Alcohol Use, Depressive Symptoms and the Receipt of Antiretroviral Therapy in Southwest Uganda
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Alcohol use and depressive symptoms are associated with reduced access to antiretroviral therapy (ART) in the developed world. Whether alcohol use and depressive symptoms limit access to ART in resource-limited settings is unknown. This cross-sectional study examined the association between alcohol use, depressive symptoms and the receipt of ART among randomly selected HIV-positive persons presenting for primary health care services at an outpatient HIV clinic in Uganda. Depressive symptoms were defined by the Hopkins Symptom Checklist and alcohol use was measured through frequency of consumption questions. Antiretroviral use was assessed using a standardized survey and confirmed by medical record review. Predictors of ART use were determined via logistic regression. Among 421 HIV-infected patients, factors associated with the receipt of ART were having at least primary education, having an opportunistic infection in the last 3 months, and not drinking within the last year.
KeywordsAntiretroviral therapy Alcohol use Depression Africa Access to care
The authors would like to acknowledge Lillian Namukasa, Nicholas Musinguzi, Peace Margaret Akantorana, and the staff of the ISS Clinic and MUST-UCSF Collaboration for their contributions to the implementation of the study. We would also like to acknowledge Dr. Paul Bolton of Boston University for generously providing the locally validated version of the Hopkins Symptom Check list. This study received funding from the National Institute on Alcohol Abuse and Alcoholism (NIAAA 15287, NIAAA 14784) and the National Institute of Mental Health (NIMH 54907).
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