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Exploring the Association Between Social Support and Hazardous Alcohol Use Among Persons Living with HIV in South Western Uganda

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Abstract

Hazardous alcohol use and psychological distress are common among persons living with HIV (PLWH). In Uganda, HIV prevalence is 6.2% with average pure alcohol consumption per capita of 9.8 L. Social support may mitigate hazardous alcohol use. In a cohort of 443 PLWH, we measured social support using the Duke—UNC functional social support scale and self-reported alcohol consumption using the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C), augmented by phosphatidylethanol (PEth). We examined the association between low social support and hazardous alcohol use using multiple logistic regression models. 30% had low social support and 44% had hazardous alcohol use (AUDIT-C ≥ 3 for women and ≥ 4 for men and/or PEth ≥ 50 ng/mL). We did not detect an association between low social support and hazardous alcohol use. Social support may play no role or a minimal role in preventing PLWH from hazardous alcohol use.

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Data Availability

The data analyzed for this manuscript will be made available via upload to the Dryad Digital Repository upon acceptance for publication.

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References

  1. World Health Organisation. Global status report on alcohol and health. Geneva: World Health Organisation; 2011.

    Google Scholar 

  2. Uganda AIDS Commission. Uganda population based HIV impact assessment. Kampala, Uganda: UAC;2017:62–5

    Google Scholar 

  3. Woolf-King SE, Steinmaus CM, Reingold AL, Hahn JA. An update on alcohol use and risk of HIV infection in sub-Saharan Africa: meta-analysis and future research directions. Int J Alcohol Drug Res. 2013. https://doi.org/10.7895/ijadr.v1i2.45.

    Article  Google Scholar 

  4. Hendershot CS, Stoner SA, Pantalone DW, Simoni JM. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009. https://doi.org/10.1097/QAI.0b013e3181b18b6e.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Velloza J, Kemp CG, Aunon FM, Ramaiya MK, Creegan E, Simoni JM. Alcohol use and antiretroviral therapy non-adherence among adults living with HIV/AIDS in sub-Saharan Africa: a systematic review and meta-analysis. AIDS Behav. 2020. https://doi.org/10.1007/s10461-019-02716-0.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Long JE, Richardson BA, Wanje G, Wilson KS, Shafi J, Mandaliya K, et al. Alcohol use and viral suppression in HIV-positive Kenyan female sex workers on antiretroviral therapy. PLoS ONE. 2020. https://doi.org/10.1371/journal.pone.0242817.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wandera B, Tumwesigye NM, Nankabirwa JI, Kambugu AD, Parkes-Ratanshi R, Mafigiri DK, et al. Alcohol consumption among HIV-infected persons in a large urban HIV clinic in Kampala Uganda: a constellation of harmful behaviors. PLoS ONE. 2015. https://doi.org/10.1371/journal.pone.0126236.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Antelman G, Smith Fawzi MC, Kaaya S, Mbwambo J, Msamanga GI, Hunter DJ, et al. Predictors of HIV-1 serostatus disclosure: a prospective study among HIV-infected pregnant women in Dar es Salaam, Tanzania. AIDS. 2001;15(14):1865–74.

    Article  CAS  Google Scholar 

  9. Namir S, Wolcott DL, Fawzy FI. Social support and HIV spectrum disease: clinical and research perspectives. Psychiatr Med. 1989;7(2):97–105.

    CAS  PubMed  Google Scholar 

  10. Groh DR, Leonard JA, Margaret DI, Olson BD. Friends, family, and alcohol abuse: an examination of general and alcohol-specific social support. Am J Addict. 2007;16(1):49–55.

    Article  Google Scholar 

  11. Kekwaletswe CT, Jordaan E, Nkosi S, Morojele NK. Social support and the mediating roles of alcohol use and adherence self-efficacy on antiretroviral therapy (ART) adherence among ART recipients in Gauteng, South Africa. AIDS Behav. 2017. https://doi.org/10.1007/s10461-016-1595-3.

    Article  PubMed  Google Scholar 

  12. Beattie MC, Longabaugh R, Elliott G, Stout RL, Fava TJ, Noel NE. Effect of the social environment on alcohol involvement and subjective well-being prior to alcoholism treatment. J Stud Alcohol. 1993. https://doi.org/10.15288/jsa.1993.54.283.

    Article  PubMed  Google Scholar 

  13. Havassy BE, Hall SM, Wasserman DA. Social support and relapse: commonalities among alcoholics, opiate users, and cigarette smokers. Addict Behav. 1991. https://doi.org/10.1016/0306-4603(91)90016-B.

    Article  PubMed  Google Scholar 

  14. Moitra E, Anderson BJ, Herman DS, Hayaki J, Pinkston MM, Kim HN, et al. Examination of using alcohol to cope, depressive symptoms, and perceived social support in persons with HIV and hepatitis C. AIDS Care. 2020. https://doi.org/10.1080/09540121.2020.1734177.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Boateng-Poku A, Benca-Bachman CE, Najera DD, Whitfield KE, Taylor JL, Thorpe RJ, et al. The role of social support on the effects of stress and depression on African American tobacco and alcohol use. Drug Alcohol Depend. 2020. https://doi.org/10.1016/j.drugalcdep.2020.107926.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Booth BM, Russell DW, Soucek S, Laughlin PR. Social support and outcome of alcoholism treatment: an exploratory analysis. Am J Drug Alcohol Abuse. 1992. https://doi.org/10.3109/00952999209001614.

    Article  PubMed  Google Scholar 

  17. Brooks AT, Magaña Lòpez M, Ranucci A, Krumlauf M, Wallen GR. A qualitative exploration of social support during treatment for severe alcohol use disorder and recovery. Addict Behav Rep. 2017. https://doi.org/10.1016/j.abrep.2017.08.002.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Beattie MC, Longabaugh R. General and alcohol-specific social support following treatment. Addict Behav. 1999;24(5):593–606.

    Article  CAS  Google Scholar 

  19. Hahn JA, Cheng DM, Emenyonu NI, Lloyd-Travaglini C, Fatch R, Shade SB, et al. Alcohol use and HIV disease progression in an antiretroviral naive cohort. J Acquir Immune Defic Syndr. 2018;77(5):492–501.

    Article  Google Scholar 

  20. Uganda MO. Addendum to the national antiretroviral treatment guidelines. Kampala, Uganda: Uganda Ministry of Health; 2013.

    Google Scholar 

  21. Hahn JA, Dobkin LM, Mayanja B, Emenyonu NI, Kigozi IM, Shiboski S, et al. Phosphatidylethanol (PEth) as a biomarker of alcohol consumption in HIV-positive patients in sub-Saharan Africa. Alcohol Clin Exp Res. 2012. https://doi.org/10.1111/j.1530-0277.2011.01669.x.

    Article  PubMed  Google Scholar 

  22. Jones J, Jones M, Plate C, Lewis D. The detection of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanol in human dried blood spots. Anal Methods. 2011. https://doi.org/10.1039/c0ay00636j.

    Article  Google Scholar 

  23. Bradley KA, McDonell MB, Bush K, Kivlahan DR, Diehr P, Fihn SD. The AUDIT alcohol consumption questions. Alcohol Clin Exp Res. 1998;22(8):1842.

    CAS  PubMed  Google Scholar 

  24. Bradley KA, Debenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007;31(7):1208–17.

    Article  Google Scholar 

  25. Hotel C. International conference. The many dimensions of poverty. The multidimensionality of poverty: an institutionalist perspective. 2005.

  26. Ironson G, Solomon GF, Balbin EG, O’Cleirigh C, George A, Kumar M, et al. The Ironson-Woods Spirituality/Religiousness Index is associated with long survival, health behaviors, less distress, and low cortisol in people with HIV/AIDS. Ann Behav Med. 2002;24(1):34–48.

    Article  Google Scholar 

  27. Radloff LS. The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults. J Youth Adolesc. 1991. https://doi.org/10.1007/BF01537606.

    Article  PubMed  Google Scholar 

  28. Ezeamama AE, Woolfork MN, Guwatudde D, Bagenda D, Manabe YC, Fawzi WW, et al. Depressive and anxiety symptoms predict sustained quality of life deficits in HIV-positive Ugandan adults despite antiretroviral therapy: a prospective cohort study. Medicine (United States). 2016. https://doi.org/10.1097/MD.0000000000002525.

    Article  Google Scholar 

  29. Takada S, Weiser SD, Kumbakumba E, Muzoora C, Martin JN, Hunt PW, et al. The dynamic relationship between social support and HIV-related stigma in rural Uganda. Ann Behav Med. 2014;48(1):26–37.

    Article  Google Scholar 

  30. Folasire OF, Akinyemi O, Owoaje E. Perceived social support among HIV positive and HIV negative people in Ibadan, Nigeria. World J AIDS. 2014. https://doi.org/10.4236/wja.2014.41003.

    Article  Google Scholar 

  31. Matthews S, Stansfeld S, Power C. Social support at age 33: the influence of gender, employment status and social class. Soc Sci Med. 1999. https://doi.org/10.1016/S0277-9536(99)00122-7.

    Article  PubMed  Google Scholar 

  32. Perkins JM, Nyakato VN, Kakuhikire B, Tsai AC, Subramanian S, Bangsberg DR, et al. Food insecurity, social networks and symptoms of depression among men and women in rural Uganda: a cross-sectional, population-based study. Public Health Nutr. 2018. https://doi.org/10.1017/S1368980017002154.

    Article  PubMed  Google Scholar 

  33. Thompson WE. Social support, religious involvement and alcohol use among students at a conservative Religious University. Behav Sci (Basel). 2017. https://doi.org/10.3390/bs7020034.

    Article  Google Scholar 

  34. Brick LAD, Nugent NR, Kahana SY, Bruce D, Tanney MR, Fernández MI, et al. Interaction effects of neighborhood disadvantage and individual social support on frequency of alcohol use in youth living with HIV. Am J Community Psychol. 2018. https://doi.org/10.1002/ajcp.12227.

    Article  PubMed  Google Scholar 

  35. Amirkhanian YA, Kelly JA, Tarima SS, Kuznetsova AV, Difranceisco WJ, Musatov VB, et al. Prevalence of alcohol use and factors associated with problem drinking in social networks of people living with HIV infection in St. Petersburg, Russia. AIDS Educ Prev. 2019;31(4):380–93.

    Article  Google Scholar 

  36. Ncama BP, McInerney PA, Bhengu BR, Corless IB, Wantland DJ, Nicholas PK, et al. Social support and medication adherence in HIV disease in KwaZulu-Natal, South Africa. Int J Nurs Stud. 2008. https://doi.org/10.1016/j.ijnurstu.2008.06.006.

    Article  PubMed  Google Scholar 

  37. Hahn JA, Emenyonu NI, Fatch R, Muyindike WR, Kekiibina A, Carrico AW, et al. Declining and rebounding unhealthy alcohol consumption during the first year of HIV care in rural Uganda, using phosphatidylethanol to augment self-report. Addiction. 2016. https://doi.org/10.1111/add.13173.

    Article  PubMed  Google Scholar 

  38. Parcesepe AM, Nash D, Tymejczyk O, Reidy W, Kulkarni SG, Elul B. Gender differences and psychosocial factors associated with problem drinking among adults enrolling in HIV care in Tanzania. AIDS Behav. 2019. https://doi.org/10.1007/s10461-018-2340-x.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Monroe AK, Lau B, Mugavero MJ, Mathews WC, Mayer KH, Napravnik S, et al. Heavy alcohol use is associated with worse retention in HIV care. J Acquir Immune Defic Syndr. 2016. https://doi.org/10.1097/QAI.0000000000001083.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Mavandadi S, Helstrom A, Sayers S, Oslin D, Patts GJ, Cheng DM, et al. The moderating role of perceived social support on alcohol treatment outcomes. J Stud Alcohol Drugs. 2015;76(5):818–22.

    Article  Google Scholar 

  41. Velloza J, Watt MH, Abler L, Skinner D, Kalichman SC, Dennis AC, et al. HIV-risk behaviors and social support among men and women attending alcohol-serving venues in South Africa: implications for HIV prevention. AIDS Behav. 2017. https://doi.org/10.1007/s10461-017-1853-z.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Campbell JI, Musiimenta A, Burns B, Natukunda S, Musinguzi N, Haberer JE, et al. The importance of how research participants think they are perceived: results from an electronic monitoring study of antiretroviral therapy in Uganda. AIDS Care. 2019. https://doi.org/10.1080/09540121.2018.1556381.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Strine TW, Chapman DP, Balluz L, Mokdad AH. Health-related quality of life and health behaviors by social and emotional support. Soc Psychiatry Psychiatr Epidemiol. 2008. https://doi.org/10.1007/s00127-007-0277-x.

    Article  PubMed  Google Scholar 

  44. Remor E. Social support and quality of life in the HIV infection. Atención Primaria. 2002;30(03):143–8.

    Article  CAS  Google Scholar 

  45. Hunter-Reel D, McCrady BS, Hildebrandt T, Epstein EE. Indirect effect of social support for drinking on drinking outcomes: the role of motivation*. J Stud Alcohol Drugs. 2010. https://doi.org/10.15288/jsad.2010.71.930.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Farley J, Miller E, Zamani A, Tepper V, Morris C, Oyegunle M, et al. Screening for hazardous alcohol use and depressive symptomatology among HIV-infected patients in Nigeria: prevalence, predictors, and association with adherence. J Int Assoc Physicians AIDS Care. 2010. https://doi.org/10.1177/1545109710371133.

    Article  Google Scholar 

  47. Wolff B, Busza J, Bufumbo L, Whitworth J. Women who fall by the roadside: gender, sexual risk and alcohol in rural Uganda. Addiction. 2006. https://doi.org/10.1111/j.1360-0443.2006.01516.x.

    Article  PubMed  Google Scholar 

  48. Villalonga-Olives E, Almansa J, Shaya F, Kawachi I. Perceived social capital and binge drinking in older adults: the Health and Retirement Study, US data from 2006–2014. Drug Alcohol Depend. 2020. https://doi.org/10.1016/j.drugalcdep.2020.108099.

    Article  PubMed  Google Scholar 

  49. Muyindike WR, Lloyd-Travaglini C, Fatch R, Emenyonu NI, Adong J, Ngabirano C, Cheng DM, Winter MR, Samet JH, Hahn JA. Phosphatidylethanol confirmed alcohol use among ART-naïve HIV-infected persons who denied consumption in rural Uganda. AIDS Care. 2017;29(11):1442–1447. https://doi.org/10.1080/09540121.2017.1290209.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Bajunirwe F, Haberer JE, Boum Y, Hunt P, Mocello R, Martin JN, et al. Comparison of self-reported alcohol consumption to phosphatidylethanol measurement among HIV-infected patients initiating antiretroviral treatment in Southwestern Uganda. PLoS ONE. 2014. https://doi.org/10.1371/journal.pone.0113152.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to extend appreciation to study participants, ISS clinic staff, and research assistants for their assistance in collecting the data and National Institute of Health for funding.

Funding

This study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) U01AA020776 (Hahn), K24AA022586 (Hahn), U24AA020779 (Cheng). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda

    Christine Ngabirano & Winnie R. Muyindike

  2. Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA

    Robin Fatch, Nneka I. Emenyonu, Sheri D. Weiser & Judith A. Hahn

  3. Department of Internal Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda

    Winnie R. Muyindike & Julian Adong

  4. Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

    Jeffrey H. Samet

  5. Boston University School of Public Health, Boston, MA, USA

    Jeffrey H. Samet & Debbie M. Cheng

  6. Department of Medicine, University of California, San Francisco, 550 16th Street, Room 3550, UCSF Box 1224, San Francisco, CA, 94158, USA

    Judith A. Hahn

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  1. Christine Ngabirano
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  2. Robin Fatch
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  3. Winnie R. Muyindike
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  4. Nneka I. Emenyonu
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  9. Judith A. Hahn
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CN, RF and DC. The first draft of the manuscript was written by CN and JAH provided critical review of the manuscript. All authors commented on the previous versions and approved the final manuscript.

Corresponding author

Correspondence to Judith A. Hahn.

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The authors declare no conflict of interest.

Consent to Participate

Informed consent was obtained from all individual participants in the study.

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All participants signed informed consent regarding publishing their data and all authors consented to publication of the manuscript.

Ethical Approval

The study was approved by the Institutional Review Boards of Mbarara University of Science and Technology (MUST) #03/05-05, Uganda National Council for Science and Technology (UNCST) #HS1075, University of California San Francisco (UCSF) #11-06825 and Boston University (BU) #H-31435.

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Ngabirano, C., Fatch, R., Muyindike, W.R. et al. Exploring the Association Between Social Support and Hazardous Alcohol Use Among Persons Living with HIV in South Western Uganda. AIDS Behav 26, 2113–2122 (2022). https://doi.org/10.1007/s10461-021-03557-6

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