A Systematic Review and Meta-analysis of Alcohol Use Disorders and Its determinants in People Living with HIV in Africa: A Continent based Review and Meta-analysis study
Background Alcohol use disorder among people living with HIV/AIDS contributes to decreased adherence and effectiveness of antiretroviral medication, decreased help-seeking to HIV/AIDS care and treatment, increased load of the virus in the blood, and development of drug-resistant HIV strains. This study therefore aimed and assessed the pooled evidence on prevalence and associated factors of alcohol use disorder in retroviral infected patients in Africa. Methods We implemented our electronic data
... base search on PubMed, Scopus, EMBASE, and Psych-INFO libraries. In addition, WHO websites and Google scholar were also investigated for grey literatures. Moreover, we further investigated the reference lists of published articles. Stata-11meta-prop package with 95% confidence interval was used. Subgroup and sensitivity analysis were also performed. Cochran's Q- and the I2 test were used to check heterogeneity. Publication bias was evaluated with Egger's test and funnel plots. Results In this meta-analysis, we included 22 studies with a total of 16774 patients and the pooled prevalence of alcohol use disorder was 22.03%( 95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). Besides, the average prevalence of AUD in studies published before 2011, 2011–2015, and after 2015 was found to be 13.47%, 24.93% and 22.88% respectively. Moreover, the pooled magnitude of AUD among studies which utilized a sample size > 450 was 16.71% whereas it was 26.46% among studies that utilized sample size < 450. Furthermore, the pooled estimated prevalence of hazardous, harmful and dependent drinking was 10.87%, 8.1%, and 3.12% respectively. Being male was an associated factor for alcohol use disorder (AOR = 5.5%; 95% CI: 1.10, 9.98). Moreover, the average odds ratio of cigarette smoking and chat chewing were found to be 3.95% (95% CI: 3.00, 4.89) and 3.34% (95% CI: 1.71, 4.96) respectively. Conclusion The average estimated prevalence of AUD in HIV/AIDs patients was high and factors such as being Male, cigarette smoking and chat chewing were associated with it. Early detection and appropriate management of AUD and the mentioned associated factors have to be a routine practice.