Population attributable fraction of incident HIV infections associated with alcohol consumption in fishing communities around Lake Victoria, Uganda.

• Main Authors: Kiwanuka, Noah, Ssetaala, Ali, Ssekandi, Ismail, Nalutaaya, Annet, Kitandwe, Paul Kato, Ssempiira, Julius, Bagaya, Bernard Ssentalo, Balyegisawa, Apolo, Kaleebu, Pontiano, Hahn, Judith, Lindan, Christina, Sewankambo, Nelson Kaulukusi
• Other Authors: Braitstein, Paula
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: eScholarship, University of California 2017
• Subjects: Humans; HIV-1; HIV Infections; Incidence; Risk Factors; Longitudinal Studies; Alcohol Drinking; Risk-Taking; Fisheries; Adolescent; Adult; Middle Aged; Uganda; Female; Male; Young Adult; Lakes; Prevention; HIV/AIDS; Behavioral and Social Science; Infectious Diseases; Clinical Research; Substance Abuse; Alcoholism; Alcohol Use and Health; Infection; Stroke; General Science & Technology; Greenland
• Online Access: https://escholarship.org/uc/item/9dm0s6w5

BackgroundAlthough the association between alcohol consumption and HIV risk is well documented, few studies have examined the magnitude of new HIV infections that could be prevented by controlling alcohol use. We report the population attributable fraction (PAF) of incident HIV infections due to alcohol consumption among the HIV high-risk population of fishing communities along Lake Victoria, Uganda.MethodsIn a community-based cohort study, 1607 HIV sero-negative participants aged 18-49 years were enrolled from eight fishing communities along Lake Victoria, Uganda. At follow up 12 months later, 1288 (80.1%) were seen and interviewed. At baseline and follow-up visits, participants completed interviewer-administered questionnaires on alcohol consumption, demographics, and sexual risk behavior, and were tested for HIV infection. HIV incidence and adjusted incident rate ratios (adjusted IRRs) were estimated using Poisson regression models; the crude and adjusted PAFs of incident HIV infections associated with alcohol consumption were calculated using the Greenland and Drescher method for cohort studies.ResultsAmong the 1288 participants seen at follow up, 53.5% reported drinking alcohol of whom 24.4% drank occasionally (2 days a week or less) and 29.1% drank regularly (3-7 days a week). Forty eight incident HIV infections occurred giving an incidence rate of 3.39/100 person years at-risk (pyar) (95% CI, 2.55-4.49). Compared to non-drinkers, the adjusted IRR of HIV was 3.09 (1.13-8.46) among occasional drinkers and 5.34 (2.04-13.97) among regular drinkers. The overall adjusted PAF of incident HIV infections due alcohol was 64.1 (95% CI; 23.5-83.1); ranging from 52.3 (11.9-74.2) among Muslims to 71.2 (32.6-87.7) for participants who reported ≥ 2 sexual partners in the past 12 months.ConclusionIn fishing communities along Lake Victoria, Uganda, 64% of new HIV infections can be attributed to drinking alcohol. Interventions to reduce alcohol consumption should be integrated in HIV/AIDS prevention activities for ...