{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:32:00Z","timestamp":1783398720483,"version":"3.54.6"},"reference-count":48,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funding: This research was funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC\/DFID Concordat agreement, the MRC Tropical Epidemiology Group (TEG) (MR\/K012126\/1) and International AIDS V","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: We determined the prevalence of and risk factors for alcohol misuse and illicit drug use among young Ugandans in fishing communities, a recognised \u201ckey population\u201d for human immunodeficiency virus (HIV) infection. Methods: We conducted a cross-sectional survey among young people (15\u201324 years) in fishing communities in Koome, Uganda, in December 2017\u2013July 2018. Using Audio-Assisted Self-Interviewing, we collected data on socio-demographic characteristics and alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT) and timeline follow-back calendar (TLFB). Blood samples were analysed for HIV, herpes simplex virus 2 (HSV2), and Phosphatidyl ethanol (PEth 16:0\/18:1). Urine samples were analysed for illicit drugs. Results: Among 1281 participants (52.7% male, mean age 20 years), 659 (51.4%) reported ever drinking alcohol, 248 (19.4%) had 12-month-AUDIT \u2265 8, and 261 (20.5%) had whole-blood PEth 16:0\/18:1 concentration \u2265 20 ng\/mL, indicating significant consumption. In multivariable analyses, PEth 16:0\/18:1 \u2265 20ng\/mL, AUDIT \u2265 8 and binge drinking (\u22656 standard drinks per drinking occasion in the previous month from TLFB) were all strongly associated with older age, low education, smoking, and HSV2. Illicit drug use prevalence was 5.2% and was associated with older age, low education, being single, and smoking. Conclusion: Levels of alcohol misuse were high among young people in fishing communities and associated with HSV2, a proxy for risky sexual behaviour. Alcohol and illicit drug harm reduction services and HIV prevention programs in Uganda should prioritise young fisherfolk.<\/jats:p>","DOI":"10.3390\/ijerph17072401","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T11:57:14Z","timestamp":1585828634000},"page":"2401","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15\u201324 Years in Fishing Communities in Uganda"],"prefix":"10.3390","volume":"17","author":[{"given":"Monica O.","family":"Kuteesa","sequence":"first","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe 49, Uganda"},{"name":"Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC 1E, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-7936","authenticated-orcid":false,"given":"Helen A.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Medical Research Council Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London WC 1E, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC 1E, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0583-5272","authenticated-orcid":false,"given":"Janet","family":"Seeley","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe 49, Uganda"},{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC 1E, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine N.","family":"Ssentongo","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe 49, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kizindo","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe 49, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ngonzi","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe 49, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Sewankambo","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe 49, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4019-7456","authenticated-orcid":false,"given":"Emily L.","family":"Webb","sequence":"additional","affiliation":[{"name":"Medical Research Council Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London WC 1E, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,1]]},"reference":[{"key":"ref_1","unstructured":"World Health Organisation (2018). Global Status Report on Alcohol and Health, World Health Organisation."},{"key":"ref_2","unstructured":"United Nations Office on Drug and Crime (2019, June 27). World Drug Report. Available online: https:\/\/wdr.unodc.org\/wdr2019\/prelaunch\/WDR19_Booklet_1_EXECUTIVE_SUMMARY.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S2215-0366(16)00013-4","article-title":"Why young people\u2019s substance use matters for global health","volume":"3","author":"Hall","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S2215-0366(15)00508-8","article-title":"The increasing global health priority of substance use in young people","volume":"3","author":"Degenhardt","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/S0140-6736(17)30330-6","article-title":"Alcohol industry looks to boost drinks sales in Africa","volume":"389","author":"McCall","year":"2017","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1192","DOI":"10.1016\/S2214-109X(17)30375-3","article-title":"Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review","volume":"5","author":"Degenhardt","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_7","unstructured":"UNAIDS (2018, April 09). Fact sheet\u2014Latest statistics on the status of the AIDS epidemic. Available online: http:\/\/www.unaids.org\/en\/resources\/fact-sheet."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kuteesa, M.O., Seeley, J., Weiss, H.A., Cook, S., Kamali, A., and Webb, E.L. (2019). Alcohol misuse and illicit drug use among occupational groups at high risk of HIV in sub-Saharan Africa: A systematic review. AIDS Behav.","DOI":"10.1007\/s10461-019-02483-y"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1176\/appi.ajp.2013.12060782","article-title":"DSM-5 criteria for substance use disorders: recommendations and rationale","volume":"170","author":"Hasin","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/OLQ.0b013e318251555d","article-title":"High HIV incidence and socio-behavioral risk patterns in fishing communities on the shores of Lake Victoria, Uganda","volume":"39","author":"Seeley","year":"2012","journal-title":"Sex. Transm. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"P219","DOI":"10.1186\/1742-4690-9-S2-P219","article-title":"Alcohol and illicit drug use among potential HIV vaccine efficacy trial volunteers along Lake Victoria, Uganda","volume":"9","author":"Ssekandi","year":"2012","journal-title":"Retrovirology"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kiene, S.M., Lule, H., Sileo, K.M., Silmi, K.P., and Wanyenze, R.K. (2017). Depression, alcohol use, and intimate partner violence among outpatients in rural Uganda: vulnerabilities for HIV, STIs and high risk sexual behavior. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-016-2162-2"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Tumwesigye, N.M., Atuyambe, L., Wanyenze, R.K., Kibira, S.P., Li, Q., Wabwire-Mangen, F., and Wagner, G. (2012). Alcohol consumption and risky sexual behaviour in the fishing communities: evidence from two fish landing sites on Lake Victoria in Uganda. BMC Public Health, 12.","DOI":"10.1186\/1471-2458-12-1069"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kiwanuka, N., Ssetaala, A., Nalutaaya, A., Mpendo, J., Wambuzi, M., Nanvubya, A., Sigirenda, S., Kitandwe, P.K., Nielsen, L.E., and Balyegisawa, A. (2014). High incidence of HIV-1 infection in a general population of fishing communities around Lake Victoria, Uganda. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0094932"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1080\/09540121.2013.824541","article-title":"A meta-analysis and systematic review of HIV risk behavior among fishermen","volume":"26","author":"Smolak","year":"2014","journal-title":"AIDS Care"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kwena, Z.A., Camlin, C.S., Shisanya, C.A., Mwanzo, I., and Bukusi, E.A. (2013). Short-term mobility and the risk of HIV infection among married couples in the fishing communities along Lake Victoria, Kenya. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0054523"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/s10461-015-1077-z","article-title":"\u201cSuch Behaviors Are Not in My Home Village, I Got Them Here\u201d: A Qualitative Study of the Influence of Contextual Factors on Alcohol and HIV Risk Behaviors in a Fishing Community on Lake Victoria, Uganda","volume":"20","author":"Sileo","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kiwanuka, N., Ssetaala, A., Ssekandi, I., Nalutaaya, A., Kitandwe, P.K., Ssempiira, J., Bagaya, B.S., Balyegisawa, A., Kaleebu, P., and Hahn, J. (2017). Population attributable fraction of incident HIV infections associated with alcohol consumption in fishing communities around Lake Victoria, Uganda. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0171200"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1093\/cid\/ciy761","article-title":"The Impact of Intensive Versus Standard Anthelminthic Treatment on Allergy-related Outcomes, Helminth Infection Intensity, and Helminth-related Morbidity in Lake Victoria Fishing Communities, Uganda: Results From the LaVIISWA Cluster-randomized Trial","volume":"68","author":"Sanya","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/tmi.12545","article-title":"Schistosoma mansoni and HIV infection in a Ugandan population with high HIV and helminth prevalence","volume":"20","author":"Sanya","year":"2015","journal-title":"Trop. Med. Int. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1111\/tmi.12267","article-title":"Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa","volume":"19","author":"Francis","year":"2014","journal-title":"Trop. Med. Int. Health"},{"key":"ref_22","unstructured":"Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B., and Monteiro, M.G. (2001). The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, World Health Organization."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sobell, L., and Sobell, M. (1992). Timeline Followback: A Technique for Assessing Self Reported Ethanol Consumption, Humana Press.","DOI":"10.1007\/978-1-4612-0357-5_3"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1373\/clinchem.2008.120923","article-title":"Molecular species of the alcohol biomarker phosphatidylethanol in human blood measured by LC-MS","volume":"55","author":"Helander","year":"2009","journal-title":"Clin. Chem."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/j.1530-0277.2011.01669.x","article-title":"Phosphatidylethanol (PEth) as a biomarker of alcohol consumption in HIV-positive patients in sub-Saharan Africa","volume":"36","author":"Hahn","year":"2012","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_26","first-page":"1109","article-title":"Illicit drug use","volume":"Volume 1","author":"Degenhardt","year":"2004","journal-title":"Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"World Health Organisation ASSIST Working Group (2002). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addict. (Abingdon Engl.), 97, 1183\u20131194.","DOI":"10.1046\/j.1360-0443.2002.00185.x"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1369-1600.2009.00185.x","article-title":"Phosphatidylethanol: normalization during detoxification, gender aspects and correlation with other biomarkers and self-reports","volume":"15","author":"Wurst","year":"2010","journal-title":"Addict. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"14788","DOI":"10.3390\/ijms131114788","article-title":"Phosphatidylethanol in blood as a marker of chronic alcohol use: a systematic review and meta-analysis","volume":"13","author":"Viel","year":"2012","journal-title":"Int. J. Mol. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_31","unstructured":"Preedy, V.R. (2019). Phosphatidylethanol Homologs in Blood as Biomarkers for the Time Frame and Amount of Recent Alcohol Consumption. Neuroscience of Alcohol, Academic Press. Chapter 58."},{"key":"ref_32","first-page":"1747","article-title":"National harmonization of the alcohol biomarker PEth","volume":"110","author":"Helander","year":"2013","journal-title":"Lakartidningen"},{"key":"ref_33","unstructured":"Ministry of Health Uganda (2016). National HIV Testing Services Policy and Implementation Guidelines."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/ije\/26.1.224","article-title":"The role of conceptual frameworks in epidemiological analysis: a hierarchical approach","volume":"26","author":"Victora","year":"1997","journal-title":"Int. J. Epidemiol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Francis, J.M., Weiss, H.A., Mshana, G., Baisley, K., Grosskurth, H., and Kapiga, S.H. (2015). The epidemiology of alcohol use and alcohol use disorders among young people in northern Tanzania. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0140041"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2935","DOI":"10.18203\/2394-6040.ijcmph20182626","article-title":"Prevalence and pattern of alcohol consumption using alcohol use disorder identification test among students at a medicalcollege in Goa, India","volume":"5","author":"Verenkar","year":"2018","journal-title":"Int. J. Community Med. Public Health"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Weiss, H.A., Vandepitte, J., Bukenya, J.N., Mayanja, Y., Nakubulwa, S., Kamali, A., Seeley, J., and Grosskurth, H. (2016). High levels of persistent problem drinking in women at high risk for HIV in Kampala, Uganda: A prospective cohort study. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13020153"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1097\/QAD.0000000000001847","article-title":"Depressive symptoms and problematic alcohol and other substance use in 1476 gay, bisexual, and other MSM at three research sites in Kenya","volume":"32","author":"Korhonen","year":"2018","journal-title":"AIDS (London, Engl.)"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1080\/14330237.2016.1208961","article-title":"Correlates of illicit drug use among university students in Africa and the Caribbean","volume":"26","author":"Peltzer","year":"2016","journal-title":"J. Psychol. Afr."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Haug, S., Nunez, C.L., Becker, J., Gmel, G., and Schaub, M.P. (2014). Predictors of onset of cannabis and other drug use in male young adults: results from a longitudinal study. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1202"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.addbeh.2010.07.003","article-title":"Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers","volume":"35","author":"Howell","year":"2010","journal-title":"Addict. Behav."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1111\/j.1530-0277.2010.01223.x","article-title":"Changes in Sensation Seeking and Risk-Taking Propensity Predict Increases in Alcohol Use Among Early Adolescents","volume":"34","author":"MacPherson","year":"2010","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_43","first-page":"203","article-title":"Alcohol\u2019s role in HIV transmission and disease progression","volume":"33","author":"Pandrea","year":"2010","journal-title":"Alcohol. Res. Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1477-7517-6-24","article-title":"Injection drug use, unsafe medical injections, and HIV in Africa: a systematic review","volume":"6","author":"Reid","year":"2009","journal-title":"Harm Reduct. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/QAI.0b013e3181b18b6e","article-title":"Alcohol use and antiretroviral adherence: review and meta-analysis","volume":"52","author":"Hendershot","year":"2009","journal-title":"J. Acquir. Immune Defic. Syndr. (1999)"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S1473-3099(17)30405-X","article-title":"Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis","volume":"17","author":"Looker","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_47","unstructured":"Rothman, K.J., Greenland, S., and Lash, T.L. (2008). Modern Epidemiology, Wolters Kluwer Health\/Lippincott Williams & Wilkins."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1093\/aje\/kwj036","article-title":"Reporting Participation in Epidemiologic Studies: A Survey of Practice","volume":"163","author":"Morton","year":"2005","journal-title":"Am. J. Epidemiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/7\/2401\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:14:16Z","timestamp":1760174056000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/7\/2401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,1]]},"references-count":48,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["ijerph17072401"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17072401","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,1]]}}}