Prevalence and correlates of alcohol use and alcohol use disorder among undergraduate students in Johannesburg, South Africa: a cross-sectional study

Abstract Background: Alcohol use and alcohol use disorder (AUD) are a significant public health problem globally. Young people, including university students, are among the most affected populations. We conducted the study to determine the prevalence and correlates of alcohol use and AUD among undergraduate students in the Faculty of Health Sciences at the University of the Witwatersrand, South Africa. Methods: We conducted a cross-sectional study using an anonymous, self-administered online survey in REDCap. The survey questionnaire consisted of socio demographic, and alcohol use questions using the AUD identification screening tool (AUDIT-C). We performed descriptive statistics, bivariate and multivariable logistic regression to determine factors associated with alcohol use and AUD. The p-value of <0.05 was considered statistically significant. Results: The response rate was 15.7%, most participants were female (69.6%), in their 3rd and 4th year of study; and the largest racial representation was from those identifying as White (38.1%). The prevalence of reported ever use of alcohol was 79.1%, and among the ever users; 70.2% reported alcohol use in the last 12-months, 37.1% reported alcohol use in the last 30 days. The prevalence of AUD was 54.8% among ever drinkers. Factors significantly associated with reported current alcohol use were family members alcohol use as follows: siblings (aOR = 1.79, 95% CI: 1.02-3.15) and parents (aOR = 2.58, 95% CI: 1.39–4.80), white race (aOR = 5.70, 95% CI: 3.12–10.41), and high exposure to alcohol in the media (aOR = 3.31, 95% CI: 1.07–10.24). Whereas those associated with AUD were: Indian/Asian race (aOR = 2.82, 95% CI: 1.09-7.31), White race (aOR = 2.15, 95% CI: 1.14-4.04), and most of the time (aOR = 3.42, 95% CI: 1.29-9.04) and high (aOR = 3.31, 95% CI: 1.07-10.24) exposure to alcohol through media. Conclusion: The reported alcohol use and AUD were common amongst undergraduate students at Wits university. There is an urgent need to design, pilot and adapt targeted interventions for this population group.