Ziegel, Leo;Sjöland, Carl Fredrik;Nabunya, Erinah ;Bulamba, Robert;Kyasanku, Emmanuel;Mugamba, Stephen;Kigozi, Godfrey;Kigozi, Grace;Daama, Alex;Miller, Amanda P.;Hollander, Anna-Clara;Hammarberg, Anders;Nalugoda, Fred;Ekström, Anna Mia2025-08-292025-08-292025-04-10Ziegel, L., Sjöland, C. F., Nabunya, E., Bulamba, R., Kyasanku, E., Mugamba, S., … Ekström, A. M. (2025). Social determinants of hazardous alcohol use in a Ugandan population cohort. Global Health Action, 18(1). https://doi.org/10.1080/16549716.2025.2484870ISSN 1654-9716, 1654-9880EISSN 1654-9880https://nru.uncst.go.ug/handle/123456789/12031There is a limited population-based data on hazardous alcohol use and associated social determinants in many African countries. To examine patterns of hazardous alcohol use across a range of social determinants of health in Uganda, with a particular focus on gender differences. This cross-sectional study used data collected in 2021-2022 from an open population cohort spanning urban, semi-urban, and rural communities. Alcohol use was assessed with the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Covariates were selected according to the WHO's Social Determinants of Health framework. Poisson regression with robust variance was used for data analysis. Of the 3459 participants, 2085 (60%) were women. Overall, the prevalence of hazardous alcohol use was 5% among women and 18% among men. Strong positive associations with hazardous use were found for individuals residing in semi-urban areas (female aPR 2.1 [95% CI 1.3-3.3], male aPR 1.8 [95% CI 1.4-2.5]), past-year perpetration of intimate partner violence (female aPR 2.2 [95% CI 0.8-5.6], male aPR 1.4 [95% CI 0.9-2.2]), smoking, middle age for men (aPR 1.6 [95% CI 1.2-2.2]), and employment as a vendor in a restaurant or bar for women (aPR 1.5 [95% CI 1.0-2.2]). Strong negative associations were found for high educational attainment, Muslim or Pentecostal religion, and living in a marriage or union for women (aPR 0.7 [95% CI 0.5-1.0]). Hazardous alcohol use was prevalent, especially among men, in a representative Ugandan population sample. Specific target groups for public health and clinical interventions were identified, such as women working in the hospitality sector. Residents of semi-urban communities may encounter unique risks for hazardous alcohol use, compared with rural and highly urban populations. MEDLINEenArticle