Evidence map›Paper›PMID 34600249›Full record

ArticleDrug and alcohol dependence2021

Alcohol use and alcohol-related consequences are associated with not being virally suppressed among persons living with HIV in the Rakai region of Uganda.

Amanda P Miller, Eileen V Pitpitan, Susan M Kiene, Anita Raj, Sonia Jain, María Luisa Zúñiga, Dorean Nabulaku, Fred Nalugoda, Robert Ssekubugu, Betty Nantume and 7 more

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Amanda P MillerUniversity of California, San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, CA, 92093, United States; San Diego State University School of Public Health, San Diego, CA, United States. Electronic address: apmiller@health.ucsd.edu.
Eileen V PitpitanSan Diego State University School of Social Work, San Diego, CA, United States.
Susan M KieneSan Diego State University School of Public Health, San Diego, CA, United States.
Anita RajUniversity of California, San Diego School of Medicine, Division of Infectious Diseases and Global Public Health, La Jolla, CA, 92082, United States.
Sonia JainUniversity of California, San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, CA, 92093, United States.
María Luisa ZúñigaSan Diego State University School of Social Work, San Diego, CA, United States.
Dorean NabulakuRakai Health Sciences Program, Entebbe, Uganda.
Fred NalugodaRakai Health Sciences Program, Entebbe, Uganda.
Robert SsekubuguRakai Health Sciences Program, Entebbe, Uganda.
Betty NantumeRakai Health Sciences Program, Entebbe, Uganda.
Godfrey KigoziRakai Health Sciences Program, Entebbe, Uganda.
Nelson K SewankamboRakai Health Sciences Program, Entebbe, Uganda; Makerere University School of Medicine, Kampala, Uganda.
Joseph KagaayiRakai Health Sciences Program, Entebbe, Uganda.
Steven J ReynoldsRakai Health Sciences Program, Entebbe, Uganda; Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, United States; Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
Kate GrabowskiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States; Department of Pathology, Johns Hopkins School of Medicine, Baltimore, United States.
Maria WawerRakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States; Department of Medicine, Johns Hopkins School of Medicine, United States.
Jennifer A WagmanUniversity of California, Los Angeles Fielding School of Public Health, Department of Community Health Sciences, Los Angeles, CA, United States.

Funding

Evaluating Demand Generation (Stylish Man) for HIV/Family Planning Services RakaiR01AI114438 · NIAID · JOHNS HOPKINS UNIVERSITY · PI WAWER, MARIA J · 2014 to 2017
$3.0M
Estimating Mediation and Moderation Effects in HIV Incidence Prevention TrialsR01DA042666 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI PITPITAN, EILEEN VIRTUSIO · 2018 to 2022
$2.6M
Prevention and Planning LinkagesR01HD072695 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SANTELLI, JOHN S. · 2012 to 2016
$2.2M
Alcohol Epidemiology and Pilot Intervention to Reduce Alcohol, IPV and HIV in Women in UgandaK01AA024068 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI WAGMAN, JENNIFER ANN · 2015 to 2019
$917k
Assessing the role of alcohol and intimate partner violence on HIV care and viral suppression in UgandaF31AA028198 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MILLER, AMANDA PEARL · 2019 to 2020
$68k
CGH CDC HHS U2G GH000817NIAAA NIH HHS F31 AA028198NIAAA NIH HHS K01 AA024068NIAID NIH HHS R01 AI114438NICHD NIH HHS R01 HD072695NIDA NIH HHS R01 DA042666
6 · The paper itself

Abstract

backgroundAlcohol use is common among persons living with HIV (PWH) in Uganda and associated with poor HIV care outcomes; findings regarding the relationship between alcohol use and viral suppression (VS) have been inconclusive.

methodsData from two rounds (2017-2020) of the Rakai Community Cohort Study, an open population-based cohort study in the Rakai region, Uganda, were analyzed. Two alcohol exposures were explored: past year alcohol use and alcohol-related consequences. Multivariable models (GEE) were used to estimate associations between alcohol exposures and VS for the overall sample and stratified by sex, adjusting for repeated measurement. Causal mediation by ART use was explored.

resultsOver half (55 %) of participants (n = 3823 PWH) reported alcohol use at baseline; 37.8 % of those reporting alcohol use reported alcohol-related consequences. ART use and VS at baseline significantly differed by alcohol use with person reporting alcohol use being less likely to be on ART or VS. Alcohol use was significantly associated with decreased odds of VS among women but not men (adj. OR 0.72 95 % CI 0.58-0.89, p = 0.0031). However, among males who use alcohol, experiencing alcohol-related consequences was significantly associated with decreased odds of VS (adj. OR 0.69 95 % CI 0.54-0.88, p = 0.0034). The relationships between both alcohol exposures and VS were not significant in models restricted to persons on ART.

conclusionsWe provide sex-stratified estimates of associations between two alcohol measures and VS in the context of current HIV treatment guidelines. This study confirms that alcohol use is adversely associated with VS but ART use mediates this pathway, suggesting that initiation and retention on ART are critical steps to addressing alcohol-related disparities in VS.

Indexed as

Alcohol DrinkingHIV InfectionsCohort StudiesFemaleHealth Status DisparitiesHumansMaleUgandaAlcoholHIV care continuumTreatment adherenceUgandaViral suppression

Identifiers

PMID34600249
PMCPMC8628865

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.