Tags

Type your tag names separated by a space and hit enter

HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status.
BMJ Open. 2018 02 21; 8(2):e017955.BO

Abstract

OBJECTIVES

To quantify HIV/AIDS mortality attributable to alcohol use in the adult general population of South Africa in 2012 by socioeconomic status (SES).

DESIGN

Comparative risk assessment based on secondary individual data, aggregate data and risk relations reported in the literature.

SETTING

South African adult general population.

PARTICIPANTS

For metrics of alcohol use by SES, sex and age: 27 070 adults that participated in a nationally representative survey in 2012. For HRs of dying from HIV/AIDS by SES: 87 029 adults that participated in a cohort study (years 2000 to 2014) based out of the Umkhanyakude district, KwaZulu-Natal.

MAIN OUTCOME MEASURES

Alcohol-attributable fractions for HIV/AIDS mortality by SES, age and sex were calculated based on the risk of engaging in condom-unprotected sex under the influence of alcohol and interactions between SES and alcohol use. Age-standardised HIV/AIDS mortality rates attributable to alcohol by SES and sex were estimated using alcohol-attributable fractions and SES-specific and sex-specific death counts. Rate ratios were calculated comparing age-standardised rates in low versus high SES by sex.

RESULTS

The age-standardised HIV/AIDS mortality rate attributable to alcohol was 31.0 (95% uncertainty interval (UI) 21.6 to 41.3) and 229.6 (95% UI 108.8 to 351.6) deaths per 100 000 adults for men of high and low SES, respectively. For women the respective rates were 10.8 (95% UI 5.5 to 16.1) and 75.5 (95% UI 31.2 to 144.9). The rate ratio was 7.4 (95% UI 3.4 to 13.2) for men and 7.0 (95% UI 2.8 to 18.2) for women. Sensitivity analyses corroborated marked differences in alcohol-attributable HIV/AIDS mortality, with rate ratios between 2.7 (95% UI 0.8 to 7.6; women) and 15.1 (95% UI 6.8 to 27.7; men).

CONCLUSIONS

The present study showed that alcohol use contributed considerably to the socioeconomic differences in HIV/AIDS mortality. Targeting HIV infection under the influence of alcohol is a promising strategy for interventions to reduce the HIV/AIDS burden and related socioeconomic differences in South Africa.

Authors+Show Affiliations

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada. Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa. Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada. Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany. Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada. Department of Psychiatry, University of Toronto, Toronto, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

29467131

Citation

Probst, Charlotte, et al. "HIV/AIDS Mortality Attributable to Alcohol Use in South Africa: a Comparative Risk Assessment By Socioeconomic Status." BMJ Open, vol. 8, no. 2, 2018, pp. e017955.
Probst C, Parry CDH, Rehm J. HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status. BMJ Open. 2018;8(2):e017955.
Probst, C., Parry, C. D. H., & Rehm, J. (2018). HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status. BMJ Open, 8(2), e017955. https://doi.org/10.1136/bmjopen-2017-017955
Probst C, Parry CDH, Rehm J. HIV/AIDS Mortality Attributable to Alcohol Use in South Africa: a Comparative Risk Assessment By Socioeconomic Status. BMJ Open. 2018 02 21;8(2):e017955. PubMed PMID: 29467131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HIV/AIDS mortality attributable to alcohol use in South Africa: a comparative risk assessment by socioeconomic status. AU - Probst,Charlotte, AU - Parry,Charles D H, AU - Rehm,Jürgen, Y1 - 2018/02/21/ PY - 2018/2/23/entrez PY - 2018/2/23/pubmed PY - 2018/9/7/medline KW - AIDS KW - HIV KW - South Africa KW - alcohol KW - burden of disease KW - inequalities KW - socioeconomic status SP - e017955 EP - e017955 JF - BMJ open JO - BMJ Open VL - 8 IS - 2 N2 - OBJECTIVES: To quantify HIV/AIDS mortality attributable to alcohol use in the adult general population of South Africa in 2012 by socioeconomic status (SES). DESIGN: Comparative risk assessment based on secondary individual data, aggregate data and risk relations reported in the literature. SETTING: South African adult general population. PARTICIPANTS: For metrics of alcohol use by SES, sex and age: 27 070 adults that participated in a nationally representative survey in 2012. For HRs of dying from HIV/AIDS by SES: 87 029 adults that participated in a cohort study (years 2000 to 2014) based out of the Umkhanyakude district, KwaZulu-Natal. MAIN OUTCOME MEASURES: Alcohol-attributable fractions for HIV/AIDS mortality by SES, age and sex were calculated based on the risk of engaging in condom-unprotected sex under the influence of alcohol and interactions between SES and alcohol use. Age-standardised HIV/AIDS mortality rates attributable to alcohol by SES and sex were estimated using alcohol-attributable fractions and SES-specific and sex-specific death counts. Rate ratios were calculated comparing age-standardised rates in low versus high SES by sex. RESULTS: The age-standardised HIV/AIDS mortality rate attributable to alcohol was 31.0 (95% uncertainty interval (UI) 21.6 to 41.3) and 229.6 (95% UI 108.8 to 351.6) deaths per 100 000 adults for men of high and low SES, respectively. For women the respective rates were 10.8 (95% UI 5.5 to 16.1) and 75.5 (95% UI 31.2 to 144.9). The rate ratio was 7.4 (95% UI 3.4 to 13.2) for men and 7.0 (95% UI 2.8 to 18.2) for women. Sensitivity analyses corroborated marked differences in alcohol-attributable HIV/AIDS mortality, with rate ratios between 2.7 (95% UI 0.8 to 7.6; women) and 15.1 (95% UI 6.8 to 27.7; men). CONCLUSIONS: The present study showed that alcohol use contributed considerably to the socioeconomic differences in HIV/AIDS mortality. Targeting HIV infection under the influence of alcohol is a promising strategy for interventions to reduce the HIV/AIDS burden and related socioeconomic differences in South Africa. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/29467131/HIV/AIDS_mortality_attributable_to_alcohol_use_in_South_Africa:_a_comparative_risk_assessment_by_socioeconomic_status_ L2 - http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=29467131 DB - PRIME DP - Unbound Medicine ER -