Effect of Biomarker Confirmed Unhealthy Alcohol Use on Viral Suppression Among Adolescents and Young Adults With HIV in East Africa

作者：Florence Mwangwa, Sarah B. Puryear, Marilyn Nyabuti, Helen Nakato, Gordon Orori, D Black, James Peng, Elizabeth Bukusi, Laura B. Balzer, Carol S. Camlin, James Ayieko, Theodore Ruel, Moses R. Kamya, Diane V. Havlir, Gabriel Chamie, Judith A. Hahn · 发表于：Journal of the International Association of Providers of AIDS Care (JIAPAC) · 年份：2026 · DOI：10.1177/23259582261432032 · 研究领域：HIV/AIDS Research and Interventions、HIV-related health complications and treatments、HIV Research and Treatment

Background Unhealthy alcohol use is common among people affected by HIV and is associated with poor treatment outcomes, but its impact among adolescents and young adults living with HIV (AYAH) in Africa is rarely explored. This study aimed to estimate the prevalence of unhealthy alcohol use and examine its association with HIV viral suppression among AYAH in Uganda and Kenya. Methods We conducted a cross-sectional survey among AYAH enrolled in the intervention arm of the SEARCH Youth study, a life stage based trial evaluating an intervention to improve viral suppression among youth aged 15 to 24 years. At their 30 to 36 month follow-up visit, AYAH were interviewed for self-reported alcohol consumption using the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C, modified to cover the last 3 months) and tested for phosphatidylethanol (PEth), a blood-based biomarker of prior month alcohol consumption. Unhealthy alcohol use was defined as AUDIT-C ≥ 3 for females, ≥4 for males or PEth≥50 ng/mL. We estimated underreporting of alcohol use among those with PEth ≥50 ng/mL and examined the association between unhealthy alcohol use and viral non suppression (≥400 copies/mL) using logistic regression, adjusting for gender, age, and country. Results Unhealthy alcohol use was assessed in 715 AYAH; 409 (57.0%) in Uganda and 309 (43.0%) in Kenya. Eighty percent were female, median age at the time of the survey was 24 years (interquartile range: 21-26), and 95.0% were virally sup...