SUBSTANCE USE AND HIV INFECTION AWARENESS AMONG HIV-INFECTED FEMALE SEX WORKERS IN LILONGWE, MALAWI
Identifieur interne : 000E19 ( Main/Merge ); précédent : 000E18; suivant : 000E20SUBSTANCE USE AND HIV INFECTION AWARENESS AMONG HIV-INFECTED FEMALE SEX WORKERS IN LILONGWE, MALAWI
Auteurs : Kathryn E. Lancaster [États-Unis] ; Vivian F. Go [États-Unis] ; Thandie Lungu [Malawi] ; Pearson Mmodzi [Malawi] ; Mina C. Hosseinipour [Malawi, États-Unis] ; Katy Chadwick [Malawi] ; Kimberly A. Powers [États-Unis] ; Brian W. Pence [États-Unis] ; Irving F. Hoffman [Malawi, États-Unis] ; William C. Miller [États-Unis]Source :
- The International journal on drug policy [ 0955-3959 ] ; 2016.
Abstract
HIV diagnosis, the first step in HIV care and treatment engagement, may be inhibited by substance use among female sex workers (FSW). We assessed the relationship between alcohol and marijuana use and lack of HIV infection awareness among HIV-infected FSW in Lilongwe, Malawi.
From July to September, 2014, 200 FSW aged ≥18 years were enrolled using venue-based sampling to examine substance use, HIV testing history, and serostatus ascertained by HIV rapid test. We used Poisson regression with robust variance estimates to estimate the associations of alcohol and marijuana use and lack of HIV infection awareness.
Of the 138 HIV-infected FSW, 20% were unaware of their HIV infection, with 70% not testing within 6 months prior. According to the Alcohol Use Disorder Identification Tests (AUDIT), 55% of FSW unaware of their HIV infection reported hazardous, harmful, or dependent alcohol consumption. We observed a dose-response relationship between alcohol use and lack of HIV infection awareness, with alcohol dependency significantly associated with lack of HIV infection awareness (adjusted prevalence ratio: 3.0, 95% CI: 1.3, 6.8). Current marijuana use was uncommon (26%) among unaware HIV-infected FSW and weakly associated with lack of HIV infection awareness adjusted prevalence ratio: 1.1, 95% CI: 0.5, 2.5).
Increased levels of alcohol use is associated with lack of HIV infection awareness among HIV-infected FSW in Malawi. Frequent, consistent HIV testing integrated with alcohol reduction strategies could improve the health and infection awareness of substance-using FSW.
Url:
DOI: 10.1016/j.drugpo.2016.02.020
PubMed: 26987607
PubMed Central: 4829472
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">SUBSTANCE USE AND HIV INFECTION AWARENESS AMONG HIV-INFECTED FEMALE SEX WORKERS IN LILONGWE, MALAWI</title>
<author><name sortKey="Lancaster, Kathryn E" sort="Lancaster, Kathryn E" uniqKey="Lancaster K" first="Kathryn E." last="Lancaster">Kathryn E. Lancaster</name>
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<author><name sortKey="Go, Vivian F" sort="Go, Vivian F" uniqKey="Go V" first="Vivian F." last="Go">Vivian F. Go</name>
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<author><name sortKey="Mmodzi, Pearson" sort="Mmodzi, Pearson" uniqKey="Mmodzi P" first="Pearson" last="Mmodzi">Pearson Mmodzi</name>
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<author><name sortKey="Hosseinipour, Mina C" sort="Hosseinipour, Mina C" uniqKey="Hosseinipour M" first="Mina C." last="Hosseinipour">Mina C. Hosseinipour</name>
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<orgName type="university">Université de Caroline du Nord à Chapel Hill</orgName>
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<region type="state">Caroline du Nord</region>
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<affiliation wicri:level="4"><nlm:aff id="A4">Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina</wicri:regionArea>
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<author><name sortKey="Chadwick, Katy" sort="Chadwick, Katy" uniqKey="Chadwick K" first="Katy" last="Chadwick">Katy Chadwick</name>
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<wicri:regionArea>Theatre for a Change, Lilongwe</wicri:regionArea>
<wicri:noRegion>Lilongwe</wicri:noRegion>
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<author><name sortKey="Powers, Kimberly A" sort="Powers, Kimberly A" uniqKey="Powers K" first="Kimberly A." last="Powers">Kimberly A. Powers</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina</wicri:regionArea>
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<author><name sortKey="Pence, Brian W" sort="Pence, Brian W" uniqKey="Pence B" first="Brian W." last="Pence">Brian W. Pence</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
<settlement type="city">Chapel Hill (Caroline du Nord)</settlement>
</placeName>
<orgName type="university">Université de Caroline du Nord à Chapel Hill</orgName>
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<author><name sortKey="Hoffman, Irving F" sort="Hoffman, Irving F" uniqKey="Hoffman I" first="Irving F." last="Hoffman">Irving F. Hoffman</name>
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<country xml:lang="fr">Malawi</country>
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<orgName type="university">Université de Caroline du Nord à Chapel Hill</orgName>
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<wicri:regionArea>Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina</wicri:regionArea>
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<orgName type="university">Université de Caroline du Nord à Chapel Hill</orgName>
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<author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C." last="Miller">William C. Miller</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina</wicri:regionArea>
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</placeName>
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<affiliation wicri:level="4"><nlm:aff id="A4">Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America</nlm:aff>
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</placeName>
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<series><title level="j">The International journal on drug policy</title>
<idno type="ISSN">0955-3959</idno>
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<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P2">HIV diagnosis, the first step in HIV care and treatment engagement, may be inhibited by substance use among female sex workers (FSW). We assessed the relationship between alcohol and marijuana use and lack of HIV infection awareness among HIV-infected FSW in Lilongwe, Malawi.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P3">From July to September, 2014, 200 FSW aged ≥18 years were enrolled using venue-based sampling to examine substance use, HIV testing history, and serostatus ascertained by HIV rapid test. We used Poisson regression with robust variance estimates to estimate the associations of alcohol and marijuana use and lack of HIV infection awareness.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">Of the 138 HIV-infected FSW, 20% were unaware of their HIV infection, with 70% not testing within 6 months prior. According to the Alcohol Use Disorder Identification Tests (AUDIT), 55% of FSW unaware of their HIV infection reported hazardous, harmful, or dependent alcohol consumption. We observed a dose-response relationship between alcohol use and lack of HIV infection awareness, with alcohol dependency significantly associated with lack of HIV infection awareness (adjusted prevalence ratio: 3.0, 95% CI: 1.3, 6.8). Current marijuana use was uncommon (26%) among unaware HIV-infected FSW and weakly associated with lack of HIV infection awareness adjusted prevalence ratio: 1.1, 95% CI: 0.5, 2.5).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P5">Increased levels of alcohol use is associated with lack of HIV infection awareness among HIV-infected FSW in Malawi. Frequent, consistent HIV testing integrated with alcohol reduction strategies could improve the health and infection awareness of substance-using FSW.</p>
</sec>
</div>
</front>
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