Correlates of Alcohol Use and Hazardous Alcohol Consumption Among Adults Living with HIV in Tanzania: Evidence from the Tanzania HIV Impact Survey, 2022-2023.

Hazardous alcohol consumption (HAC) among people living with HIV (PLHIV) has been associated with poor antiretroviral therapy (ART) adherence and unsuppressed HIV viral load (VL). We examined potential correlates of alcohol use and HAC among PLHIV aged ≥ 18 years using nationally representative data from the Tanzania HIV Impact Survey 2022-2023, a cross-sectional population-based household survey. Consenting individuals were tested for HIV and HIV-positive specimens were tested for HIV VL. HAC was determined using the World Health Organization "Alcohol Use Disorders Identification Test-Concise." Correlates of alcohol use and HAC were determined using binary logistic regression and sampling weights. Jackknife variance estimation was used to generate 95% confidence intervals (95% CI) and p values. Of 1793 individuals with positive HIV test results, 686 (34.5%) reported any alcohol consumption in the past year, and 364 (17.8%) reported HAC. Higher odds of HAC were observed among PLHIV aged 35-44 years (aOR = 2.35; 95% CI, 1.12-4.93; p = 0.026), 45-54 years (aOR = 2.66; 95% CI, 1.23-5.74; p = 0.015), and 55-64 years (aOR = 2.92; 95% CI, 1.31-6.55; p = 0.011) compared to those aged ≤ 24 years (7.5%). Also, among PLHIV with one sexual partner (18.3%, aOR = 1.85; 95% CI, 1.29-2.65; p = 0.002) and multiple partners (27.7%, aOR = 3.27; 95% CI, 1.84-5.81; p < 0.001) compared to those with no partner in the past 12 months (11.0%). No significant associations were found between alcohol use or HAC and reported ART missed days or VL suppression. In Tanzania, although nearly one-fifth of PLHIV reported HAC, it was not associated with HIV treatment outcomes.