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Int. J. Environ. Res. Public Health 2016, 13(2), 153; doi:10.3390/ijerph13020153

High Levels of Persistent Problem Drinking in Women at High Risk for HIV in Kampala, Uganda: A Prospective Cohort Study

MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Uganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Entebbe, Uganda
Department of Community Health and Behavioral Sciences, School of Public Health, Colleges of Health Sciences, Makerere University, Kampala, Uganda
Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London WC1E 9RE, UK
The new e-mail address of Susan Nakubulwa
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 20 October 2015 / Revised: 30 November 2015 / Accepted: 18 January 2016 / Published: 22 January 2016
View Full-Text   |   Download PDF [306 KB, uploaded 22 January 2016]


The aim of this study was to describe the epidemiology of problem drinking in a cohort of women at high-risk of HIV in Kampala, Uganda. Overall, 1027 women at high risk of HIV infection were followed from 2008 to 2013. The CAGE and AUDIT questionnaires were used to identify problem drinkers in the cohort. Interviewer-administered questionnaires were used to ascertain socio-demographic and behavioural factors. Blood and genital samples were tested for HIV and other sexually transmitted infections. At enrollment, most women (71%) reported using alcohol at least weekly and about a third reported having drunk alcohol daily for at least 2 weeks during the past 3 months. Over half (56%) were problem drinkers by CAGE at enrollment, and this was independently associated with vulnerability (being divorced/separated/widowed, less education, recruiting clients at bars/clubs, and forced sex at first sexual experience). Factors associated with problem drinking during follow-up included younger age, meeting clients in bars/clubs, number of clients, using drugs and HSV-2 infection. HIV prevalence was associated with drinking at enrollment, but not during follow-up. This longitudinal study found high levels of persistent problem drinking. Further research is needed to adapt and implement alcohol-focused interventions in vulnerable key populations in sub-Saharan Africa. View Full-Text
Keywords: alcohol; sex work; Uganda; HIV; problem drinking alcohol; sex work; Uganda; HIV; problem drinking
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Weiss, H.A.; Vandepitte, J.; Bukenya, J.N.; Mayanja, Y.; Nakubulwa, S.; Kamali, A.; Seeley, J.; Grosskurth, H. High Levels of Persistent Problem Drinking in Women at High Risk for HIV in Kampala, Uganda: A Prospective Cohort Study. Int. J. Environ. Res. Public Health 2016, 13, 153.

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