{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T21:51:31Z","timestamp":1784670691877,"version":"3.55.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW009595"],"award-info":[{"award-number":["D43TW009595"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Alcohol use disorders (AUD) are prevalent among people living with HIV (PLHIV), with 2\u20136 times higher than in the general population. These conditions are linked to increased morbidity and mortality among PLHIV and amplify sexual risk behaviors, thus exacerbating the transmission of HIV. Despite these negative consequences, a paucity of studies have explored this issue in Tanzania. This study aimed to determine AUD\u2019s prevalence and associated factors among PLHIV attending Care and Treatment Centers (CTCs).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A multifacility-based cross-sectional study was carried out among 532 PLHIV attending four CTC centers in Moshi Municipal, Kilimanjaro. A multistage cluster systematic sampling method was utilized to choose CTCs and participants. Data were collected using standardized tools through interviewer administration. Statistical analyses were performed using STATA (version 16). Binary logistic regression model was used to examine the associations between AUD and the independent variables, with odds ratios and their 95% confidence intervals calculated to quantify the strength of these associations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age of participants was 46.6 years (SD\u00b113.3). The weighted prevalence of alcohol use disorders (AUDIT \u2265 8) within the past 12 months was 28.2%. Factors significantly associated with AUD in the final model included male sex (AOR = 4.18, P &lt;0.001), healthcare level (reference: tertiary health facility; secondary health facility AOR = 1.80, P&lt;0.001, primary health facility AOR = 9.65, P&lt;0.001), being divorced or widowed (AOR = 2.82, P&lt;0.001), secondary education (AOR = 1.35, P = 0.005), and probable depression (AOR = 2.48, P &lt;0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The findings revealed a high prevalence of AUD among PLHIV, highlighting the need for policy refinement aimed at enhancing the integration of psychosocial services at CTCs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318120","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T18:25:50Z","timestamp":1738607150000},"page":"e0318120","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence and factors associated with alcohol use disorders among people living with HIV attending care and treatment centers at Kilimanjaro, Tanzania: A cross-sectional study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4324-6468","authenticated-orcid":true,"given":"Florian Emanuel","family":"Ghaimo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester Steven","family":"Mzilangwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Chacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saidi Bakari","family":"Kuganda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"pone.0318120.ref001","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS). Fact sheet 2024\u2014Latest global and regional HIV statistics on the status of the AIDS epidemic. 2024; https:\/\/www.unaids.org\/en"},{"key":"pone.0318120.ref002","unstructured":"UNAIDS. HIV-AIDS Tanzania Factsheet. 2023(UNAIDS 2021):1\u20133. https:\/\/www.usaid.gov\/tanzania\/fact-sheet\/jun-13-2023-tanzania-hivaids-fact-sheet"},{"key":"pone.0318120.ref003","unstructured":"WHO. Global alcohol action plan [Internet]. 2022. https:\/\/iris.who.int\/bitstream\/handle\/10665\/376939\/9789240090101-eng.pdf?sequence=1"},{"key":"pone.0318120.ref004","unstructured":"Organiza\u00e7\u00e3o Mundial de Sa\u00fade. World health statistics 2022 (Monitoring health of the SDGs) [Internet]. Monitoring health of the SDGs. 2022. 1\u2013131 p. http:\/\/apps.who.int\/bookorders."},{"issue":"1","key":"pone.0318120.ref005","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1037\/cou0000248","article-title":"Mental Help Seeking Attitudes Scale (MHSAS): Development, reliability, validity, and comparison with the ATSPPH-SF and IASMHS-PO","volume":"65","author":"JH Hammer","year":"2018","journal-title":"Journal of counseling psychology"},{"issue":"1","key":"pone.0318120.ref006","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/QAI.0b013e318278f3fa","article-title":"Risk factors for hospitalization and medical intensive care unit (MICU) admission among HIV-infected Veterans","volume":"62","author":"KM Akg\u00fcn","year":"2013","journal-title":"JAIDS Journal of Acquired Immune Deficiency Syndromes"},{"issue":"3","key":"pone.0318120.ref007","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.drugalcdep.2010.06.014","article-title":"A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization","volume":"112","author":"MM Azar","year":"2010","journal-title":"Drug and alcohol dependence"},{"key":"pone.0318120.ref008","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/s10461-018-2242-y","article-title":"Alcohol use and multimorbidity among individuals living with HIV","volume":"23","author":"TN Crawford","year":"2019","journal-title":"AIDS and Behavior"},{"key":"pone.0318120.ref009","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s10461-019-02716-0","article-title":"Alcohol use and antiretroviral therapy non-adherence among adults living with HIV\/AIDS in sub-Saharan Africa: a systematic review and meta-analysis","volume":"24","author":"J Velloza","year":"2020","journal-title":"AIDS and Behavior"},{"issue":"1","key":"pone.0318120.ref010","doi-asserted-by":"crossref","first-page":"1441783","DOI":"10.1080\/16549716.2018.1441783","article-title":"Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life","volume":"11","author":"KN Pokhrel","year":"2018","journal-title":"Global health action"},{"issue":"5","key":"pone.0318120.ref011","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1089\/aid.2009.0211","article-title":"Alcohol use accelerates HIV disease progression","volume":"26","author":"MK Baum","year":"2010","journal-title":"AIDS research and human retroviruses"},{"key":"pone.0318120.ref012","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s10461-009-9525-2","article-title":"Stress, substance use and sexual risk behaviors among primary care patients in Cape Town, South Africa","volume":"14","author":"LA Avalos","year":"2010","journal-title":"AIDS and Behavior"},{"key":"pone.0318120.ref013","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1007\/s10461-009-9589-z","article-title":"Alcohol as a correlate of unprotected sexual behavior among people living with HIV\/AIDS: review and meta-analysis","volume":"13","author":"PA Shuper","year":"2009","journal-title":"AIDS and Behavior"},{"issue":"2","key":"pone.0318120.ref014","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1080\/14659890802624261","article-title":"The correlation between alcohol consumption and risky sexual behaviours among people living with HIV\/AIDS","volume":"14","author":"GB Gerbi","year":"2009","journal-title":"Journal of substance use"},{"issue":"Supplement 2","key":"pone.0318120.ref015","doi-asserted-by":"crossref","first-page":"S197","DOI":"10.1097\/QAD.0000000000002983","article-title":"The Joint United Nations Programme on HIV\/AIDS 95\u201395\u201395 targets: worldwide clinical and cost benefits of generic manufacture","volume":"35","author":"K Heath","year":"2021","journal-title":"Aids"},{"key":"pone.0318120.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-017-2374-0","article-title":"Alcohol use disorders among people living with HIV\/AIDS in Southern Brazil: prevalence, risk factors and biological markers outcomes","volume":"17","author":"CM Da Silva","year":"2017","journal-title":"BMC infectious diseases"},{"issue":"2","key":"pone.0318120.ref017","doi-asserted-by":"crossref","first-page":"179","DOI":"10.15288\/jsa.2002.63.179","article-title":"The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study","volume":"63","author":"FH Galvan","year":"2002","journal-title":"Journal of studies on alcohol"},{"key":"pone.0318120.ref018","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13011-019-0212-7","article-title":"Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross-sectional study","volume":"14","author":"B Duko","year":"2019","journal-title":"Substance abuse treatment, prevention, and policy"},{"key":"pone.0318120.ref019","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1007\/s10461-017-1820-8","article-title":"HIV stigma and unhealthy alcohol use among people living with HIV in Russia","volume":"21","author":"K Lunze","year":"2017","journal-title":"AIDS and Behavior"},{"key":"pone.0318120.ref020","doi-asserted-by":"crossref","first-page":"107753","DOI":"10.1016\/j.drugalcdep.2019.107753","article-title":"Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV","volume":"206","author":"L Lipira","year":"2020","journal-title":"Drug and alcohol dependence"},{"issue":"038","key":"pone.0318120.ref021","first-page":"10","article-title":"Adherence to antiretroviral therapy among adult persons living with HIV\/AIDS in Southern Ethiopia","volume":"5","author":"HC Koyra","year":"2018","journal-title":"Int J Virol AIDS"},{"key":"pone.0318120.ref022","unstructured":"NBS (National Bureau of Statistics). Tanzania in Figures 2012."},{"issue":"8","key":"pone.0318120.ref023","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.jclinepi.2003.12.013","article-title":"Patterns of intra-cluster correlation from primary care research to inform study design and analysis","volume":"57","author":"G Adams","year":"2004","journal-title":"Journal of clinical epidemiology"},{"issue":"1","key":"pone.0318120.ref024","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13011-022-00479-x","article-title":"Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey","volume":"17","author":"D Mushi","year":"2022","journal-title":"Substance Abuse Treatment, Prevention, and Policy"},{"issue":"10","key":"pone.0318120.ref025","doi-asserted-by":"crossref","first-page":"e0140041","DOI":"10.1371\/journal.pone.0140041","article-title":"The epidemiology of alcohol use and alcohol use disorders among young people in northern Tanzania","volume":"10","author":"JM Francis","year":"2015","journal-title":"PloS one"},{"key":"pone.0318120.ref026","volume-title":"International guide for monitoring alcohol consumption and related harm","author":"T Stockwell","year":"2000"},{"key":"pone.0318120.ref027","doi-asserted-by":"crossref","first-page":"108441","DOI":"10.1016\/j.jsat.2021.108441","article-title":"Validity and item response theory properties of the Alcohol Use Disorders Identification Test for primary care alcohol use screening in Mozambique (AUDIT-MZ)","volume":"127","author":"DL Atkins","year":"2021","journal-title":"Journal of substance abuse treatment"},{"key":"pone.0318120.ref028","doi-asserted-by":"crossref","DOI":"10.1177\/20503121221077568","article-title":"Psychometric properties of alcohol use disorder Identification test screening tool among medical outpatients in dilla university referral hospital, southern Ethiopia, 2020","volume":"10","author":"E Habtamu","year":"2022","journal-title":"SAGE Open Medicine"},{"issue":"6","key":"pone.0318120.ref029","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","article-title":"Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II","volume":"88","author":"JB Saunders","year":"1993","journal-title":"Addiction"},{"issue":"9","key":"pone.0318120.ref030","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ\u20109: validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"Journal of general internal medicine"},{"key":"pone.0318120.ref031","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.npbr.2018.11.002","article-title":"Validating the Patient Health Questionnaire-9 (PHQ-9) for screening of depression in Tanzania","volume":"31","author":"MC Fawzi","year":"2019","journal-title":"Neurology, Psychiatry and Brain Research"},{"issue":"11","key":"pone.0318120.ref032","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1017\/S1368980014002468","article-title":"Women\u2019s autonomy and social support and their associations with infant and young child feeding and nutritional status: community-based survey in rural Nicaragua","volume":"18","author":"S Ziaei","year":"2015","journal-title":"Public health nutrition"},{"key":"pone.0318120.ref033","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/00005650-198807000-00006","article-title":"The Duke-UNC Functional Social Support Questionnaire: Measurement of social support in family medicine patients","volume":"1","author":"WE Broadhead","year":"1988","journal-title":"Medical care"},{"key":"pone.0318120.ref034","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1007\/s00127-012-0633-3","article-title":"Validation of the modified DUKE-UNC Functional Social Support Questionnaire in patients with schizophrenia","volume":"48","author":"L Mas-Exp\u00f3sito","year":"2013","journal-title":"Social psychiatry and psychiatric epidemiology"},{"issue":"1","key":"pone.0318120.ref035","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12888-022-04496-9","article-title":"Prevalence, severity, and associated factors of depression in newly diagnosed people living with HIV in Kilimanjaro, Tanzania: a cross-sectional study","volume":"23","author":"K Madundo","year":"2023","journal-title":"BMC psychiatry"},{"issue":"8","key":"pone.0318120.ref036","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1080\/09540120701245999","article-title":"Validation of the HIV\/AIDS stigma instrument\u2014Plwa (Hasi-P)","volume":"19","author":"WL Holzemer","year":"2007","journal-title":"AIDS care"},{"key":"pone.0318120.ref037","article-title":"Prevalence of depression and suicidal ideation and associated risk factors in adolescents receiving care and treatment for HIV\/AIDS at a tertiary health facility in Kilimanjaro Region, Tanzania","author":"E Gamassa","year":"2023","journal-title":"Research Square"},{"key":"pone.0318120.ref038","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13011-019-0240-3","article-title":"The prevalence of alcohol use disorders among people living with HIV\/AIDS: a systematic review and meta-analysis","volume":"14","author":"B Duko","year":"2019","journal-title":"Substance abuse treatment, prevention, and policy"},{"issue":"7","key":"pone.0318120.ref039","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1080\/10826084.2017.1392986","article-title":"\u201c[Drinking is] Like a Rule That You Can\u2019t Break\u201d: perceived barriers and facilitators to reduce alcohol use and improve antiretroviral treatment adherence among people living with HIV and alcohol use disorder in Vietnam","volume":"53","author":"RB Hershow","year":"2018","journal-title":"Substance use & misuse"},{"issue":"5","key":"pone.0318120.ref040","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1080\/09540121.2023.2299324","article-title":"Epidemiology of alcohol use and alcohol use disorders among people living with HIV on antiretroviral therapy in Northwest Tanzania: implications for ART adherence and case management","volume":"36","author":"P Ayieko","year":"2024","journal-title":"AIDS care"},{"key":"pone.0318120.ref041","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1007\/s10461-016-1556-x","article-title":"Alcohol use and food insecurity among people living with HIV in Mbarara, Uganda and St. Petersburg, Russia","volume":"21","author":"GJ Patts","year":"2017","journal-title":"AIDS and Behavior"},{"key":"pone.0318120.ref042","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13011-020-00301-6","article-title":"The prevalence and factors associated with alcohol use disorder among people living with HIV\/AIDS in Africa: a systematic review and meta-analysis","volume":"15","author":"M Necho","year":"2020","journal-title":"Substance abuse treatment, prevention, and policy"},{"key":"pone.0318120.ref043","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2147\/OPTO.S294618","article-title":"The prevalence and determinant factors of self-reported depressive symptoms among elderly people with visual impairment attending an outpatient clinic in Ethiopia","volume":"17","author":"YM Yimer","year":"2021","journal-title":"Clinical optometry"},{"key":"pone.0318120.ref044","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1007\/s11524-019-00390-0","article-title":"HIV stigma, mental health, and alcohol use disorders among people living with HIV\/AIDS in New Orleans","volume":"96","author":"EA Felker-Kantor","year":"2019","journal-title":"Journal of urban health"},{"issue":"9","key":"pone.0318120.ref045","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/abm\/kax050","article-title":"Stigma, coping, and alcohol use severity among people living with HIV: a prospective analysis of bidirectional and mediated associations","volume":"52","author":"JD Wardell","year":"2018","journal-title":"Annals of Behavioral Medicine"},{"key":"pone.0318120.ref046","unstructured":"Tanzania national guidelines for the management of HIV and AIDS, 7th edition April 2019."},{"issue":"sup1","key":"pone.0318120.ref047","doi-asserted-by":"crossref","first-page":"S78","DOI":"10.1080\/09540121.2014.906558","article-title":"Patterns and predictors of antiretroviral therapy use among alcohol drinkers at HIV clinics in Tshwane, South Africa","volume":"26","author":"CT Kekwaletswe","year":"2014","journal-title":"AIDS care"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T18:26:02Z","timestamp":1738607162000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318120"}},"subtitle":[],"editor":[{"given":"Joel Msafiri","family":"Francis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":47,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318120","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]}}}