The Relationship between Alcohol Outlets, HIV Risk Behavior, and HSV-2 Infection among South African Young Women

BACKGROUND:

Alcohol consumption has a disinhibiting effect that may make sexual risk behaviors and disease transmission more likely. The characteristics of alcohol-serving outlets (e.g. music, dim lights, lack of condoms) may further encourage risky sexual activity. We hypothesize that frequenting alcohol outlets will be associated with HIV risk.

METHODS:

In a sample of 2,533 school-attending young women in rural South Africa, we performed a cross-sectional analysis to examine the association between frequency of alcohol outlet visits in the last six months and four outcomes related to HIV risk: number of sex partners in the last three months, unprotected sex acts in the last three months, transactional sex with most recent partner, and HSV-2 infection. We also tested for interaction by alcohol consumption.

RESULTS:

Visiting alcohol outlets was associated with having more sex partners, more unprotected sex acts, higher levels of transactional sex, and HSV-2 infection. In combination with exposure to alcohol consumption, visits to alcohol outlets were more strongly associated with all four outcomes than with either risk factor alone. Statistical evidence of interaction between alcohol outlet visits and alcohol consumption was observed for all outcomes except transactional sex.

CONCLUSIONS:

Frequenting alcohol outlets was associated with increased sexual risk in rural South African young women, especially when they consumed alcohol. Sexual health interventions targeted at alcohol outlets may effectively reach adolescents at high risk for sexually transmitted infections like HIV and HSV-2.

Full article at:   http://goo.gl/y0VL6y

By:   Molly Rosenberg,^1,2,3,* Audrey Pettifor,^2,3,7 Annelies Van Rie,² Harsha Thirumurthy,^3,4 Michael Emch,^2,3,5 William C. Miller,^2,6 F. Xavier Gómez-Olivé,^7,12 Rhian Twine,⁷ James P. Hughes,⁸ Oliver Laeyendecker,^9,10 Amanda Selin,³ andKathleen Kahn^7,11,12

Michael Hoonbae Chung, Academic Editor

¹Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, United States of America

²Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America

³Carolina Population Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America

⁴Department of Health Policy and Management, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America

⁵Department of Geography, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America

⁶Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America

⁷MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

⁸Department of Biostatistics, University of Washington, Seattle, Washington, United States of America

⁹Laboratory of Immunoregulation, NIAID, NIH, Baltimore, Maryland, United States of America

¹⁰Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

¹¹Centre for Global Health Research, Umeå University, Umeå, Sweden

¹²INDEPTH Network, Accra, Ghana

University of Washington, UNITED STATES

PLoS One. 2015; 10(5): e0125510.

Published online 2015 May 8. doi:  10.1371/journal.pone.0125510

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