Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
School of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
AIDS Care. 2023 Oct;35(10):1555-1562. doi: 10.1080/09540121.2022.2092589. Epub 2022 Jun 27.
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 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 < 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.
通过一项全国代表性的家庭调查，我们测量了赞比亚不健康饮酒（UAU）的流行率和相关因素，以及其与艾滋病毒护理连续体的关联。分析了 2016 年赞比亚基于人口的艾滋病毒影响评估中的青少年和成人（15-59 岁）数据，包括酒精使用障碍识别测试-消费（AUDIT-C）。UAU 的定义为女性 AUDIT-C 得分为 3+，男性得分为 4+。在 20923 名参与者中，15.3%有 UAU；艾滋病毒感染者（PLWH）中这一比例为 21.6%。男性、年龄增长、就业、城市居住和感染艾滋病毒是 UAU 的独立相关因素（均<0.05）。在 PLWH 中，UAU 与 HIV 诊断减少（调整后的优势比[OR]：0.66，95%置信区间 0.50-0.88）以及诊断后抗逆转录病毒治疗使用率降低（OR：0.73，95%置信区间 0.73-1.10）和接受抗逆转录病毒治疗时病毒抑制率降低（OR：0.91，95%置信区间 0.57-1.44）呈负相关。总的来说，与禁欲相比，UAU 使病毒抑制率降低了 25%。UAU 在赞比亚不成比例地影响某些群体，包括 PLWH。要实现并维持赞比亚的艾滋病毒流行控制，需要采取基于证据的方法来筛查和治疗 UAU。
