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Abstract：
Alcohol use among people living with HIV (PWH) is common and may negatively affect engagement in HIV care. We evaluated the relationships between alcohol use, ART use, and viral suppression among PWH in Uganda. PATH/Ekkubo was a trial evaluating a linkage to HIV care intervention in four Ugandan districts, Nov 2015-Sept 2021. Our analytical sample included: (1) baseline data from individuals not enrolled in the intervention trial (previously diagnosed HIV+); and 12-month follow-up data from the control group (newly diagnosed or previously diagnosed, but not in care). Level of alcohol use was categorized using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C): none (AUDIT-C = 0), low (women = 1-2, men = 1-3), medium (women = 3-5, men = 4-5), high/very high (6-12). Multivariable logistic regression models evaluated associations between alcohol use, ART use and viral suppression (a viral load of < 20); we also stratified by gender. Among 931 PWH, medium (OR: 0.43 [95% CI 0.25-0.72]) and high/very high (OR: 0.22 [95% CI 0.11-0.42]) levels of alcohol use were associated with lower odds of being on ART. In a sub-sample of 664, medium use (OR: 0.63 [95% CI 0.41-0.97]) was associated with lower odds of viral suppression. However, this association was not statistically significant when restricting to those on ART, suggesting the relationship between alcohol use and viral suppression is explained by ART use. Among men, high/very high, and among women, medium alcohol use levels were associated with lower odds of being on ART and being virally suppressed. Interventions for PWH who use higher levels of alcohol may be needed to optimize the benefits of Uganda\'s Universal Test and Treat strategy.
摘要：
在艾滋病毒感染者（PWH）中使用酒精很常见，可能会对参与艾滋病毒护理产生负面影响。我们评估了酒精使用之间的关系，ART使用,以及乌干达PWH中的病毒抑制。PATH/Ekkubo是一项试验，评估了乌干达四个地区与艾滋病毒护理干预的联系，2015年11月-2021年9月。我们的分析样本包括：（1）来自未参加干预试验的个体的基线数据（先前诊断为HIV+）；以及来自对照组的12个月随访数据（新诊断或先前诊断，但不关心)。酒精使用水平使用酒精使用障碍识别测试消费（AUDIT-C）进行分类：无（AUDIT-C=0），低（女性=1-2，男性=1-3），中等（女性=3-5，男性=4-5），高/非常高（6-12）。多变量逻辑回归模型评估了酒精使用，ART使用和病毒抑制（病毒载量<20）；我们还按性别分层。在931PWH中，中(OR:0.43[95%CI0.25-0.72])和高/非常高(OR:0.22[95%CI0.11-0.42])的酒精使用水平与接受ART的几率较低相关.在664个子样本中，培养基使用（OR：0.63[95％CI0.41-0.97]）与较低的病毒抑制几率相关。然而,当限制使用ART时，这种关联没有统计学意义，提示酒精使用与病毒抑制之间的关系可以通过ART使用来解释。在男性中,高/非常高，在女性中，中等酒精使用水平与接受ART和病毒抑制的几率较低相关.可能需要对使用较高水平酒精的PWH进行干预，以优化乌干达通用测试和治疗策略的好处。
