The study was conducted at Mizan Tep university hospital from October 10 to December
9, 2017, which is located in southern nation nationality people region (SNNPR) of
Ethiopia .It is 832 km from the capital city of the region called Hawassa. It is also
588 km`s from Addis Ababa, which is the capital city of the country. It provides different services for outpatient and inpatient population from SNNPR
and neighbouring region called Gambela and Oromia in Ethiopia.
Institutional based cross-sectional study design was used.
All HIV positive patients who have follow up at ART Clinic in MTUTH, Southwest Ethiopia
during data collection period.
Those sampled HIV positive patients who attend ART clinic during the study period
in the hospital
Sampled HIV positive patients with age greater than or equal to 15 years were included
in the study.
Exclusion criteria:-sampled patients who were unwilling to give informed consent and severely ill
Sample size determination
The required sample size was calculated by using single population proportion formula.
The Proportion of alcohol use disorder among PLWHA was used from cross sectional study
done at Jimma in 2012 which is 32.6%  with 5% marginal error and 95% confidence interval (CI) of certainty (alpha=0.05).
Where: n= sample size, Z α/2= Critical value=1.96
P= Prevalence of alcohol use among PLWHA=0.326 (32.6%)
d= precision (marginal error) =0.05
Therefore, n = (Zα/2)2 P (1-P) / d2, n = (1.96)2 *0.326 (1 -0.326)/ (0.05)2 =338
Since total number of HIV positive patients visiting ART clinic at HUCSH are <10,000, we used correction formula to know the final sample size as follows.
nf = ni where: ni – Initial sample size
1 + ni/N
nf – Final sample size
nf = 338
N – Total number of PLWHA visiting ART clinic
Ten percent of the calculated value of non-respondents will be 30.2.
nf = 302+30.2 , nf = 332.2332
Study participants were selected by systematic sampling method by drawing those ART
patients having follow up in the ART registration book by establishing the sampling
frame. The sample size for the study comprised of 332 patients who were selected by
systematic random sampling, calculating sampling interval 𝐾= (𝑁/Tsz). 𝑁 denotes total numbers of patients having ART follow up during the study period in
MTUTH which was 1024 and Tsz is the total sample size. So, every 3nd patient was selected from sampling frame. The sampled ART outpatients were present
and exit interviews were carried out.
:-Age, sex, marital status, occupational, educational status, religion, ethnicity,
living condition and income.
Clinical variables:-stage of HIV, year of serostatus, CD4 count, Viral load, HIV/AIDS stage, On ART or not, social support and HIV related stigma.
Substance use:-Tobacco , Khat, Cocaine, Alcohol.
Data Collection Instruments
Data was collected by semi structured self-administered questionnaire prepared in
English and translated into Amharic and re translated to English to ensure its consistency.
The questionnaires are adopted and modified from WHO-substance use survey questionnaire.
It consists of socio-demographic variables, substance use, health status and stigma
related questions. The structured questioner, Oslo-3 social support scale, perceived HIV stigma scale
and Alcohol Use Disorder Identification Test (AUDIT) was used to assess alcohol use
disorder. Supervision was done while data collectors collect data and the information was
checked for completeness and internal consistency.
Data Processing and Analysis
Data was checked and coded for its completeness and entered into Epidata 3.1 version
then Statistical Package for Social Sciences (SPSS) version 20 was used for analysis.
Both descriptive and inferential statistics procedures were undertaken. Tables and
figures were used to present the data. Binary logistic regression model was used to
identify factors associated with alcohol use disorder. Crude and adjusted odds ratios
with 95% confidence interval were used to determine the strength of association between
dependent and independent variables. Those Variables with P value <0.05 were considered
Social Drinker: The total AUDIT scores of the drinkers among 1 to 7.
Hazardous Drinking: the total AUDIT scores of the drinkers among 8 to 15.
Harmful Drinking: the total AUDIT scores of the drinkers among 16 to 19.
Alcohol Dependence: the total AUDIT scores of the drinkers among 20 to 40.
Alcohol use disorder: a patient who scored AUDIT scores > 8.
Poor support: Those who score <8 in Oslo-3 Social Support Scale (OSS-3)
Perceived stigma: Those who score > 11 in HIV Stigma Scale
Dissemination and Utilization
Finally the result from this study was disseminated to MTUTH
Ethical clearance was obtained from Mizan Aman health Science College and permission
was obtained from MTUTH. All participants of the study were asked and signed an informed
consent after elaborating clearly the objectives of the study. Their right to refuse
were also kept honestly.