Intersection of alcohol use, HIV infection, and the HIV care continuum in Zambia: nationally representative survey
Date
2023
Authors
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Publisher
AIDS Care
Abstract
Through a nationally representative household survey, we measured the prevalence and correlates
of unhealthy alcohol use (UAU) in Zambia and its association with the HIV care continuum.
Adolescent and adult (ages 15–59 years) data, including the Alcohol Use Disorders Identification
Test-Consumption (AUDIT-C), from the 2016 Zambia Population-based HIV Impact Assessment,
were analyzed. UAU was defined as AUDIT-C of 3+ points for women and 4+ for men. Among
Of 20,923 participants, 15.3% had UAU; this was 21.6% among people living with HIV (PLWH).
Male sex, increasing age, being employed, urban residence, and having HIV were independent
correlates of UAU (all P<0.05). Among PLWH, UAU was associated with reduced HIV diagnosis
(adjusted odds ratio [AOR]: 0.66, 95% CI 0.50–0.88) and non-significant trends toward reduced
ART use if diagnosed (AOR: 0.73, 95% CI 0.73–1.10) and reduced viral suppression (VS) if
on ART (AOR: 0.91, 95% CI 0.57–1.44). Overall, UAU was linked to 25% lower odds of
VS compared to abstinence. UAU in Zambia disproportionately affects certain groups including
PLWH. Achieving and sustaining HIV epidemic control in Zambia will require evidence-based
approaches to screen and treat UAU.
Description
Research Article
Keywords
unhealthy alcohol use, HIV care continuum, sub-Saharan Africa