Alcohol abuse among patients with and without HIV infection attending public clinics in western Kenya.

Objective: To evaluate the prevalence of hazardous drinking among persons with and without HIV/AIDS attending both urban/hospital-based and rural clinics in western Kenya.

Design: Cross sectional survey.

Setting: The Moi Teaching and Referral Hospital and the Mosoriot rural health care Centre.

Subjects: Two hundred and ninety nine adults with and without HIV/AIDS at a teaching and referral hospital and rural health centre.

Main Outcome Measures: Results of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT) where a score of > 8 is indicative of hazardous alcohol consumption. Independent correlates of hazardous drinking were identified using logistic regression analysis including adjustment for common covariables.

Results: Study participants were relatively young (38 +/- 9 years) with 55% being male and 54% completing the AUDIT in Kiswahili. Home-made alcohol was more commonly drunk by patients attending the rural health centre while commercial beer was more commonly drunk by patients attending the teaching and referral hospital clinics. Approximately half (54%) of participants reported hazardous drinking behaviour (AUDIT score=9.9 +/- 9.4). Hazardous drinking was most prevalent among men attending the rural health centre (83% hazardous drinkers, AUDIT score=16.0 +/- 9.1). In multivariable analyses adjusting for age, sex and site of care, men remained more than nine times (odds ratio=9.3, 95% C.I.=5.1-16.9) likely to report hazardous drinking behaviour compared to women.

Conclusions: Hazardous drinking is common among patients with and without HIV/ AIDS in western Kenya and is dramatically more common among rural men than women. Effective interventions for HIV/AIDS in this setting must include a concetrated effort to reduce hazardous drinking.