Evidence map›Paper›PMID 40185960›Full record

Trial reportAIDS and behavior2025

Alcohol Use and the Pre-exposure Prophylaxis Continuum of Care Among Men in Rural South Africa: Results from a Longitudinal Study.

Alison C Castle, Jacob Busang, Jaco Dreyer, Carina Herbst, Nonhlanhla Okesola, Natsayi Chimbindi, Thembelihle Zuma, Jana Jarolimova, Judith A Hahn, Christina Psaros and 3 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in AIDS and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

13 authors.

Alison C CastleAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa. accastle@mgb.org.ORCID http://orcid.org/0000-0001-7752-6236
Jacob BusangAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Jaco DreyerAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Carina HerbstAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Nonhlanhla OkesolaAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Natsayi ChimbindiAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Thembelihle ZumaAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Jana JarolimovaDivision of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.
Judith A HahnDivision of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, USA.
Christina PsarosHarvard Medical School, Boston, MA, USA.
Sheela V ShenoiYale University School of Medicine, New Haven, CT, USA.
Maryam Shahmanesh *Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Mark J Siedner *Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa.

Funding

Partnership for Global Health Research Training Program (Renewal)-Supplement for OBSSR, NCI, NCI-AIDS and NIDCDD43TW010543 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, DAVIDSON HOWES HAMER · 2017 to 2026
$12.1M
PROGRAM FOR AIDS CLINICAL RESEARCH TRAINING (PACRT)T32AI007433 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI MARK J SIEDNER · 1992 to 2026
$11.4M
Maximizing combination HIV prevention, uptake and retention by adolescent girls and young womenR01MH114560 · NIMH · KWAZULU-NATAL RESEARCH INSTITUTE TB-HIV · PI SHAHMANESH, MARYAM · 2017 to 2023
$2.0M
Training in Research Program on Alcohol Use by Persons with our at Risk for HIVK24AA022586 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HAHN, JUDITH ALISSA · 2013 to 2023
$1.8M
Mentoring patient-oriented research to improve cardiovascular health among people with HIV in sub-Saharan AfricaK24HL166024 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI MARK J SIEDNER · 2022 to 2026
$616k
Engaging men outside the HIV prevention paradigm in rural South AfricaK23MH136873 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI Alison Clare Castle · 2025 to 2026
$392k
FIC NIH HHS D43 TW010543NHLBI NIH HHS K24 HL166024NIAAA NIH HHS K24 AA022586NIAID NIH HHS T32 AI007433NIMH NIH HHS K23 MH136873NIMH NIH HHS R01 MH114560NIMH NIH HHS R01MH114560Wellcome TrustWellcome Trust 201433/Z/16/A
6 · The paper itself

Abstract

Despite freely available oral HIV pre-exposure prophylaxis (PrEP), HIV incidence among young men in South Africa remains high. This study explores the impact of alcohol use on PrEP initiation and continuation among South African men. We performed a secondary data analysis from a trial involving men aged 16-29, randomly selected in KwaZulu-Natal. Participants were referred to sexual health services, and those who were HIV negative and sexually active were offered oral PrEP. Alcohol consumption was categorized using AUDIT-C criteria as no/low risk (0-3) and hazardous alcohol use (4-12). Primary outcomes were PrEP initiation and continuation, defined as refilling prescriptions for ≥ 4 months. Logistic regression models adjusted for clinical and demographic confounders estimated relationships between PrEP initiation/continuation and alcohol use. Among 325 men analyzed, average age was 22.9 years (SD 3.6), with 146 (45%) reporting hazardous alcohol consumption. PrEP initiation was greatest among the hazardous/very-high risk group (40%), with the lowest uptake among men who do not use alcohol (17%). In multivariate analyses, those with hazardous alcohol use remained more likely to initiate PrEP compared to those with no/low risk alcohol use (aOR 1.96, 95%CI 1.13-3.40; p-value = 0.017). Only 27% (24/88) remained on PrEP at 4 months, with continuation similar between alcohol use groups (aOR 1.56, 95%CI: 0.47-5.12, p = 0.47). Hazardous alcohol use is prevalent among men in rural South Africa and associated with increased PrEP initiation. However, overall PrEP continuation was low and consistent across alcohol use levels. Hazardous alcohol use should not deter PrEP implementation efforts to engage young men.

Indexed as

Alcohol DrinkingAnti-HIV AgentsContinuity of Patient CareHIV InfectionsPre-Exposure ProphylaxisAdolescentAdultHumansLogistic ModelsLongitudinal StudiesMaleRural PopulationSexual BehaviorSouth AfricaYoung AdultAnti-HIV AgentsAlcoholHIV preventionMenPre-exposure prophylaxisRetentionSouth Africa

Identifiers

PMID40185960
PMCPMC12229763

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

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.