Abstract
BACKGROUND: Probable alcohol use disorder is rarely on the minds of people who use alcohol, probably due to technicality related to making that diagnosis. Men who have sex with men are more vulnerable to alcohol use, usually as a coping strategy to manage minority distress, stigma, violence and validation. This study determined the prevalence and factors associated with probable alcohol use disorder among men who have sex with men enrolled in the HIV pre-exposure prophylaxis program in Tanga, Tanzania. METHODOLOGY: This study included 364 men who have sex with men recruited through respondent driven sampling. Structured questionnaire was used for socio-demographic and sexual characteristics data collection. Probable alcohol use disorder was assessed using the Alcohol Use Disorder Identification Test (AUDIT). A modified Poisson regression model was used to determine the factors associated with probable alcohol use disorder among men who have sex with men. RESULTS: Our study found that about 45% of participants had probable alcohol use disorder. The prevalence was high among participants with a history of having group sex (aPR=1.29; 95% CI: 1.00-1.65, P=0.051), who had ever paid for oral or anal sex (aPR=1.65; 95% CI: 1.21-2.25, p=0.002), who reported facing financial difficulties (aPR=1.40; 95% CI: 1.10-1.79, p=0.007), those who experienced moderate stigma (aPR=1.44;95% CI: 1.13-1.84, p=0.003) and higher stigma (aPR=1.39;95% CI: 1.02-1.91, p=0.040). CONCLUSION: The prevalence of probable alcohol use disorder was found to be relatively high among men who have sex with men, especially those with a history of group sex, paying for sex, facing financial difficulties and those who reported experiencing a moderate-to-high level of stigma. This highlights the need to intensify health, reproductive and safe sex practices programs while escalating anti-stigma campaigns. We recommend the integration of substance screening and harm reduction services in HIV treatments and prevention programming.