六个非洲国家的危险饮酒与艾滋病毒指标：基于人群的艾滋病毒影响评估，2015-2017 年的结果。

Hazardous alcohol use and HIV indicators in six African countries: results from the Population-based HIV Impact Assessments, 2015-2017.

机构信息

Division of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

PHI/CDC Global Health Fellowship Program, Oakland, California, USA.

出版信息

J Int AIDS Soc. 2022 Nov;25(11):e26029. doi: 10.1002/jia2.26029.

DOI:10.1002/jia2.26029

PMID:36408717

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9677379/

Abstract

INTRODUCTION

Hazardous alcohol use (HAU), defined as a pattern of alcohol consumption that increases the risk of harmful consequences for the user or others, is associated with an elevated risk of human immunodeficiency virus (HIV) infection and poor health outcomes. We describe the association between people living with HIV (PLHIV) who report HAU and key HIV indicators. Gaps in current literature in estimating HAU on HIV outcomes at the regional level of Eastern and Southern Africa still exist and our analysis aims to address this issue.

METHODS

We used weighted pooled data (2015-2017) from the nationally representative Population-based HIV Impact Assessments among adults who provided written consent aged 18-59 years from Eswatini, Malawi, Namibia, Tanzania, Zambia and Zimbabwe. We estimated differences in the prevalence of HIV infection and The Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 indicators between PLHIV by HAU status using log-binomial regression, stratified by sex. HAU was determined using the Alcohol Use Identification Test-Consumption.

RESULTS

Among the 9755 women and 4444 men who tested HIV positive, 6.6% of women and 21.8% of men engaged in HAU. Women who reported HAU were more likely to be HIV positive (adjusted prevalence ratio [aPR] = 1.31, 95% CI: 1.18-1.46) compared to those who did not report HAU. For the UNAIDS 90-90-90 targets, women who engaged in HAU were more likely to be unaware of their HIV-positive status (aPR = 1.22, 95% CI: 1.01-1.47) and not on antiretroviral therapy (ART) (aPR = 1.73, 95% CI: 1.26-2.37). Men who engaged in HAU were more likely to be unaware of their HIV-positive status (aPR = 1.56, 95% CI 1.39-1.76) and not on ART (aPR = 1.72, 95% CI: 1.30-2.29). No difference in viral load suppression, defined as <1000 copies/ml of HIV RNA, was seen by sex.

CONCLUSIONS

PLHIV who engage in HAU were more likely to have suboptimal outcomes along the HIV care continuum when compared to those who did not engage in HAU. Targeted interventions, such as alcohol screening for HAU in HIV testing and treatment settings and HIV prevention efforts in alcohol-based venues, may help countries reach HIV epidemic control by 2030.

摘要

简介

危险饮酒（HAU）定义为饮酒模式增加使用者或他人发生有害后果的风险，与人类免疫缺陷病毒（HIV）感染和健康不良结局的风险增加有关。我们描述了报告有 HAU 的 HIV 感染者（PLHIV）与关键 HIV 指标之间的关联。在东非和南部非洲地区，关于 HIV 结局的 HAU 估算方面，目前的文献仍存在空白，我们的分析旨在解决这一问题。

方法

我们使用了来自 2015 年至 2017 年在斯威士兰、马拉维、纳米比亚、坦桑尼亚、赞比亚和津巴布韦的具有全国代表性的成年人进行的基于人群的 HIV 影响评估中获得的经加权的汇总数据，这些成年人提供了书面同意，年龄在 18 至 59 岁之间。我们使用对数二项式回归，按性别分层，估计了 HIV 感染者（PLHIV）中 HAU 状况与 HIV 感染率和联合国艾滋病规划署（UNAIDS）90-90-90 指标之间的差异。使用酒精使用识别测试-消耗来确定 HAU。

结果

在 9755 名女性和 4444 名男性 HIV 检测呈阳性者中，分别有 6.6%的女性和 21.8%的男性存在 HAU。与未报告 HAU 的人相比，报告有 HAU 的女性更有可能 HIV 阳性（调整后患病率比[aPR] = 1.31，95%置信区间：1.18-1.46）。对于 UNAIDS 90-90-90 目标，有 HAU 的女性更有可能不知道自己 HIV 阳性（aPR = 1.22，95%置信区间：1.01-1.47）且未接受抗逆转录病毒治疗（ART）（aPR = 1.73，95%置信区间：1.26-2.37）。有 HAU 的男性更有可能不知道自己 HIV 阳性（aPR = 1.56，95%置信区间 1.39-1.76）且未接受 ART（aPR = 1.72，95%置信区间：1.30-2.29）。无论性别如何，病毒载量抑制（定义为 HIV RNA <1000 拷贝/ml）都没有差异。