Sex differences in alcohol use patterns and related harms: A mixed-methods, cross-sectional study of men and women in northern Tanzania.

In northern Tanzania, alcohol use disorders (AUD) are under-diagnosed and under-treated, and current services are mostly limited to men in clinical settings despite significant alcohol-related harm in the community. The study objective was to identify sex differences in alcohol use and alcohol-related harms within and across community and clinical settings. This was a congruent triangulation mixed methods study consisting of focus group discussions (FGDs) and cross-sectional surveys. Quantitative analysis was conducted via Drinker Inventory of Consequences (DrInC) and Alcohol Use Disorders Identification Test (AUDIT) data from injury patients presenting for care at the Kilimanjaro Christian Medical Center Emergency Department and community participants. Differences in scores by sex were assessed using unpaired t-tests. K-means algorithms were run independently in both samples. Deductive thematic analysis was conducted on FGDs with community members, injury patients, and injury patient relatives. Differences in mean scores between sexes in the community and patient samples were statistically significant (p