STRIVE Tackling the structural drivers of HIV

Alcohol use is a significant problem among young people in northern Tanzania. This study argues for the urgent need to develop, pilot and deliver interventions to help young people delay initiation and reduce levels of harmful drinking, particularly among college students and casual labourers.

State of existing evidence

Excessive alcohol use is a global public health problem accounting for 6% of mortality and 5% of disability adjusted life years lost worldwide. The World Health Organization (WHO) estimates that, globally, 53% of people aged 15 years+ have ever used alcohol and 39% used it in the last year.

Within Africa, an estimated 43% of those aged 15 years+ have used alcohol and 30% used it in the last year. The reported prevalence of alcohol use disorders (AUD), defined by an Alcohol Use Disorders Identification Test (AUDIT), is estimated at 4% globally and 3% in Africa, and is generally more prevalent among men. AUD are associated with acute and long-term medical complications and may interfere with the treatment of chronic diseases such as diabetes and HIV/ AIDS due to poor treatment adherence.

Methods

Few data are available on the epidemiology of alcohol use and AUD among young people in sub-Saharan Africa. For this study, researchers conducted a cross-sectional survey among four groups of young people aged 15–24 years old in two regions (Kilimanjaro and Mwanza) of northern Tanzania. Using a multistage stratified random sampling strategy, information was collected on demographics, alcohol use and behavioural factors.

To identify the severity of alcohol use, researchers used the AUDIT and estimated the quantity and frequency of alcohol consumption using the timeline-follow-back-calendar (TLFB) method.

Patterns of alcohol use in the last year

• 24% of male secondary students and 60% of male college students preferred bottled beer.
• Wine was popular among females.
• Up to 35% consume locally brewed drinks.  
• Male college students and casual workers reported the highest frequency of heavy episodic drinking.
• 64% of male college students reported consuming more than 6 drinks on a typical drinking occasion.
• 11–14% of college students and casual labourers reported having such occasions every week.

Frequency and amount of alcohol used over the last 2 months

• Alcohol use in the last 2 months was reported by:
  • 3% of female and 9% of male secondary school students
  • 16% of female and 27% of male college students
  • 11% of female and 14% of male employees
  • 30% of female and 18% of male casual workers respectively
  • Based on the TLFB method, 71% of male college students and 57% of male casual labourers reported the highest alcohol consumption.
  • Male employees and female casual labourers reported a similar number of drinking events with a lower median monthly number of standard drinks.
  • Women of the other three sub-groups reported low levels of alcohol consumption.

Findings

• The prevalence of reported alcohol use was higher among males (47–70% ever users and 20–45% current users) than females (24– 54% ever users and 12–47% current users).
• Prevalence of use was substantially higher in Kilimanjaro than Mwanza region.
• In both regions, participants reported high exposure to alcohol advertisements and wide alcohol availability.
• College students reported the highest prevalence of current alcohol use (45% among males; 26% among females) and of heavy episodic drinking (71% among males; 27% among females), followed by casual labourers.
• Males were more likely to have AUD than females, with 11–28% of males screening positive for AUD.
• Alcohol use was associated with male gender, being in a relationship, greater disposable income, non-Muslim religion and a higher number of sexual partners.