Epidemiological Findings of Alcohol Misuse and Dependence Symptoms among Adolescent Girls and Young Women Involved in High-Risk Sexual Behavior in Kampala, Uganda
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Setting
2.2. Study Participant Eligibility Criteria
2.3. Study Outcomes and Measures
- Participants who scored ≥8 were categorized as moderate to high risk drinkers.
- Participants who scored ≥16 were categorized as high-risk drinkers.
2.4. Independent Variables
2.5. Laboratory Methods
2.6. Data Collection
2.7. Statistical Analysis
- We determined the proportion with AUD as the number that had AUDIT score ≥8 divided by the total number enrolled, and expressed as a percentage.
- Of those with AUD, we also determined the proportion who were high-risk drinkers as the number that had AUDIT score ≥16 divided by the total number enrolled, and expressed as a percentage.
- The proportion with dependence symptoms were those who had a score of ≥4 divided by the total number enrolled, and expressed as a percentage.
2.8. Missing Data (Sensitivity Analysis)
2.9. Ethics Statement
3. Results
3.1. Baseline Characteristics of AGYW Enrolled at the GHWP Clinic in Kampala, Uganda
3.2. Alcohol Consumption Patterns and Dependence Scores of AGYW
3.3. Prevalence of Alcohol Misuse (AUDIT ≥8 and AUDIT ≥16) by Sociodemographic and Behavioral Characteristics
3.4. Factors Associated with Alcohol Misuse among AGYW
3.5. Factors Associated with Dependence Symptoms among AGYW
4. Discussion
5. Limitations and Strengths
6. Conclusions and Recommendations
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Availability of Data and Materials
References
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Variable | Categories | Frequency (N = 1440) | Percent (%) |
---|---|---|---|
Age (Years) | |||
15–19 | 360 | 25.0 | |
20–24 | 1080 | 75.0 | |
Education level | |||
None | 82 | 5.7 | |
Less than secondary | 1115 | 77.4 | |
Secondary or higher | 243 | 16.9 | |
Marital status | |||
Single (never married) | 746 | 51.8 | |
Married | 61 | 4.2 | |
Widowed/separated | 633 | 44.0 | |
Number of biological children | |||
None | 435 | 30.2 | |
One | 586 | 40.7 | |
>1 | 419 | 29.1 | |
Ever used illicit drugs | |||
Yes | 505 | 35.1 | |
No | 935 | 64.9 | |
Ever tested for HIV | |||
Yes | 1325 | 92.0 | |
No | 115 | 8.0 | |
Last HIV test a | |||
≤6 months | 954 | 72.0 | |
>6 months | 371 | 28.0 | |
HIV status | |||
Positive | 297 | 20.6 | |
Negative | 1143 | 79.4 | |
Main job | |||
Sex work | 972 | 67.5 | |
Other job | 468 | 32.5 | |
Paying sexual partners in past one month | |||
<10 partners | 291 | 20.2 | |
≥10 partners | 1149 | 79.8 | |
Condom use with paying partners in past month | |||
Consistent | 707 | 49.1 | |
Inconsistent | 733 | 50.9 | |
Ever experienced intimate partner violence (IPV) | |||
Yes | 662 | 46.0 | |
No | 778 | 54.0 | |
Contraceptive use | |||
Yes | 964 | 66.9 | |
No | 476 | 33.1 |
AUDIT Score | Risk Level | Alcohol Consumption Pattern | Dependence Symptoms (Dependence Score ≥4) |
---|---|---|---|
Frequency (N = 1440) n (%) | Frequency (n = 227) n (%) | ||
0–7 | Low-risk drinking/Abstinence | 577 (40.1) | 0 (0) |
8–15 | Moderate-risk/hazardous drinking | 439 (30.5) | 19 (8.4) |
16–19 | High-risk/harmful drinking | 192 (13.3) | 51 (22.5) |
≥20 | High-risk/Alcohol dependent | 232 (16.1) | 157 (69.1) |
AUDIT Score ≥8 | AUDIT Score ≥16 | ||||
---|---|---|---|---|---|
Variable | Sub-Category | n (col %) | χ2 p-value | n (col %) | χ2 p-value |
Overall | 863 (59.9) | 424 (29.4) | |||
Age (years) | 0.002 | 0.062 | |||
15–19 | 191 (53.1) | 92 (25.6) | |||
20–24 | 672 (62.2) | 332 (30.7) | |||
Education level | 0.928 | 0.103 | |||
Less than secondary | 718 (60.0) | 363 (30.3) | |||
Secondary or higher | 145 (59.7) | 61 (25.1) | |||
Marital Status | 0.07 | 0.271 | |||
Single never married | 441 (59.1) | 206 (27.6) | |||
Married | 29 (47.5) | 18 (29.5) | |||
Separated or widowed | 393 (62.1) | 200 (31.6) | |||
Biological children | 0.46 | 0.992 | |||
None | 267 (61.4) | 128 (29.4) | |||
≥1 | 596 (59.3) | 195 (29.5) | |||
Current illicit drug use | <0.001 | <0.001 | |||
No | 538 (52.7) | 229 (22.4) | |||
Yes | 325 (77.6) | 222 (46.5) | |||
Ever experienced IPV | <0.001 | <0.001 | |||
No | 431 (55.4) | 173 (22.2) | |||
Yes | 432 (65.3) | 251 (37.9) | |||
Number of paying sexual partners in past month | 0.014 | 0.002 | |||
<10 | 156 (53.6) | 64 (22.0) | |||
≥10 | 707 (61.5) | 360 (31.3) | |||
Consistent condom use with paying sexual partners | <0.001 | <0.001 | |||
No | 472 (64.4) | 254 (34.7) | |||
Yes | 391 (55.3) | 170 (24.1) | |||
Contraceptive use | 0.092 | 0.277 | |||
No | 300 (63.0) | 149 (31.3) | |||
Yes | 563 (58.4) | 275 (28.5) | |||
HIV status | 0.232 | 0.949 | |||
Positive | 169 (56.9) | 87 (29.3) | |||
Negative | 694 (60.7) | 337 (29.5) |
AUDIT Score ≥8 | AUDIT Score ≥16 | ||||||
---|---|---|---|---|---|---|---|
Variable | Sub-Category | Unadjusted OR (95% CI) | LRT p-value | Adjusted OR (95% CI) | Unadjusted OR (95% CI) | LRT p-value | Adjusted OR (95% CI) |
Age (years) | 0.062 | ||||||
15–17 | 1.00 | 0.002 | 1.00 | 1.00 | 1.00 | ||
20–24 | 1.46 (1.15–1.85) | 1.61 (1.24–2.08) | 1.29 (0.99–1.69) | 1.43 (1.06–1.92) | |||
Education level | 0.928 | 0.104 | |||||
Less than secondary | 1.00 | 1.00 | 1.00 | 1.00 | |||
Secondary or higher | 0.99 (0.75–1.31) | 1.03 (0.77–1.39) | 0.77 (0.56–1.06) | 0.83 (0.59–1.17) | |||
Marital Status | 0.277 | 0.106 | |||||
Single never married | 1.00 | - | 1.00 | 1.00 | |||
Married | 0.63 (0.37–1.06) | - | 1.09 (0.62–1.94) | 1.14 (0.62–2.07) | |||
Separated or widowed | 1.13 (0.91–1.41) | - | 1.21 (0.96–1.53) | 1.03 (0.80–1.33) | |||
Biological children | 0.461 | 0.992 | |||||
None | 1.00 | - | 1.00 | - | |||
≥1 | 0.92 (0.73–1.15) | - | 1.00 (0.78–1.28) | - | |||
Current illicit drug use | <0.001 | <0.001 | |||||
No | 1.00 | 1.00 | 1.00 | 1.00 | |||
Yes | 3.10 (2.39–4.03) | 3.04 (2.32–3.98) | 3.01 (2.36–3.83) | 2.80 (2.18–3.61) | |||
Ever experienced IPV | <0.001 | <0.001 | |||||
No | 1.00 | 1.00 | 1.00 | 1.00 | |||
Yes | 1.51 (1.22–1.87) | 1.35 (1.07–1.69) | 2.14 (1.69–2.69) | 1.87 (1.46–2.39) | |||
Paying partners (past month) | 0.014 | 0.002 | |||||
<10 | 1.00 | 1.00 | 1.00 | 1.00 | |||
≥10 | 1.38 (1.07–1.79) | 1.12 (0.85–1.48) | 1.62 (1.19–2.19) | 1.20 (0.87–1.66) | |||
Condom use with paying sexual partners | <0.001 | <0.001 | |||||
Consistent | 1.00 | 1.00 | 1.00 | 1.00 | |||
Inconsistent | 1.46 (1.18–1.81) | 1.44 (1.15–1.80) | 1.68 (1.33–2.11) | 1.60 (1.25–2.04) | |||
Contraceptive use | 0.092 | 0.277 | |||||
No | 1.00 | 1.00 | 1.00 | - | |||
Yes | 0.82 (0.66–1.03) | 0.83 (0.65–1.05) | 0.88 (0.69–1.11) | - | |||
HIV status | 0.232 | 0.949 | |||||
Positive | 1.00 | 1.00 | 1.00 | 1.00 | |||
Negative | 1.17 (0.90–1.52) | 1.52 (1.15–2.01) | 1.01 (0.76–1.34) | 1.27 (0.94–1.72) |
Variable | Sub-Category | Dependence Symptoms (Score ≥4) | Unadjusted OR | p-value | Adjusted OR |
---|---|---|---|---|---|
n (col %) | |||||
Overall | 227 (15.8) | ||||
Age (years) | 0.337 | ||||
15–19 | 51 (14.2) | 1.00 | 1.00 | ||
20–24 | 176 (16.3) | 1.18 (0.84–1.65) | 1.44 (0.99–2.07) | ||
Education level | 0.224 | ||||
Less than secondary | 195 (16.3) | 1.00 | 1.00 | ||
Secondary or higher | 32 (13.2) | 0.78 (0.52–1.17) | 0.80 (0.52–1.22) | ||
Marital status | 0.514 | ||||
Single never married | 113 (15.2) | 1.00 | - | ||
Married | 10 (16.4) | 1.09 (0.54–2.23) | - | ||
Widowed/separated | 104 (16.4) | 1.10 (0.82–1.47) | - | ||
Biological children | 0.185 | ||||
None | 77 (17.7) | 1.00 | 1.00 | ||
≥1 | 150 (14.9) | 0.82 (0.60–1.10) | 0.75 (0.54–1.04) | ||
Current illicit drug use | <0.001 | ||||
No | 110 (11.8) | 1.00 | 1.00 | ||
Yes | 117 (23.2) | 2.26 (1.69–3.01) | 2.30 (1.70–3.11) | ||
Ever experienced IPV | <0.001 | ||||
No | 94 (12.1) | 1.00 | 1.00 | ||
Yes | 133 (20.1) | 1.83 (1.37–2.44) | 1.53 (1.13–2.06) | ||
Paying sexual partners in past month | <0.001 | ||||
<10 partners | 27 (9.3) | 1.00 | 1.00 | ||
≥10 partners | 200 (17.4) | 2.06 (1.35–3.15) | 1.69 (1.09–2.63) | ||
Condom use with paying partners | <0.001 | ||||
Consistent | 148 (20.2) | 1.00 | 1.00 | ||
Inconsistent | 79 (11.2) | 2.01 (1.49–2.70) | 1.95 (1.43–2.64) | ||
Contraceptive use | 0.217 | ||||
No | 67 (14.1) | 1.00 | - | ||
Yes | 160 (16.6) | 1.21 (0.89–1.65) | - | ||
HIV status | 0.495 | ||||
Positive | 43 (14.5) | 1.00 | 1.00 | ||
Negative | 184 (16.1) | 1.13 (0.79–1.62) | 1.43 (0.98–2.09) |
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Mayanja, Y.; Kamacooko, O.; Bagiire, D.; Namale, G.; Seeley, J. Epidemiological Findings of Alcohol Misuse and Dependence Symptoms among Adolescent Girls and Young Women Involved in High-Risk Sexual Behavior in Kampala, Uganda. Int. J. Environ. Res. Public Health 2020, 17, 6129. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176129
Mayanja Y, Kamacooko O, Bagiire D, Namale G, Seeley J. Epidemiological Findings of Alcohol Misuse and Dependence Symptoms among Adolescent Girls and Young Women Involved in High-Risk Sexual Behavior in Kampala, Uganda. International Journal of Environmental Research and Public Health. 2020; 17(17):6129. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176129
Chicago/Turabian StyleMayanja, Yunia, Onesmus Kamacooko, Daniel Bagiire, Gertrude Namale, and Janet Seeley. 2020. "Epidemiological Findings of Alcohol Misuse and Dependence Symptoms among Adolescent Girls and Young Women Involved in High-Risk Sexual Behavior in Kampala, Uganda" International Journal of Environmental Research and Public Health 17, no. 17: 6129. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176129