Abstract
Many drinkers globally are at risk of developing an alcohol use disorder (AUD). The study aimed to identify the extent of AUDs and associated individual and societal-level risk factors or vulnerabilities among adult drinkers in a country with high levels of heavy episodic drinking. A household survey was conducted in the Tshwane Metro, South Africa, using multistage stratified cluster random sampling. Complete data were available on 949 adult drinkers. Half (49%) reported symptoms of alcohol problems, as a proxy for AUDs, as measured using the RAPS4. Gender and age were not associated with symptoms of alcohol problems. White persons had 74% lower odds of symptoms of alcohol problems compared to Black Africans, and persons who reported stressful life events in the past 6 months were four times more likely to report symptoms of alcohol problems. Persons whose primary drinking location was a pub/bar/tavern and “other club” were more than twice as likely to have symptoms of alcohol problems than persons who drank at home, and persons whose primary beverage was wine were 74% less likely to have symptoms of alcohol problems compared to beer drinkers. The findings raise important implications regarding particular vulnerabilities experienced by Black Africans; the sale of alcoholic beverages, and especially beer, in locations such as pubs/bars/taverns; and the need for more comprehensive epidemiological research to assess the nature and extent of AUDs in South Africa together with focused contextual research on particular groups at risk.
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Acknowledgements
This study was supported by the International Development Research Centre (IDRC) Canada (grant number 107198-001) and the South African Medical Research Council. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the IDRC. We thank the Research Coordinator (Elmarie Nel), the project assistants (Naledi Kitleli, Frans Masango, Shirley Hlope, and Chantal Graca-Correia), as well as all the field supervisors and interviewers for their role in data collection for the survey. In addition, we are grateful to Natasha Morris and Ndabezitha Shezi for preparing the maps for sampling purposes, Mukhethwa Londani for data management, and Kirsten Stenius for her comments on an earlier draft of this manuscript. Finally, we express our appreciation to all the participants who gave of their time to take part in this research.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 1975 Declaration of Helsinki, as revised in 2000. Informed consent was obtained from all participants for being included in the study.
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Parry, C.D.H., Trangenstein, P., Lombard, C. et al. Identifying Alcohol Problems and Selected Individual and Contextual Risk Factors Among Adults in South Africa: Findings from the International Alcohol Control Study. Int J Ment Health Addiction 17, 56–72 (2019). https://doi.org/10.1007/s11469-017-9865-5
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DOI: https://doi.org/10.1007/s11469-017-9865-5