Associations between alcohol misuse and risks for HIV infection among men who have multiple female sexual partners in Cape Town, South Africa
Associations between alcohol misuse and risks for HIV infection among men who have multiple female sexual partners in Cape Town, South Africa
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DOI：
10.1080/09540121.2010.482128
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Flisher, Alan J.
中科院分区：
文献类型：
--
作者：
Townsend, Loraine;Rosenthal, Samantha R.;Flisher, Alan J.
在南非艾滋病毒高流行的背景下，高饮酒率的出现对该国的健康构成了重大挑战。这篇论文旨在回答三个问题，以加深我们对酒精使用和艾滋病毒感染之间联系的了解：(A)酗酒问题者比不饮酒的人更有可能同时有多个伴侣；(B)与不饮酒的人相比，问题饮酒者使用Oare避孕套的效果更差，一致性更差；(C)问题饮酒者的女性性伴侣与非饮酒者的女性性伴侣是否不同？o两项横断面艾滋病毒生物行为监测调查是在南非开普敦郊区的两个城市环境中进行的，采用受访者驱动抽样。招募了848名年龄在25-55岁之间、同时有多个女性性伴侣的男性。问题饮酒者在CAGE问卷上的得分为epsilon 3。询问了有关伴侣数量、避孕套使用和伴侣特征的问题。多变量Logistic回归模型被开发来确定结果变量和问题饮酒之间的显著关联。58%的男性酗酒。与没有问题的饮酒者相比，有问题的饮酒者报告有任何性传播感染症状、因饮酒而不使用避孕套、对所有伴侣类型的避孕套使用不一致、最近的一次性伴侣失业、最近的伴侣是在饮酒场所认识的，以及有过一次性性关系的可能性要大得多。酒精可能会助长一次性的性接触，通常以交易性行为和女性在谈判性行为和使用避孕套方面的有限权力为特征；这些因素可能会促进艾滋病毒的传播。迫切需要专门针对饮酒者的艾滋病毒预防干预措施、问题饮酒发生的背景和多次性伙伴关系。
The occurrence of high rates of alcohol consumption in a context of high HIV prevalence in South Africa poses a significant health challenge for this country. This paper aims to answer three questions that could further our knowledge regarding the links between alcohol use and HIV infection: (a) oAre problem drinkers more likely to have multiple concurrent partners than those who are not?o; (b) oAre condoms applied less effectively and less consistently by problem drinkers compared to those who are not?o; (c) oAre the female sexual partners of problem drinkers different from those who are not?o Two cross-sectional HIV bio-behavioural surveillance surveys using Respondent-Driven Sampling were conducted in two peri-urban settings on the outskirts of Cape Town, South Africa. Eight hundred and forty-eight men aged 25-55 years who have multiple, concurrent female sexual partners were recruited. Problem drinkers had a score of epsilon 3 on the CAGE questionnaire. Questions enquired about partner numbers, condom use and partner traits. Multivariate logistic regression models were developed to determine significant associations between outcome variables and problem drinking. Fifty-eight percent of men were problem drinkers. Compared to non-problem drinkers, problem drinkers were significantly more likely to report having any symptom of a STI; not using condoms due to drinking; inconsistent condom use with all partner types; that their most recent once-off partner was unemployed; having met their most recent partner at an alcohol-serving venue; and having had a once-off sexual relationship. Alcohol may fuel once-off sexual encounters, often characterised by transactional sex and women's limited authority to negotiate sex and condom use; factors that can facilitate transmission of HIV. HIV prevention interventions specifically targeting drinkers, the contexts in which problem drinking occurs and multiple sexual partnering are urgently needed.