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Alcohol Use, Socioeconomic Status and Risk of HIV Infections

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Abstract

The present study investigated the associations among alcohol use, socioeconomic status (SES), and human immunodeficiency virus (HIV) status, in the South African context. It was hypothesized that SES (predictor; measured as median split asset score) and alcohol use in the past 12 months (predictor) would interact such that current drinkers of low SES would be at an increased risk of testing HIV-positive (outcome). Nationally representative, cross-sectional survey data from 2005 (N = 16,110), 2008 (N = 13,055), and 2012 (N = 25,979) were analyzed using multinomial regression models. Current drinkers of low SES had an elevated risk of HIV infection in all survey years, ranging from a relative risk ratio (RRR) of 1.94 (95% confidence interval (CI) 1.29–3.00, t = 2.93, p = 0.002) in 2012 to RRR of 3.51 (95% CI 2.02–6.08, t = 4.47, p < 0.001) in 2008. Targeting preventive strategies to alcohol users of low SES could help reduce HIV burden and associated socioeconomic differences.

Resumen

El presente estudio investigó las asociaciones entre el consumo de alcohol, el nivel socioeconómico (NSE) y el estado de Virus de Inmunodeficiencia Humana (VIH) en Sudáfrica. Se planteó la hipótesis de que el NSE (predictor, medido como la puntuación mediana de activos materiales) y el consumo de alcohol en los últimos 12 meses (predictor) interactuarían de tal manera que los actuales bebedores de bajo NSE presentarían un mayor riesgo de obtener una prueba positiva al VIH. Se analizaron datos de encuestas transversales nacionales de 2005 (N = 16.110), 2008 (N = 13.055) y 2012 (N = 25.979), utilizando modelos de regresión multinomial. En todos los años de la encuesta, los bebedores actuales de bajo NSE presentaron con un alto riesgo de infección por el VIH, variando desde una relación de riesgo relativo (RRR) de 1,94 (intervalo de confianza del 95% (IC) 1,29–3,00, t = 2,93, p = 0,002) en 2012 a una RRR de 3,51 (IC del 95% 2,02–6,08, t = 4,47, p < 0,001). La orientación de las estrategias preventivas relacionadas a los usuarios de alcohol con bajo NSE podría ayudar a reducir la carga del VIH y las diferencias socioeconómicas asociadas.

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Acknowledgements

This work used data of the South African National HIV Prevalence, Incidence, Behaviour and Communication surveys in 2005, 2008, and 2012. The 2005 survey was funded by the Nelson Mandela Foundation, the Nelson Mandela Children’s Fund, the USA’s Centers for Disease control and Prevention (2005, 2008, 2012), the Swiss Agency for Development Cooperation (2005) and the Human Sciences Research Council (HSRC; 2005, 2008, 2012), the Bill & Melinda Gates Foundation (2008, 2012), the United Nations Children’s Fund (2008, 2012), and the South African National AIDS Council (2012). We would like to thank the HSRC’s research staff (including data collectors and community outreach staff), the communities in which the three surveys were conducted and all families who participated in the surveys.

Funding

This study was funded by the Centre for Addiction and Mental Health, and the German Academic Scholarship Foundation. The funding sources did not play a role at any stage of the study including the writing of the manuscript and the decision to submit it for publication.

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Authors and Affiliations

  1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada

    Charlotte Probst, Paul A. Shuper & Jürgen Rehm

  2. Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany

    Charlotte Probst & Jürgen Rehm

  3. Human Sciences Research Council (HSRC), Plein Park Building, 69 Plein Street, Cape Town, 8001, South Africa

    Leickness C. Simbayi

  4. Department of Psychiatry and Mental Health, J-Block, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, 7935, South Africa

    Leickness C. Simbayi

  5. Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, 7505, South Africa

    Charles D.H. Parry

  6. Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, 7505, South Africa

    Charles D.H. Parry

  7. Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada

    Paul A. Shuper

  8. Addiction Policy, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada

    Jürgen Rehm

  9. Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON, M5S 1A8, Canada

    Jürgen Rehm

  10. Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada

    Jürgen Rehm

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  1. Charlotte Probst
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Correspondence to Charlotte Probst.

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Ethics approval was obtained from the Centre for Addiction and Mental Health Research Ethics Board (CAMH REB; Reference # 117/2016).

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Probst, C., Simbayi, L.C., Parry, C.D. et al. Alcohol Use, Socioeconomic Status and Risk of HIV Infections. AIDS Behav 21, 1926–1937 (2017). https://doi.org/10.1007/s10461-017-1758-x

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