Alcohol and HIV: a study among sexually active adults in rural southwest Uganda

Objective. To investigate the association between alcohol consumption and H IV sere-positivity in a rural Ugandan population. Methods. The adult population residing in a cluster of 15 neighbouring vill ages has been kept under epidemiological surveillance for HIV infection usi ng annual censuses and sere-surveys since 1989. At the eighth annual survey all respondents were asked about their history of alcohol consumption, the sale of alcohol in their household, and other socio-demographic informatio n. After informed consent, blood was drawn for HIV serology. Results. Of the total adult population 3279 (60%) were interviewed; 48% wer e males; 905 (27%) had not started sexual activity and were excluded from f urther analysis. Of the remaining 2374, 8% were HIV infected, 57% had ever drunk alcohol, and 4% lived in households where alcohol was sold. Living in a household where alcohol was sold was associated with a history of having ever drunk alcohol (OR 2.9, 95% CI: 1.7-4.8). HN prevalence among adults l iving in households selling alcohol was 15% compared with 8% among those li ving in households not selling alcohol (OR 2.0, 95% CI:1.1-3.6). Individual s who had ever drunk alcohol experienced an HIV prevalence twice that of th ose who had never drunk, 10% versus 5% (OR 2.0, 95% CI:1.5-2.8). This assoc iation remained after adjusting for potential confounders including sale of alcohol in the household and Muslim religion (OR 1.8, 95% CI:1.2-2.7). Onl y age, marital status and having ever drunk alcohol independently predicted HIV sere-positivity in a logistic regression model. Conclusions: We have demonstrated an association between a history of alcoh ol consumption and being HIV sere-positive. This unexplored factor may expl ain in part the observed lower prevalence of HIV infection among Muslims. P ublic health campaigns need to stress the relationship between HIV and alco hol.