The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis

Mogesie Necho,Yibeltal Getachew,Asmare Belete

doi:10.1186/s13011-020-00301-6

Mogesie Necho, Yibeltal Getachew + Show 1 more

Open Access

https://doi.org/10.1186/s13011-020-00301-6

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Abstract

BackgroundAlcohol 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.MethodsWe 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.ResultsOf 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.ConclusionThe 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.

Highlights

Alcohol use disorder (AUD) in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patient’s decreases adherence and effectiveness of medications and help-seeking to HIV/AIDS care and treatment
We conducted our search in PubMed with the following key terms and words: (Prevalence odds ratios (OR) epidemiology OR magnitude OR incidence) AND (Alcohol use disorder OR alcohol abuse OR alcohol use) AND (HIV OR human immunodeficiency virus OR AIDS OR PLWHA OR antiretroviral treatment (ART)) AND AND (Southern Africa OR Central Africa OR East Africa OR North Africa OR Western Africa OR Sub-Saharan Africa)
In general, AUD in people living with HIV/AIDS is highly prevalent and linked with non-adherence to antiretroviral therapy, decreased help-seeking, and health care utilization as well as poor HIV treatment outcomes [63]

Summary

Introduction

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, assessed the average 1 year prevalence and associated factors of alcohol use disorder in HIV/AIDS patients. Its Harmful use is associated with tremendous health, social and economic consequences [1,2,3]. AUDs contribute to 3.8% of the burden of disease globally [4] The global burden of deaths due to alcohol outweighs the synergized burden of deaths from acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV), tuberculosis and violence [3]. AUDs can be of harmful use, hazardous or dependence use [5]. Harmful alcohol use is a pattern of use in the control of the will of individuals, whereas hazardous use is a pattern of use with the risk of harmful social, physical, and mental consequences. Alcohol dependence is the most severe end of the AUD spectrum [4, 5]

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