, Saitz R. Alcohol and falls among people with HIV infection: A view from Russia and the United States. Alcohol Clin Exp Res 2022; 46:1742-1752. [PMID: 35957545 PMCID: PMC9509482 DOI: 10.1111/acer.14915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Both human immunodeficiency virus (HIV) infection and alcohol use predispose to autonomic/sensory neuropathy, imbalance symptoms, and cognitive impairment-conditions associated with a greater risk of falls-yet it is unclear how to identify people with HIV (PWH) whose drinking is associated with falls. Research on alcohol and falls using the same instruments in different countries could help to specify the level of alcohol use associated with fall risk. We examined whether a consumption-based measure (the Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]) and/or a symptom-based measure (DSM-5 criteria for alcohol use disorder [AUD]) are associated with sustaining a fall among PWH in St Petersburg, Russia and Boston, Massachusetts in the United States. METHODS Separate multivariate logistic regressions were used for each cohort to examine cross-sectional associations for each alcohol measure predicting fall. Potential confounders included physical functioning, depressive symptoms, and other substance use (measured with the Addiction Severity Index). RESULTS A fall was reported by 35% (87/251) of the sample in Boston and 12% (46/400) in St Petersburg. Each additional AUD criterion-but not higher AUDIT-C score-was significantly associated with a fall in both Boston (odds ratio [OR] = 1.10; 95% confidence interval [CI] 1.02, 1.18) and St Petersburg (adjusted OR AOR = 1.10; 95% CI 1.02, 1.18). Heavy alcohol use (>6 drinks/occasion, any vs. none) was associated with more than twice the odds of a fall (AOR = 2.24; 95% CI 1.21, 4.13) in Boston. CONCLUSIONS These findings suggest that while fall risk may vary by setting and population, heavy alcohol use and AUD symptom severity are potential targets for interventions to prevent falls. Studies in diverse global settings advance our understanding of the relationship between alcohol and falls in PWH.
Collapse
Affiliation(s)
- Theresa W Kim
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA (TWK, JHS, NG, RS)
| | - Timothy C. Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA (TCH)
| | - Jeffrey H. Samet
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA (TWK, JHS, NG, RS)
| | - Nicolas Bertholet
- Department of Psychiatry, Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (NB)
| | - Christine Lloyd-Travaglini
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA (CLT, MRW, LJR)
| | - Michael R. Winter
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA (CLT, MRW, LJR)
| | - Kara M. Magane
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA, USA (JHS, KM, RS)
| | - Natalia Gnatienko
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA (TWK, JHS, NG, RS)
| | - Kendall Bryant
- HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, Maryland, USA
| | - Lindsey J Rateau
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA (CLT, MRW, LJR)
| | - Winnie R Muyindike
- Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda (WRM)
| | - Judith A Hahn
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA (JAH)
| | - Elena Blokhina
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russian Federation (EB)
| | - Richard Saitz
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA (TWK, JHS, NG, RS)
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA (TCH)
| |
Collapse
|
12
|
Mushi D, Moshiro C, Hanlon C, Francis JM, Teferra S. Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey. Subst Abuse Treat Prev Policy 2022; 17:50. [PMID: 35794580 PMCID: PMC9258127 DOI: 10.1186/s13011-022-00479-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The study aimed to identify the missed opportunity for detection and management of alcohol use disorder by primary health care workers. DESIGN A cross-sectional survey SETTING: Outpatient services in the six governmental primary health care facilities in Moshi district council in Tanzania. PARTICIPANTS A total of 1604 adults were screened for alcohol use disorder (AUD) using the Alcohol Use Disorder Identification Test (AUDIT). Participants scoring 8 or above then provided details about their help-seeking behavior and barriers to seeking care. Participants' records were reviewed to assess the screening and management of AUD. RESULTS In the last 12 months, 60.7% reported alcohol use, and heavy episodic drinking (HED) was reported by 37.3%. AUD (AUDIT ≥ 8) was present in 23.9%. Males were more likely to have HED (aPR = 1.43;95% CI:1.3 to 1.4) or AUD (aPR = 2.9; 95% CI 1.9 to 4.2). Both HED and AUD increased with age. Only one participant (0.3%) had documented AUD screening and management. Only 5% of participants screening positive for AUD had sought help. Reasons for not seeking care were thinking that the problem would get better by itself (55.0%), wanting to handle the problem alone (42.0%), or not being bothered by the problem (40.0%). CONCLUSION While reported alcohol use, HED, and AUD are common among patients presenting to primary healthcare facilities in northern Tanzania, help-seeking behavior and detection are very low. Not screening for AUD in primary health care is a missed opportunity for early detection and management. There is an urgent need to develop interventions to increase the detection of AUD by health care providers, while also addressing help-seeking behavior and barriers to seeking care.
Collapse
Affiliation(s)
- Dorothy Mushi
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Centre for Innovative Drug Development and Therapeutics Trial for Africa (CDT-Africa) College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Candida Moshiro
- Department of Epidemiology and Biostatistics Muhimbili, University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Charlotte Hanlon
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Joel M Francis
- Department of Epidemiology and Biostatistics Muhimbili, University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Family Medicine and Primary Care, Witwatersrand University, Faculty of Health Sciences, Johannesburg, South Africa
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
13
|
Woolf-King SE, Sheinfil AZ, Ramos J, Foley JD, Moskal D, Firkey M, Kellen D, Maisto SA. A conceptual model of alcohol use and adherence to antiretroviral therapy: systematic review and theoretical implications for mechanisms of action. Health Psychol Rev 2022; 16:104-133. [PMID: 32757813 PMCID: PMC8972079 DOI: 10.1080/17437199.2020.1806722] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol consumption is one of the most prevalent correlates of antiretroviral therapy (ART) adherence, yet causal processes underlying this association remain largely unexplored. The goal of this systematic review was to develop a conceptual model that describes the causal effect of alcohol consumption on ART nonadherence. We reviewed 230 studies that examined the association between alcohol consumption and ART adherence with three primary aims: (1) to replicate and extend previous reviews of the literature, (2) to summarize and critique study designs capable of answering questions about temporal overlap and (3) to summarize potential mechanisms of action. A model of alcohol-associated ART nonadherence was proposed to guide future work, integrating general theories of ART adherence and theory on the psychological and behavioral effects of alcohol intoxication. The conceptual model describes two mechanistic processes-prospective memory impairment and interactive toxicity beliefs/avoidance behaviors-involved in alcohol-associated intentional and unintentional nonadherence, respectively. This model can be used to guide future research on the causal processes involved in the frequently observed correlation between alcohol consumption and adherence.
Collapse
Affiliation(s)
| | - Alan Z. Sheinfil
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jeremy Ramos
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jacklyn D. Foley
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Dezarie Moskal
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Madison Firkey
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - David Kellen
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | | |
Collapse
|
14
|
Riebensahm C, Chitundu H, Muula G, Chihota B, Sinkala E, Sunkutu V, Maurer MH, Dufour JF, Berzigotti A, Egger M, Bolton-Moore C, Vinikoor M, Wandeler G. Screening for hepatocellular carcinoma among adults with HIV/HBV co-infection in Zambia: a pilot study. Int J Infect Dis 2022; 116:391-396. [PMID: 34952210 PMCID: PMC9912380 DOI: 10.1016/j.ijid.2021.12.338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIMS Chronic hepatitis B virus (HBV) infection is the main cause of hepatocellular carcinoma (HCC) in sub-Saharan Africa (SSA). An HCC screening initiative was piloted in an established cohort of individuals co-infected with human immunodeficiency virus (HIV) and HBV on antiretroviral therapy (ART) at two outpatient clinics in Lusaka, Zambia. METHODS All patients underwent abdominal ultrasound (AUS) and transient elastography. RESULTS Among 279 patients co-infected with HIV/HBV, 165 (59.1%) were men, median age was 34 years [interquartile range (IQR) 28-39 years] and median CD4 count was 246 cells/µL (IQR 112-355 cells/µL) at ART initiation. While 102 (55.7%) individuals had elevated transaminases, 114 (59.7%) had HBV levels >2000 IU/mL and 59 (24.6%) had significant fibrosis. At their first AUS measurement, 75 (26.9%) participants had hepatomegaly and 69 (24.7%) had periportal fibrosis. Five patients had a liver lesion >1 cm, an indication for confirmatory imaging. CONCLUSIONS In one of the first HCC screening initiatives in SSA, 2% of patients co-infected with HIV/HBV had significant liver lesions, and one-quarter had findings suggestive of schistosomiasis-induced liver damage.
Collapse
Affiliation(s)
- C Riebensahm
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - H Chitundu
- Department of Radiology, University Teaching Hospital, Lusaka, Zambia
| | - G Muula
- Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia
| | - B Chihota
- Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - E Sinkala
- Department of Medicine, University Teaching Hospital, Lusaka, Zambia
| | - V Sunkutu
- Department of Radiology, University Teaching Hospital, Lusaka, Zambia
| | - M H Maurer
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - J F Dufour
- Hepatology, Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - A Berzigotti
- Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Hepatology, Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - M Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Centre for Infectious Diseases Research, University of Cape Town, Cape Town, Republic of South Africa
| | - C Bolton-Moore
- Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia; Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - M Vinikoor
- Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia; Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - G Wandeler
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
15
|
Silumbwe A, Sabastian MS, Michelo C, Zulu JM, Johansson K. Sociodemographic factors associated with daily tobacco smoking and binge drinking among Zambians: evidence from the 2017 STEPS survey. BMC Public Health 2022; 22:205. [PMID: 35101017 PMCID: PMC8805266 DOI: 10.1186/s12889-022-12594-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/04/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The burden of disease attributable to tobacco smoking and harmful alcohol consumption poses a major threat to sustainable development in most low- and middle-income countries. However, evidence on tobacco use and harmful alcohol consumption to inform context-specific interventions addressing these harmful social behaviours is limited in the African context. This study aimed to determine the sociodemographic factors associated with daily tobacco smoking and binge drinking in Zambia. METHODS The study stems from nationwide population-based representative survey data collected using the World Health Organization's STEPwise approach for non-communicable disease risk factor surveillance in 2017 among 18-69-year-old Zambians. The main outcomes were daily tobacco smoking and binge drinking, and the demographic and socioeconomic variables included sex, marital status, age, residence, level of education and occupation. Prevalence ratios (PR) were calculated using log-binomial regression analysis. RESULTS Overall, 4302 individuals (weighted percentage 49.0% men and 51.0% women) participated in the survey. The prevalence of daily tobacco smoking was 9.0%, and 11.6% of participants engaged in binge drinking, both of which were higher among men than women (17.1% vs. 1.3% and 18.6% vs. 5.3%, respectively). The adjusted prevalence of daily tobacco smoking was 14.3 (95% CI: 9.74-21.01) times higher in men than women, and 1.44 (95% CI 1.03-1.99) times higher in the > 45-year-old group compared to the 18-29-year-old group. Significant positive associations with daily tobacco smoking were found among those with no education 2.70 (95% CI 1.79- 4.07) or primary education 1.86 (95% CI 1.22-2.83) compared to those with senior secondary or tertiary education. The adjusted prevalence of daily tobacco smoking was 0.37 times lower (95% CI 0.16-0.86) among students and homemakers compared to employed participants. The adjusted prevalence of binge drinking was 3.67 times higher (95% CI 2.83-4.76) in men than in women. Significantly lower adjusted prevalences of binge drinking were found in rural residents 0.59 (95% CI: 0.46-0.77) compared to urban residents and in students/homemakers 0.58 (95% CI: 0.35-0.94) compared to employed participants. CONCLUSION This study shows huge differences between men and women regarding tobacco smoking and binge drinking in Zambia. A high occurrence of tobacco smoking was observed among men, older members of society and those with lower levels of education, while binge drinking was more common in men and in those living in urban areas. There is a need to reshape and refine preventive and control interventions for tobacco smoking and binge drinking to target the most at-risk groups in the country.
Collapse
Affiliation(s)
- Adam Silumbwe
- Department of Health Policy and Management, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
| | - Miguel San Sabastian
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
| | - Charles Michelo
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia
| | - Joseph Mumba Zulu
- Department of Health Policy and Management, School of Public Health, University of Zambia, PO Box 50110, Lusaka, Zambia
| | - Klara Johansson
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
| |
Collapse
|
16
|
Maurage P, Lannoy S, Mange J, Grynberg D, Beaunieux H, Banovic I, Gierski F, Naassila M. What We Talk About When We Talk About Binge Drinking: Towards an Integrated Conceptualization and Evaluation. Alcohol Alcohol 2021; 55:468-479. [PMID: 32556202 DOI: 10.1093/alcalc/agaa041] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Binge drinking (BD), characterized by recurring alternations between intense intoxication episodes and abstinence periods, is the most frequent alcohol consumption pattern in youth and is growing in prevalence among older adults. Many studies have underlined the specific harmful impact of this habit by showing impaired abilities in a wide range of cognitive functions among binge drinkers, as well as modifications of brain structure and function. AIMS Several controversies and inconsistencies currently hamper the harmonious development of the field and the recognition of BD as a specific alcohol consumption pattern. The main concern is the absence of consensual BD conceptualization, leading to variability in experimental group selection and alcohol consumption evaluation. The present paper aims at overcoming this key issue through a two-step approach. METHODS AND CONCLUSIONS First, a literature review allows proposing an integrated BD conceptualization, distinguishing it from other subclinical alcohol consumption patterns. Six specific characteristics of BD are identified, namely, (1) the presence of physiological symptoms related to BD episodes, (2) the presence of psychological symptoms related to BD episodes, (3) the ratio of BD episodes compared to all alcohol drinking occasions, (4) the frequency of BD episodes, (5) the consumption speed and (6) the alternation between BD episodes and soberness periods. Second, capitalizing on this conceptual clarification, we propose an evaluation protocol jointly measuring these six BD characteristics. Finally, several research perspectives are presented to refine the proposed conceptualization.
Collapse
Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve 1348, Belgium
| | - Séverine Lannoy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford 94305, CA, USA
| | - Jessica Mange
- Laboratoire de Psychologie Caen Normandie (LPCN; EA 7452), University of Caen Normandy, Caen 14032, France
| | - Delphine Grynberg
- SCALab UMR 9193, Sciences Cognitives et Sciences Affectives, University of Lille, CNRS, CHU Lille, Lille 59000, France.,Institut Universitaire de France, Paris 75231, France
| | - Hélène Beaunieux
- Laboratoire de Psychologie Caen Normandie (LPCN; EA 7452), University of Caen Normandy, Caen 14032, France
| | - Ingrid Banovic
- CRFDP EA 7475, University of Rouen Normandie, Rouen 76000, France
| | - Fabien Gierski
- Cognition, Health, Society Laboratory (C2S-EA 6291), University of Reims Champagne Ardenne (URCA), Reims 51571, France.,INSERM UMR 1247, Research Group on Alcohol and Pharmacodependences, GRAP, University of Picardie Jules Verne, Amiens 80025, France
| | - Mickaël Naassila
- INSERM UMR 1247, Research Group on Alcohol and Pharmacodependences, GRAP, University of Picardie Jules Verne, Amiens 80025, France
| |
Collapse
|
17
|
Johnson WE, Odom A, Cintron C, Muthaiah M, Knudsen S, Joseph N, Babu S, Lakshminarayanan S, Jenkins DF, Zhao Y, Nankya E, Horsburgh CR, Roy G, Ellner J, Sarkar S, Salgame P, Hochberg NS. Comparing tuberculosis gene signatures in malnourished individuals using the TBSignatureProfiler. BMC Infect Dis 2021; 21:106. [PMID: 33482742 PMCID: PMC7821401 DOI: 10.1186/s12879-020-05598-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Background Gene expression signatures have been used as biomarkers of tuberculosis (TB) risk and outcomes. Platforms are needed to simplify access to these signatures and determine their validity in the setting of comorbidities. We developed a computational profiling platform of TB signature gene sets and characterized the diagnostic ability of existing signature gene sets to differentiate active TB from LTBI in the setting of malnutrition. Methods We curated 45 existing TB-related signature gene sets and developed our TBSignatureProfiler software toolkit that estimates gene set activity using multiple enrichment methods and allows visualization of single- and multi-pathway results. The TBSignatureProfiler software is available through Bioconductor and on GitHub. For evaluation in malnutrition, we used whole blood gene expression profiling from 23 severely malnourished Indian individuals with TB and 15 severely malnourished household contacts with latent TB infection (LTBI). Severe malnutrition was defined as body mass index (BMI) < 16 kg/m2 in adults and based on weight-for-height Z scores in children < 18 years. Gene expression was measured using RNA-sequencing. Results The comparison and visualization functions from the TBSignatureProfiler showed that TB gene sets performed well in malnourished individuals; 40 gene sets had statistically significant discriminative power for differentiating TB from LTBI, with area under the curve ranging from 0.662–0.989. Three gene sets were not significantly predictive. Conclusion Our TBSignatureProfiler is a highly effective and user-friendly platform for applying and comparing published TB signature gene sets. Using this platform, we found that existing gene sets for TB function effectively in the setting of malnutrition, although differences in gene set applicability exist. RNA-sequencing gene sets should consider comorbidities and potential effects on diagnostic performance. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05598-z.
Collapse
Affiliation(s)
- W Evan Johnson
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, USA. .,Bioinformatics Program, Boston University, Boston, MA, USA. .,Division of Computational Biomedicine and Bioinformatics Program, Boston University, Boston, MA, USA.
| | - Aubrey Odom
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, USA.,Bioinformatics Program, Boston University, Boston, MA, USA.,Division of Computational Biomedicine and Bioinformatics Program, Boston University, Boston, MA, USA
| | | | | | | | - Noyal Joseph
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Senbagavalli Babu
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - David F Jenkins
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, USA.,Bioinformatics Program, Boston University, Boston, MA, USA.,Division of Computational Biomedicine and Bioinformatics Program, Boston University, Boston, MA, USA
| | - Yue Zhao
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, USA.,Bioinformatics Program, Boston University, Boston, MA, USA.,Division of Computational Biomedicine and Bioinformatics Program, Boston University, Boston, MA, USA
| | - Ethel Nankya
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, USA.,Bioinformatics Program, Boston University, Boston, MA, USA.,Division of Computational Biomedicine and Bioinformatics Program, Boston University, Boston, MA, USA
| | - C Robert Horsburgh
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Gautam Roy
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jerrold Ellner
- Department of Medicine, Center for Emerging Pathogens, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Sonali Sarkar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Padmini Salgame
- Department of Medicine, Center for Emerging Pathogens, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Natasha S Hochberg
- Boston Medical Center, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
18
|
Surial B, Bertholet N, Daeppen JB, Darling KEA, Calmy A, Günthard HF, Stöckle M, Bernasconi E, Schmid P, Rauch A, Furrer H, Wandeler G. The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study. J Clin Med 2021; 10:jcm10020295. [PMID: 33466907 PMCID: PMC7830571 DOI: 10.3390/jcm10020295] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/04/2021] [Accepted: 01/11/2021] [Indexed: 12/20/2022] Open
Abstract
Whereas excessive alcohol consumption increases liver disease incidence and mortality, evidence on the risk associated with specific drinking patterns is emerging. We assessed the impact of binge drinking on mortality and liver disease in the Swiss HIV Cohort Study. All participants with follow-up between 2013 and 2020 were categorized into one of four drinking pattern groups: “abstinence”, “non-hazardous drinking”, “hazardous but not binge drinking” (Alcohol Use Disorder Identification Test Consumption [AUDIT-C] score ≥ 3 in women and ≥4 in men), and “binge drinking” (≥6 drinks/occasion more than monthly). We estimated adjusted incidence rate ratios (aIRR) for all-cause mortality, liver-related mortality and liver-related events using multivariable quasi-Poisson regression. Among 11,849 individuals (median follow-up 6.8 years), 470 died (incidence rate 7.1/1000 person-years, 95% confidence interval [CI] 6.5–7.8), 37 experienced a liver-related death (0.6/1000, 0.4–0.8), and 239 liver-related events occurred (3.7/1000, 3.2–4.2). Compared to individuals with non-hazardous drinking, those reporting binge drinking were more likely to die (all-cause mortality: aIRR 1.9, 95% CI 1.3–2.7; liver-related mortality: 3.6, 0.9–13.9) and to experience a liver-related event (3.8, 2.4–5.8). We observed no difference in outcomes between participants reporting non-hazardous and hazardous without binge drinking. These findings highlight the importance of assessing drinking patterns in clinical routine.
Collapse
Affiliation(s)
- Bernard Surial
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.R.); (H.F.); (G.W.)
- Correspondence:
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (N.B.); (J.-B.D.)
| | - Jean-Bernard Daeppen
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (N.B.); (J.-B.D.)
| | - Katharine E. A. Darling
- Division of Infectious Diseases, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland;
| | - Alexandra Calmy
- Division of Infectious Diseases, Geneva University Hospital, University of Geneva, 1205 Geneva, Switzerland;
| | - Huldrych F. Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
| | - Marcel Stöckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
| | - Enos Bernasconi
- Division of Infectious Diseases, Regional Hospital of Lugano, 6903 Lugano, Switzerland;
| | - Patrick Schmid
- Division of Infectious Diseases, Cantonal Hospital of St. Gallen, 9007 St. Gallen, Switzerland;
| | - Andri Rauch
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.R.); (H.F.); (G.W.)
| | - Hansjakob Furrer
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.R.); (H.F.); (G.W.)
| | - Gilles Wandeler
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.R.); (H.F.); (G.W.)
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
| | | |
Collapse
|
19
|
Kane JC, Sharma A, Murray LK, Chander G, Kanguya T, Lasater ME, Skavenski S, Paul R, Mayeya J, Kmett Danielson C, Chipungu J, Chitambi C, Vinikoor MJ. Common Elements Treatment Approach (CETA) for unhealthy alcohol use among persons with HIV in Zambia: Study protocol of the ZCAP randomized controlled trial. Addict Behav Rep 2020; 12:100278. [PMID: 32637558 PMCID: PMC7330869 DOI: 10.1016/j.abrep.2020.100278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 12/23/2022] Open
Abstract
AIMS Prevalence of unhealthy alcohol use and co-occurring mental health problems is high among persons living with HIV (PLWH) in sub-Saharan Africa (SSA). Yet, there is a dearth of evidence-based treatment options that can address both unhealthy alcohol use and comorbidities in SSA HIV care settings. Recent studies testing single-session alcohol brief interventions (BIs) among PLWH in SSA have suggested that more robust treatments are needed. This paper describes the protocol of a pilot randomized controlled superiority trial that will test the effectiveness of an evidence-based transdiagnostic multi-session psychotherapy, the Common Elements Treatment Approach (CETA), compared to a control condition consisting of a single session brief alcohol intervention (BI) based on CETA, at reducing unhealthy alcohol use, mental health problems, and other substance use among PLWH in urban Zambia. METHODS The study is a single-blind, parallel, individually randomized trial conducted in HIV treatment centers in Lusaka. 160 PLWH who meet criteria for unhealthy alcohol use + mental health or substance use comorbidities and/or have a more severe alcohol use disorder are eligible. Participants are randomized 1:1 to receive the single-session BI or CETA. Outcomes are assessed at baseline and a six-month follow-up and include unhealthy alcohol use, depression, trauma symptoms, and other substance use. CONCLUSIONS The trial is a first step in establishing the effectiveness of CETA at reducing unhealthy alcohol use and comorbidities among PLWH in SSA. If effectiveness is demonstrated, a larger trial featuring long-term follow-ups and HIV treatment outcomes will be undertaken.
Collapse
Affiliation(s)
- Jeremy C. Kane
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anjali Sharma
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Laura K. Murray
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Tukiya Kanguya
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Molly E. Lasater
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ravi Paul
- University of Zambia, School of Medicine, University Teaching Hospital, Lusaka, Zambia
| | | | | | - Jenala Chipungu
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Chipo Chitambi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | |
Collapse
|
20
|
Madhombiro M, Kidd M, Dube B, Dube M, Mutsvuke W, Muronzie T, Zhou DT, Derveeuw S, Chibanda D, Chingono A, Rusakaniko S, Hutson A, Morse GD, Abas MA, Seedat S. Effectiveness of a psychological intervention delivered by general nurses for alcohol use disorders in people living with HIV in Zimbabwe: a cluster randomized controlled trial. J Int AIDS Soc 2020; 23:e25641. [PMID: 33314786 PMCID: PMC7733606 DOI: 10.1002/jia2.25641] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION There have been very few randomized clinical trials of interventions for alcohol use disorders (AUD) in people living with HIV (PLWH) in African countries. This is despite the fact that alcohol use is one of the modifiable risk factors for poor virological control in PLWH on antiretroviral therapy. METHODS Sixteen clinic clusters in Zimbabwe were selected through stratified randomization and randomized 1: 1 to Intervention and Control arms. Inclusion criteria for individual participants were being adult, living with HIV and a probable alcohol use disorder as defined by a score of 6 (women) or 7 (men) on the Alcohol Use Disorders Identification Test (AUDIT). In the Intervention clusters, participants received 8 to 10 sessions of Motivational Interviewing blended with brief Cognitive Behavioural Therapy (MI-CBT). In the control clusters, participants received four Enhanced Usual Care (EUC) sessions based on the alcohol treatment module from the World Health Organisation mhGAP intervention guide. General Nurses from the clinics were trained to deliver both treatments. The primary outcome was a change in AUDIT score at six-month post-randomization. Viral load, functioning and quality of life were secondary outcomes. A random-effects analysis-of-covariance model was used to account for the cluster design. RESULTS Two hundred and thirty-four participants (n = 108 intervention and n = 126 control) were enrolled across 16 clinics. Participants were recruited from November 2016 to November 2017 and followed through to May 2018. Their mean age was 43.3 years (SD = 9.1) and 78.6% (n = 184) were male. At six months, the mean AUDIT score fell by -6.15 (95% CI -6.32; -6.00) in the MI-CBT arm, compared to a fall of - 3.09 95 % CI - 3.21; -2.93) in the EUC arm (mean difference -3.09 (95% CI -4.53 to -1.23) (p = 0.05). Viral load reduced and quality of life and functioning improved in both arms but the difference between arms was non-significant. CONCLUSIONS Interventions for hazardous drinking and AUD comprising brief, multiple alcohol treatment sessions delivered by nurses in public HIV facilities in low-income African countries can reduce problematic drinking among PLWH. Such interventions should be integrated into the primary care management of AUD and HIV and delivered by non-specialist providers. Research is needed on cost-effectiveness and implementation of such interventions, and on validation of cut-points for alcohol use scales in low resource settings, in partnership with those with lived experience of HIV and AUD.
Collapse
Affiliation(s)
- Munyaradzi Madhombiro
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
- SUNY University at BuffaloBuffaloNYUSA
| | - Martin Kidd
- Centre for Statistical ConsultationStellenbosch UniversityStellenboschSouth Africa
| | - Bazondlile Dube
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | - Michelle Dube
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | - Wilson Mutsvuke
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | | | - Danai Tavonga Zhou
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
- Department of Medical Laboratory SciencesUniversity of ZimbabweHarareZimbabwe
| | - Sarah Derveeuw
- Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUnited Kingdom
| | - Dixon Chibanda
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | - Alfred Chingono
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | | | - Alan Hutson
- Department of Biostatistics and BioinformaticsRoswell Park Comprehensive Cancer CenterBuffaloNYUSA
| | | | - Melanie A Abas
- Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUnited Kingdom
- Lewisham HospitalSouth London and MaudsleyNHS Foundation TrustLondonUnited Kingdom
| | - Soraya Seedat
- Faculty of Medicine and Health SciencesStellenbosch UniversityStellenboschSouth Africa
| |
Collapse
|
21
|
Desai N, Burns L, Gong Y, Zhi K, Kumar A, Summers N, Kumar S, Cory TJ. An update on drug-drug interactions between antiretroviral therapies and drugs of abuse in HIV systems. Expert Opin Drug Metab Toxicol 2020; 16:1005-1018. [PMID: 32842791 DOI: 10.1080/17425255.2020.1814737] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION While considerable progress has been made in the fight against HIV/AIDS, to date there has not been a cure, and millions of people around the world are currently living with HIV/AIDS. People living with HIV/AIDS have substance abuse disorders at higher rates than non-infected individuals, which puts them at an increased risk of drug-drug interactions. AREAS COVERED Potential drug-drug interactions are reviewed for a variety of potential drugs of abuse, both licit and illicit. These drugs include alcohol, cigarettes or other nicotine delivery systems, methamphetamine, cocaine, opioids, and marijuana. Potential interactions include decreased adherence, modulation of drug transporters, or modulation of metabolic enzymes. We also review the relative incidence of the use of these drugs of abuse in People living with HIV/AIDS. EXPERT OPINION Despite considerable improvements in outcomes, disparities in outcomes between PLWHA who use drugs of abuse, vs those who do not still exist. It is of critical necessity to improve outcomes in these patients and to work with them to stop abusing drugs of abuse.
Collapse
Affiliation(s)
- Nuti Desai
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Leah Burns
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Yuqing Gong
- Department of Pharmacy Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Kaining Zhi
- Plough Center for Sterile Drug Delivery Solutions, University of Tennessee Health Science Center , Memphis, TN, USA
| | - Asit Kumar
- Department of Pharmacy Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Nathan Summers
- Division of Infectious Diseases, University of Tennessee Health Science Center College of Medicine , Memphis, TN, USA
| | - Santosh Kumar
- Department of Pharmacy Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Theodore J Cory
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| |
Collapse
|
22
|
Necho M, Belete A, Getachew Y. The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:63. [PMID: 32831129 PMCID: PMC7444054 DOI: 10.1186/s13011-020-00301-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/12/2020] [Indexed: 01/11/2023]
Abstract
Background Alcohol use disorder (AUD) in HIV/AIDS patient’s decreases adherence and effectiveness of medications and help-seeking to HIV/AIDS care and treatment. This study, therefore, assessed the average 1 year prevalence and associated factors of alcohol use disorder in HIV/AIDS patients. Methods We did an electronic data search on PubMed, Scopus, EMBASE, Psych-INFO libraries, African index Medicus and African Journals Online (AJOL). Google scholar was also investigated for non-published articles. The reference lists of published articles were also reviewed. The stata-11meta-prop package was employed. Subgroup and sensitivity analyses were done. Cochran’s Q-statistics and the Higgs I2 test were used to check heterogeneity. Publication bias was evaluated with Egger’s test and funnel plots. Results Of 1362 articles identified using the search strategies; only 22 studies were included in the final analysis. The average 1 year prevalence of AUD was 22.03% (95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). The prevalence of AUD in studies published before 2011, 2011–2015, and after 2015 was found to be 13.47, 24.93, and 22.88% respectively. The average prevalence of AUD among studies with a sample size > 450 was 16.71% whereas it was 26.46% among studies with a sample size < 450. Furthermore, the average prevalence of hazardous, harmful, and dependent drinking was 10.87, 8.1, and 3.12% respectively. Our narrative analysis showed that male sex, cigarette smoking, family history of alcohol use, missing ART medication, mental distress, khat chewing, low CD4 count, and low income were among the associated factors for AUD in people with HIV AIDS. On quantitative meta-analysis for associated factors of AUD, the AOR of being male, Cigarette smoking and khat chewing were 5.5, 3.95, and 3.34 respectively. Conclusion The average 1 year prevalence of AUD in HIV/AIDs patients was high and qualitatively factors such as being Male, cigarette smoking, and khat chewing were associated with it. Therefore, clinical services for people living with HIV/AIDS should integrate this public health problem. Policymakers should also develop guidelines and implementation strategies for addressing this problem.
Collapse
Affiliation(s)
- Mogesie Necho
- Wollo University, College of Medicine and Health Sciences, Department of Psychiatry, Dessie, Ethiopia.
| | - Asmare Belete
- Wollo University, College of Medicine and Health Sciences, Department of Psychiatry, Dessie, Ethiopia
| | - Yibeltal Getachew
- College of Medicine and Health Sciences, Department of Psychiatry, Diredawa University, Diredawa, Ethiopia
| |
Collapse
|
23
|
"Moving Forward with Life": Acceptability of a Brief Alcohol Reduction Intervention for People Receiving Antiretroviral Therapy in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165706. [PMID: 32784613 PMCID: PMC7459709 DOI: 10.3390/ijerph17165706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022]
Abstract
Background: In South Africa, interventions are needed to address the impact of hazardous drinking on antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability. We interviewed participants in a randomized controlled trial of a brief motivational interviewing and problem-solving therapy (MI-PST) intervention about their perceptions of this alcohol-reduction intervention. Methods: The trial was conducted in HIV treatment clinics operating from six hospitals in the Tshwane region of South Africa. We conducted qualitative in-depth interviews with a random selection of participants. Twenty-four participants were interviewed after the final intervention session and 25 at the six-month follow up. Results: Participants believed that it was acceptable to offer PLWH, an alcohol reduction intervention during HIV treatment. They described how the MI-PST intervention had helped them reduce their alcohol consumption. Intervention components providing information on the health benefits of reduced consumption and building problem-solving and coping skills were perceived as most beneficial. Despite these perceived benefits, participants suggested minor modifications to the dosage, content, and delivery of the intervention for greater acceptability and impact. Conclusions: Findings highlight the acceptability and usefulness of this MI-PST intervention for facilitating reductions in alcohol consumption among PLWH.
Collapse
|
24
|
Kaswa R, De Villiers M. Prevalence of substance use amongst people living with human immunodeficiency virus who attend primary healthcare services in Mthatha, South Africa. S Afr Fam Pract (2004) 2020; 62:e1-e7. [PMID: 32501039 PMCID: PMC8378084 DOI: 10.4102/safp.v62i1.5042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 02/23/2020] [Accepted: 03/20/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND About 13.3% of the South African population use some kind of substance during their lifetime. The incidence of substance use disorders is twice the global average. The use of various substances amongst people living with human immunodeficiency virus (PLWH) has increased tremendously in recent years. The growing culture of substance use amongst PLWH is a serious threat adding to the human immunodeficiency virus (HIV) epidemic and is likely to compromise the continuity of HIV care. METHODS A cross-sectional descriptive survey recruited adult PLWH who attended primary healthcare (PHC) services in Mthatha between 15 March and 15 April 2018. The Alcohol, Smoking and Substance Involvement Screening Test questionnaire (ASSIST), a tool validated by the World Health Organization, was used for data collection. RESULTS Out of a total 347 participants, 53% reported lifetime substance use and 32% admitted current use of a substance. Alcohol was the most common substance reported, followed by tobacco and cannabis. The majority of participants were female (75.2%), unemployed (70.8%), had secondary school-level education (85.2%) and a per capita household income below the national food poverty line (75%). The mean age of the participants was 37.9 years (standard deviation [SD] ± 10.33); this was marginally higher for male (39.9 years; SD ± 10.92) than female (37.2 years; SD ± 10.06) participants. CONCLUSION This study has shown that there is a high prevalence of lifetime and current alcohol abuse amongst PLWH who make use of PHC services in the Mthatha area of South Africa. Of particular concern are the strong pointers towards younger people and males.
Collapse
Affiliation(s)
- Ramprakash Kaswa
- Department of Family Medicine and Primary Care, Faculty of Medicine, Stellenbosch University, Cape Town.
| | | |
Collapse
|
25
|
Kalichman SC, Mathews C, Banas E, Kalichman MO. Alcohol-related beliefs and non-adherence to antiretroviral therapy in Cape Town, South Africa. J Behav Med 2020; 43:764-772. [PMID: 31955306 DOI: 10.1007/s10865-020-00135-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023]
Abstract
The life-saving effects of antiretroviral therapy (ART) in treating HIV infection are compromised by alcohol use. A growing body of research shows that both unintentional (e.g., memory lapses) and intentional (e.g., forgoing ART to avoid mixing with alcohol) contribute to ART non-adherence. Beliefs that it is harmful to mix alcohol with ART (alcohol-ART interactive toxicity beliefs) contribute to intentional non-adherence, but their role in overall adherence is not clear. This study conducted a clinic-based survey with 100 men and 193 women (mean age = 36) to examine the prevalence of alcohol-ART interactive toxicity beliefs and whether they contribute to treatment non-adherence in South Africa. One in three (36%, n = 106) participants reported no current alcohol use and 64% (n = 187) reported current alcohol use. The majority of participants, including current alcohol drinkers, endorsed beliefs that it is harmful to mix ART and alcohol, with 57% who currently drink reporting that they forgo taking ART when they are drinking. Participants reported being warned not to mix alcohol and ART from family, friends, and health care providers. In addition, 62% of participants who do not drink, as well as 36% of those who do drink, tell others not to mix alcohol and ART. Mediation modelling found that alcohol use directly predicts ART adherence, and that this relationship is partially mediated by alcohol-ART interactive toxicity beliefs. Health care providers can play a critical role in disputing interactive toxicity beliefs and encouraging patients to take ART even when they are drinking.
Collapse
Affiliation(s)
- Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ellen Banas
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.,Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Moira O Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
26
|
Duko B, Ayalew M, Ayano G. The prevalence of alcohol use disorders among people living with HIV/AIDS: a systematic review and meta-analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:52. [PMID: 31727086 PMCID: PMC6854786 DOI: 10.1186/s13011-019-0240-3] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/31/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Alcohol use disorder (AUD) is common among people living with HIV/AIDS (PLWHA) and associated with a greater risk of poor medication adherence, unsafe sexual behaviors as well as poor quality of life. To our knowledge, there is no previous systematic review and meta-analysis that reported the pooled prevalence estimate of AUD among PLWHA. Therefore, this review aimed to systematically review the available studies on the prevalence of AUD among PLWHA and forward possible recommendations for future clinical practice and research. METHODS PubMed, EMBASE, Psych INFO and SCOPUS databases were searched to identify the relevant studies. We have also scanned the reference lists of the eligible studies to supplement our electronic search. We used the Comprehensive Meta-Analysis software versions 3.0 to conduct a meta-analysis. Subgroup and sensitivity analysis were performed and Cochran's Q- and the I2- test were employed to see the heterogeneity. The presence of publication bias was explored by utilizing Egger's test and visual inspection of the symmetry in funnel plots. RESULTS A total of 25 studies with 25,154 participants across developed and developing countries were included in the final analysis. Our meta-analysis revealed that the pooled prevalence estimate of AUD among PLWHA was found to be 29.80% (95% CI; 24.10-35.76). The prevalence of AUD was higher in males (26.90%) than female (13.37%) HIV patients. In this study, the pooled prevalence of AUD was considerably higher (31.52%) when measured by Alcohol Use Disorders Identification Test (AUDIT) as compared to Composite International Diagnostic Interview (CIDI) (13.51%). In addition, the pooled prevalence of AUD was higher in the developed countries (42.09%) while lower for developing countries (24.52%). CONCLUSION In the current study, the pooled prevalence estimates of AUD among PLWHA was considerably high (29.80%). Screening and appropriate management of AUD among PLWHA are recommended.
Collapse
Affiliation(s)
- Bereket Duko
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
| | - Mohammed Ayalew
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| |
Collapse
|
27
|
Duko B, Toma A, Abraham Y. Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross- sectional study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:22. [PMID: 31109353 PMCID: PMC6528325 DOI: 10.1186/s13011-019-0212-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/09/2019] [Indexed: 01/17/2023]
Abstract
Background Individuals living with HIV/AIDS with co-occurring harmful alcohol use may require specialized intervention or even multi-disciplinary team follow-up and management. This study was aimed to assess alcohol use disorder and associated factors among people living with HIV/AIDS in Hawassa city, Ethiopia, 2019. Methods A facility based cross-sectional study was conducted among 195 people living with HIV/AIDS who had follow-up visit at Hawassa University Comprehensive Specialized hospital. A systematic sampling technique was used to recruit the study participants. Alcohol used disorders identification test (AUDIT) was used to measure alcohol consumption, drinking behaviors, and alcohol-related problems. The binary logistic regression model was used to see the association between alcohol use disorder (AUD) and the independent variables. The strength of association was measured by odds ratios with 95% confidence intervals. Statistical significance declared at P < 0.05. Results The mean age of the study participants was 29.88 (±SD = 10.89) years. The magnitude of alcohol use disorder among people living with HIV/AIDS was 31.8%. Being male [AOR = 2.43, (95% CI: 1.76, 5.76)], having poor social support [AOR = 1.34, (95% CI: 1.12, 6.73)], being medication non-adherent [AOR = 1.78, (95% CI: 1.33, 6.79)], current khat chewing [AOR = 1.67, (95% CI: 1.16, 5.45)] and current cigarette smoking [AOR = 3.76, (95% CI: 2.16, 7.54)] had statistically significant association with alcohol use disorder. Conclusion In the current study, magnitude of alcohol use disorder among people living with HIV was high and, calls for integrating services provided to HIV patients in HIV care and treatment clinic which enhances timely detection and management of AUD cases. This also alerts the stakeholders in HIV prevention and control programs to invest a greater efforts to retain patients in addiction treatment and rehabilitation centers. Lastly, appropriate screening and health education on consequences of alcohol use disorder is warranted.
Collapse
Affiliation(s)
- Bereket Duko
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia.
| | - Alemayehu Toma
- Faculty of Medical Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Yacob Abraham
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| |
Collapse
|