Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Sci Rep. 2024 Nov 29;14(1):29745. doi: 10.1038/s41598-024-79406-y.
Background Alcohol use disorder in people living with the human immunodeficiency virus is an important public health problem associated with high rates of HIV infection and lower antiretroviral treatment adherence. However, little is known about the prevalence of alcohol use disorders and its impact on ART adherence among people living with HIV/AIDS (PLWHA). Thus, this study aimed to evaluate the magnitude of alcohol use disorder and its impact on medication adherence among PLWHA attending the ART clinic. Methods A hospital based cross sectional study design was conducted at University of Gondar Comprehensive Specialized Hospital (UOGCSH) ART clinic from September 30, 2023 to February 30, 2024. The World Health Organization's Alcohol Use Disorders Identification Tool (AUDIT) was utilized to assess alcohol use disorder. Bivariate and multivariate logistic regression analyses were employed to investigate the relationship between AUDs and other variables. Statistical analysis was conducted using SPSS version 26, with a significance level set at P < 0.05. Results The overall prevalence of AUDs was 38.8%, with hazardous use, harmful use, and alcohol dependence accounting for 24.6%, 6.1%, and 8.1% of the total, respectively. In addition, 67.8% of the participants had medication adherence above 95%. Factors associated with alcohol use disorder were male AOR = 1.52; 95% CI (1.01, 2.30), cigarette smoking AOR = 2.384, 95% CI (1.183, 4.80), educational status AOR = 1.96, 95% CI (1.016, 3.764), and age 45-57 years AOR = 3.05, CI (1.587, 5.871). In present study, compared with social drinkers, harmful drinkers and alcohol dependents showed low medication adherence under 95% (AOR = 4.08 and AOR = 8.89, respectively). Conclusion The study reveals a high prevalence of alcohol use and dependence in PLWHA, underscoring the need for effective detection and intervention strategies particularly for males, cigarette smoker, and age between 54 and 75 years in healthcare and community settings. Alcohol use is strongly associated with poor adherence to antiretroviral therapy (ART). Individuals with hazardous alcohol use are four times more likely to have low adherence, while alcohol-dependent individuals are nearly nine times more likely to have low adherence compared to social drinkers.
在感染人类免疫缺陷病毒（HIV）的人群中，酒精使用障碍是一个重要的公共卫生问题，与 HIV 感染率高和抗逆转录病毒治疗依从性低有关。然而，对于 HIV/AIDS（艾滋病毒/艾滋病）患者中酒精使用障碍的流行程度及其对 ART 依从性的影响知之甚少。因此，本研究旨在评估酒精使用障碍的严重程度及其对接受抗逆转录病毒治疗（ART）诊所治疗的 HIV/AIDS 患者（PLWHA）药物依从性的影响。
本研究采用医院横断面研究设计，于 2023 年 9 月 30 日至 2024 年 2 月 30 日在贡德尔大学综合专科医院（UOGCSH）ART 诊所进行。采用世界卫生组织酒精使用障碍识别工具（AUDIT）评估酒精使用障碍。采用双变量和多变量逻辑回归分析来研究 AUD 与其他变量之间的关系。使用 SPSS 版本 26 进行统计分析，显著性水平设置为 P < 0.05。
总体而言，酒精使用障碍的患病率为 38.8%，其中危险使用、有害使用和酒精依赖分别占总人数的 24.6%、6.1%和 8.1%。此外，67.8%的参与者的药物依从性超过 95%。与酒精使用障碍相关的因素包括男性（AOR=1.52；95%CI（1.01，2.30））、吸烟（AOR=2.384，95%CI（1.183，4.80））、教育程度（AOR=1.96，95%CI（1.016，3.764））和年龄 45-57 岁（AOR=3.05，CI（1.587，5.871））。在本研究中，与社交饮酒者相比，有害饮酒者和酒精依赖者的药物依从性低于 95%（AOR=4.08 和 AOR=8.89）。
本研究揭示了 PLWHA 中酒精使用和依赖的高患病率，这突显了在医疗和社区环境中，特别是针对男性、吸烟者和 54 至 75 岁年龄组，需要采取有效的检测和干预策略。酒精使用与抗逆转录病毒治疗（ART）的依从性差密切相关。有危险饮酒行为的个体发生低依从性的可能性是社交饮酒者的四倍，而有酒精依赖的个体发生低依从性的可能性是社交饮酒者的近九倍。
