Kiwanuka, N., Ssetaala, A., Ssekandi, I., et al. PLOS ONE (February 2017), 12(2):e0171200, eCollection 2017, doi:10.1371/journal.pone.0171200.
This community-based cohort study examined the population-attributable fraction (PAF) of alcohol-related HIV incidence. The authors enrolled 1,607 HIV-negative participants aged 18–49 years and followed up with 1,288 (80.1%) of this group one year later. At baseline and in follow-up visits, participants completed interviewer-administered questionnaires on alcohol consumption, demographics, and sexual risk behavior, and were tested for HIV infection. Over half of participants (53.5%) reported drinking alcohol; of these, about one-fourth drank occasionally or often (24.4% and 29.1%, respectively). At follow-up, 48 incident infections had occurred: 10 among nondrinkers, 12 among occasional drinkers, and 26 among regular drinkers. Compared to nondrinkers, the adjusted incident rate ratio (IRR) of HIV was 3.09 (1.13-8.46) among occasional drinkers and 5.34 (2.04-13.97) among regular drinkers. The overall adjusted PAF of incident HIV infections due to alcohol was 64.1, ranging from 52.3 (11.9-74.2) among Muslims to 71.2 (32.6-87.7) for participants who reported two or more sexual partners in the past 12 months. Alcohol consumption was associated with HIV risk behaviors such as multiple partners, though consistent condom use was higher among regular drinkers than among occasional drinkers and nondrinkers. The authors concluded that alcohol contributes to new infections in these communities and recommended integrating interventions to reduce alcohol consumption within prevention activities for similar high-risk communities.