Implications of alcohol consumption on adherence to antiretroviral therapy: Perceptions of older people living with HIV in South-western Uganda.
DOI:
https://doi.org/10.51168/sjhrafrica.v6i9.1942Keywords:
alcohol consumption, adherence, ART, older people, HIVAbstract
Background
Alcohol consumption is associated with reduced ART adherence, poor quality of life, and worse treatment outcomes among people living with HIV. Though ART adherence levels in the older population globally have been reported to be high, they may be affected by increased levels of alcohol consumption in this population in lower and middle-income countries. We explored the implications of alcohol consumption on adherence to antiretroviral therapy in older persons living with HIV in Southwestern Uganda.
Methods
An explanatory qualitative study design was employed among 38 purposively selected older persons living with HIV in 6 health facilities in Southwestern Uganda. A total of 6 focus group discussions were held and audio recorded at the selected Health Facilities. Data was transcribed, translated, coded, and categorized into themes. Thematic analysis was used to give meaning to the data collected.
Results
Participants' reports varied, with some finding alcohol beneficial in terms of providing nutrients, especially from the brands made locally. Others reported that alcohol increases sexual libido and relieves their stress. Many, however, reported that alcohol affects adherence to ART as it increases forgetfulness of the time specified for swallowing the drugs.
Conclusion
Older people perceived alcohol consumption as a hindrance to adherence. Negative perceptions, such as alcohol having nutrients or increasing sexual libido, present difficulties in reducing the consumption of alcohol, especially in older people living with HIV.
Recommendation
There is a need for the incorporation of counseling on the effects of alcohol in the care patients receive from HIV care facilities.
References
(UNAIDS), J. U. N. P. o. H. A. (2014). People aged 50years and Older. 3-6. Retrieved from file:///C:/Users/ADMIN/Desktop/alcohol%20and%20adherence/12_Peopleaged50yearsandolder.pdf
Altura. Burton M, Zhang. Aimin, Shah. Nilank C, Shah. Gatha J, Gebrewold. Asefa Y Altura. Bella T. (2016). Euphoria from drinking alcoholic beverages may be due to reversible constriction of cerebral blood vessels: potential roles of unrecognized ionized hypomagnesemia, and release of ceramides and platelet-activating factor.
Asiimwe, C., Fatch, R., Cheng, D. M., Emenyonu, N. I., Ngabirano, C., Muyindike, W. R., & Hahn, J. A. (2022). Bar Attendance and Alcohol Use Before and After COVID-19 Related Restrictions Among HIV-infected Adults in South-Western Uganda. AIDS and Behavior, 1-10. https://doi.org/10.1007/s10461-022-03934-9 PMid:36441412 PMCid:PMC9707128
Centers for Disease Control and Prevention HIV Surveillance Report. (2017). Retrieved from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html
Deren, S., Cortes, T., Dickson, V. V., Guilamo-Ramos, V., Han, B. H., Karpiak, S., . . . Wu, B. (2019). Substance use among older people living with HIV: Challenges for health care providers. Frontiers in public health, 7, 94.
https://doi.org/10.3389/fpubh.2019.00094 PMid:31069208 PMCid:PMC6491638
Emenyonu, N. I., Fatch, R., Muyindike, W. R., Kekibiina, A., Woolf-King, S., & Hahn, J. A. (2017). Randomized Study of Assessment Effects on Alcohol Use by Persons With HIV in Rural Uganda. J Stud Alcohol Drugs, 78(2), 296-305. https://doi.org/10.15288/jsad.2017.78.296 PMid:28317511 PMCid:PMC5554109
Emiliussen, J., Andersen, K., & Nielsen, A. S. (2017). Why do some older adults start drinking excessively late in life? Results from an interpretative phenomenological study. Scandinavian journal of caring sciences, 31(4), 974-983. https://doi.org/10.1111/scs.12421 PMid:28382628
Fernandes, A., & De Sousa, A. (2014). Alcohol dependence and sexual dysfunction: A clinical review. Medical Science, 3(4).
Kabwama, S. N., Ndyanabangi, S., Mutungi, G., Wesonga, R., Bahendeka, S. K., & Guwatudde, D. (2016). Alcohol use among adults in Uganda: findings from the countrywide non-communicable diseases risk factor cross-sectional survey. Global health action, 9(1), 31302. https://doi.org/10.3402/gha.v9.31302 PMid:27491961 PMCid:PMC4974493
Kekwaletswe, C. T., & Morojele, N. K. (2014). Alcohol use, antiretroviral therapy adherence, and preferences regarding an alcohol-focused adherence intervention in patients with human immunodeficiency virus. Patient preference and adherence, 8, 401. https://doi.org/10.2147/PPA.S55547 PMid:24729688 PMCid:PMC3976236
Kohli, M., Paolillo, E. W., Saloner, R., Umlauf, A., Ellis, R., & Moore, D. J. (2020). The Effects of Low‐Risk Drinking ON Neurocognition Among Older Persons Living with HIV as Compared to Those Without HIV. Alcoholism: Clinical and Experimental Research, 44(7), 1389-1399. https://doi.org/10.1111/acer.14379 PMid:32449941 PMCid:PMC7899090
Kumar, S., Jin, M., Ande, A., Sinha, N., Silverstein, P. S., & Kumar, A. (2012). Alcohol consumption effect on antiretroviral therapy and HIV-1 pathogenesis: role of cytochrome P450 isozymes. Expert opinion on drug metabolism & toxicology, 8(11), 1363-1375. https://doi.org/10.1517/17425255.2012.714366 PMid:22871069 PMCid:PMC4033313
Ministry of Health. (2018). National Health Facility Master List 2018.
Ministry of Health, U. (2022). Uganda Population-based HIV Impact Assessment 2020. Retrieved from https://www.mediacentre.go.ug/media/release-preliminary-results-2020-uganda-population-based-hiv-impact-assessment
Nalwadda, O., Rathod, S. D., Nakku, J., Lund, C., Prince, M., & Kigozi, F. (2018). Alcohol use in a rural district in Uganda: findings from community-based and facility-based cross-sectional studies. International journal of mental health systems, 12(1), 1-10. https://doi.org/10.1186/s13033-018-0191-5 PMid:29632551 PMCid:PMC5883606
Park, L. S., Hernández-Ramírez, R. U., Silverberg, M. J., Crothers, K., & Dubrow, R. (2016). Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS: a meta-analysis. AIDS (London, England), 30(2), 273. https://doi.org/10.1097/QAD.0000000000000922 PMid:26691548 PMCid:PMC4689318
Popovici, I., & French, M. T. (2013). Does unemployment lead to greater alcohol consumption? Industrial Relations: A Journal of Economy and Society, 52(2), 444-466. https://doi.org/10.1111/irel.12019 PMid:23543880 PMCid:PMC3609661
Sileo, K. M., Kizito, W., Wanyenze, R. K., Chemusto, H., Musoke, W., Mukasa, B., & Kiene, S. M. (2019). A qualitative study on alcohol consumption and HIV treatment adherence among men living with HIV in Ugandan fishing communities. AIDS care, 31(1), 35-40. https://doi.org/10.1080/09540121.2018.1524564 PMid:30241440 PMCid:PMC6918941
Ssebunnya, J., Kituyi, C., Nabanoba, J., Nakku, J., Bhana, A., & Kigozi, F. (2020). Social acceptance of alcohol use in Uganda. BMC Psychiatry, 20(1), 1-7. https://doi.org/10.1186/s12888-020-2471-2 PMid:32028916 PMCid:PMC7006109
World Health Organization. (2019). Global status report on alcohol and health 2018: World Health Organization.
World Health Organization. ( 2001). The Alcohol Use Disorders
Identification Test. 17-20. Retrieved from https://www.who.int/publications/i/item/audit-the-alcohol-use-disorders-identification-test-guidelines-for-use-in-primary-health-care
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Wamaani Gamukama Hannington, Rachel Luwaga, Peter Ampiire, Lauben Nduhura, Jesca Kebirungi, Norbert Tayebwa, Edith Biira, Gladys Nakidde, Joshua Sheruramukama, Samuel Maling

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.