Factors associated with reporting behaviour of alcohol use in Moshi, Tanzania

BACKGROUND: Alcohol use disorder (AUD) is one of the most common mental health disorders globally. The diagnosis of AUD typically relies on self-reporting measures for identification, and requires that patients disclose their alcohol use to a provider. AIMS: To explore the factors associated with the disclosure of alcohol use to a healthcare practitioner among injury patients, considering stigma and alcohol-related consequences of disclosure as major factors. METHOD: In this cross-sectional study conducted in Moshi, Tanzania, we investigated factors influencing alcohol use disclosure among injury patients. Path analysis modelling explored the relationships among Alcohol Use Disorders Identification Test (AUDIT) scores, perceived alcohol stigma, Drinker Inventory of Consequences results and disclosure. RESULTS: Among 341 injury patients, 246 reported current or past-year alcohol use, with only 10.6% having previously disclosed alcohol use to a healthcare provider. Participants who disclosed had higher median drinks per day, elevated AUDIT scores and had experienced more alcohol-related consequences. Other factors associated with disclosure included a positive alcohol test on arrival, higher drinks per day, self-report of alcohol interfering with one's life, problems with peers, and engagement in risk behaviours. Alcohol stigma was not associated with disclosure. The relationship between disclosure and alcohol use was mediated by alcohol-related consequences. CONCLUSIONS: People who drank more and had more alcohol-related consequences were more likely to disclose their drinking to a provider. Further research is needed to understand the factors limiting disclosure.