In Practice

Heavy alcohol use in patients on highly active antiretroviral therapy: What responses are needed?

Charles David Parry, Connie Kekwaletswe, Paul A Shuper, Sebenzile Nkosi, Bronwyn J Myers, Neo K Morojele

Abstract


Background. Alcohol has a negative effect on antiretroviral therapy (ART) adherence and HIV treatment outcomes.

Method. As part of formative work for a project to test the efficacy of an alcohol-focused intervention to reduce alcohol consumption and improve HIV treatment outcomes, we investigated the extent of problem drinking among patients at ART clinics in Tshwane, South Africa (SA), using the Alcohol Use Disorders Identification Test (AUDIT).

Results. The finding that a third of drinkers reported hazardous drinking, roughly 10% reported harmful drinking, and a further 10% were possibly alcohol dependent replicates the findings of similar research in the Western Cape and Gauteng provinces of SA. It also points to the need for more routine screening of ART patients for problematic alcohol use.

Conclusion. The 10-item AUDIT may be too time consuming for health workers in busy ART clinics to administer and score, necessitating even briefer screening instruments for assessing hazardous and harmful drinking.


Authors' affiliations

Charles David Parry, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council Cape Town, South Africa; Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

Connie Kekwaletswe, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa

Paul A Shuper, Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada; Center for Health, Intervention, and Prevention, University of Connecticut, Mansfield, USA

Sebenzile Nkosi, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa

Bronwyn J Myers, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council Cape Town, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa

Neo K Morojele, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

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Keywords

Epidemiology; Alcohol; HIV; Screening; Adherence; ART

Cite this article

South African Medical Journal 2016;106(6):567-568. DOI:10.7196/SAMJ.2016.v106i6.10639

Article History

Date submitted: 2016-02-05
Date published: 2016-05-08

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