Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA 02118, USA.
AIDS Behav. 2010 Aug;14 Suppl 1(Suppl 1):S74-83. doi: 10.1007/s10461-010-9723-y.
Unprotected heterosexual transactional sex plays a central role in the spread of HIV in India. Given alcohol's association with risky sex in other populations and alcohol's role in HIV disease progression, we investigated patterns of alcohol use in HIV-infected female sex workers (FSWs) and HIV-infected male clients of FSWs in Mumbai. Analyses identified factors associated with heavy alcohol use and evaluated the relationship between alcohol use and risky sex. We surveyed 211 female and 205 male individuals; 80/211 FSWs (38%) and 127/205 male clients (62%) drank alcohol in the last 30 days. Among females, 32 and 11% drank heavily and were alcohol-dependent, respectively; among males the respective proportions were 44 and 29%. Men's heavy alcohol use was significantly associated with inconsistent condom use over the last year (AOR 2.40, 95% CI 1.21-4.77, P = 0.01); a comparable association was not seen in women. These findings suggest a need to address alcohol use both to avoid the medical complications of its heavy use in this population and to mitigate inconsistent condom use, the latter issue possibly requiring gender specific approaches. Such efforts to reduce drinking will be an important dimension to secondary HIV prevention in India.
无保护的异性性交易在印度 HIV 的传播中起着核心作用。鉴于酒精在其他人群中与高危性行为有关，以及酒精在 HIV 疾病进展中的作用，我们调查了孟买感染 HIV 的女性性工作者（FSW）和感染 HIV 的 FSW 男性客户的酒精使用模式。分析确定了与大量饮酒相关的因素，并评估了饮酒与高危性行为之间的关系。我们调查了 211 名女性和 205 名男性；211 名 FSW 中有 80 名（38%）和 205 名男性客户中有 127 名（62%）在过去 30 天内饮酒。在女性中，分别有 32%和 11%的人大量饮酒且存在酒精依赖；在男性中，这两个比例分别为 44%和 29%。男性大量饮酒与过去一年中不经常使用避孕套显著相关（AOR 2.40，95%CI 1.21-4.77，P = 0.01）；在女性中没有发现类似的关联。这些发现表明，需要解决酒精使用问题，以避免该人群中大量饮酒的医疗并发症，并减轻不经常使用避孕套的问题，后者可能需要采取针对性别的方法。减少饮酒的这些努力将是印度二级 HIV 预防的一个重要方面。
