Introduction: Harmful alcohol use is a major contributor to the global disease burden, leading to approximately three million of premature deaths each year and imposing substantial strain on healthcare systems and economies worldwide. This study examines harmful alcohol use among refugees in Uganda, where forced migration, trauma, and socioeconomic hardships heighten the risk of substance abuse and associated health outcomes. Methods: This was a secondary data analysis from a nationally representative Population-based HIV Impact Assessment (PHIA) survey from the 2021 Uganda Refugee PHIA. Harmful alcohol use was defined according to the WHO’s Alcohol Use Disorders Identification Test guidelines, and data were analyzed using descriptive statistics and multivariable logistic regression in R. Results: Of the 2610 respondents, 5.7% reported using alcohol in a harmful way. Harmful alcohol use was significantly higher among males (9.7%) compared to females (3.5%), with prevalence peaking at 11% among those aged 35–39 years. Multivariable analyses identified male gender, older age (with an adjusted odds ratio aOR of 8.56 for ages 35–39), and divorced marital status (aOR = 2.46) as robust independent predictors of harmful alcohol use. In contrast, socioeconomic factors such as wealth and region showed minimal influence, whereas secondary and tertiary education paradoxically correlated with an increased odd ( P < 0.001), highlighting the need for targeted public health interventions. Conclusion: The study reveals that harmful alcohol consumption is most common among males and mid-adults in refugee settings. Policymakers should prioritize the integration of routine alcohol screening and personalized counseling within existing health services, especially for high-risk populations. Strengthening intervention strategies for high-risk populations is essential, and this approach could enhance early detection and support.
Ng’ambi et al. (Tue,) studied this question.