Alcohol use disorders and mental health problems among men in underserved communities in South Africa
1
Infectious Disease Epidemiology and International Health, London School of Hygiene And Tropical Medicine, Mwanza, Tanzania, United Republic of
2
Mwanza Intervention Trials Unit, London School of Hygiene And Tropical Medicine, Mwanza, Tanzania, United Republic of
3
Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
4
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
5
Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Pretoria, South Africa
6
Faculty of Health Sciences, Nelson Mandela University, Ggeberha, South Africa
7
Pyschology, University of Johannesburg, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2549
ABSTRACT
BACKGROUND:
Alcohol use disorders (AUD) and mental health problems are major public health challenges among men in underserved communities in South Africa. We sought to determine the prevalence of AUD and mental health disorders (MHD), their co-occurrence, and structural, sociocultural, and individual factors associated with AUD among adult men in South Africa.
METHODS:
We conducted a household survey in three provinces (Western Cape, Eastern Cape, and North West) using a stratified, multistage probability sampling design. Men (n=1597) aged >18 years were interviewed using a structured questionnaire that included demographic measures, the Alcohol Use Disorders Identification Test (AUDIT), Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder 7-item scale (GAD-7), and Primary Care PTSD Screen (PC-PTSD-5). Weighted prevalence of AUD (AUDIT 8+) and MHD (positive for PHQ-9 or GAD-7 or PC-PTSD-5) was estimated, and we used survey-adjusted logistic regression models to assess factors associated with AUD.
RESULTS:
Participants’ median age was 35 years (IQR=26-47 years), 54% were single, and 36%-64% were unemployed across the three sites. The prevalence of AUDs ranged from 21.8%-36.5%. Between 0-31% of those with possible alcohol dependence had ever accessed treatment. The prevalence of MHD was 38.7% for depression (PHQ-9), 33.8% for GAD, and 7.7% for PTSD. About 17% had both AUD and MHD. AUD was associated with MHD (anxiety - adjusted odds ratio (AOR)=1.37, 1.04–1.82; depression – AOR=1.54, 1.16–2.04); structural factors, namely presence of recreational facilities (AOR=1.53; 1.19-2.0), and ease of buying alcohol in the community (AOR=1.96; 1.10–3.45); and sociocultural and interpersonal factors, namely living alone (AOR=1.39, 1.08–1.81).
CONCLUSIONS:
We highlight a high burden of AUD and MHD among men in communities where health care access is limited. This underscores the urgent need for interventions to address individual and underlying structural factors to reduce the use of alcohol among men in South Africa.
Alcohol use disorders (AUD) and mental health problems are major public health challenges among men in underserved communities in South Africa. We sought to determine the prevalence of AUD and mental health disorders (MHD), their co-occurrence, and structural, sociocultural, and individual factors associated with AUD among adult men in South Africa.
METHODS:
We conducted a household survey in three provinces (Western Cape, Eastern Cape, and North West) using a stratified, multistage probability sampling design. Men (n=1597) aged >18 years were interviewed using a structured questionnaire that included demographic measures, the Alcohol Use Disorders Identification Test (AUDIT), Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder 7-item scale (GAD-7), and Primary Care PTSD Screen (PC-PTSD-5). Weighted prevalence of AUD (AUDIT 8+) and MHD (positive for PHQ-9 or GAD-7 or PC-PTSD-5) was estimated, and we used survey-adjusted logistic regression models to assess factors associated with AUD.
RESULTS:
Participants’ median age was 35 years (IQR=26-47 years), 54% were single, and 36%-64% were unemployed across the three sites. The prevalence of AUDs ranged from 21.8%-36.5%. Between 0-31% of those with possible alcohol dependence had ever accessed treatment. The prevalence of MHD was 38.7% for depression (PHQ-9), 33.8% for GAD, and 7.7% for PTSD. About 17% had both AUD and MHD. AUD was associated with MHD (anxiety - adjusted odds ratio (AOR)=1.37, 1.04–1.82; depression – AOR=1.54, 1.16–2.04); structural factors, namely presence of recreational facilities (AOR=1.53; 1.19-2.0), and ease of buying alcohol in the community (AOR=1.96; 1.10–3.45); and sociocultural and interpersonal factors, namely living alone (AOR=1.39, 1.08–1.81).
CONCLUSIONS:
We highlight a high burden of AUD and MHD among men in communities where health care access is limited. This underscores the urgent need for interventions to address individual and underlying structural factors to reduce the use of alcohol among men in South Africa.
| eISSN: | 2654-1459 |
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