Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA.
BMC Public Health. 2013 Jun 15;13:583. doi: 10.1186/1471-2458-13-583.
HIV and risky alcohol use are intertwined public health issues in sub-Saharan Africa. Research supports the association between alcohol and unprotected sex, but there is limited data using event-level analysis to examine this relationship.
Using data from Demographic Health Surveys and AIDS Information Surveys collected in 8 sub-Saharan African countries (Kenya, Lesotho, Mozambique, Rwanda, Swaziland, Tanzania, Zambia, and Zimbabwe) drunkenness (reporting male partner or both male and female partner being drunk during last sexual intercourse) at last sex was tested as a predictor of unprotected last sex among the male (n = 24,512) and female (n = 28,229) participants. Partner type, HIV test results, and the other variables were evaluated as effect modifiers of this relationship.
Drunkenness at last sex had a negative effect on the likelihood of condom use among men (AOR 0.84, 95% CI 0.72-0.99) and a marginally significant effect among women (AOR 0.87, 95% CI 0.59-1.02) in Southern Africa. However, for men in Southern Africa, this effect was primarily observed with steady partners. Contrary to predictions, in both Southern and Eastern Africa, for men, drunkenness during sex with casual partners increased the odds of condom use.
These data indicate a need to implement HIV prevention efforts that consider the role of alcohol use in precipitating unprotected sex and how it varies based upon partner type.
在撒哈拉以南非洲地区，艾滋病毒和危险饮酒行为是交织在一起的公共卫生问题。研究支持酒精与无保护性行为之间的关联，但利用事件层面的分析来检验这种关系的数据有限。
利用在撒哈拉以南非洲的 8 个国家（肯尼亚、莱索托、莫桑比克、卢旺达、斯威士兰、坦桑尼亚、赞比亚和津巴布韦）收集的人口健康调查和艾滋病信息调查的数据，研究人员检验了上次性行为时的醉酒（报告男伴或男伴和女伴均醉酒）作为男性（n=24512）和女性（n=28229）参与者上次无保护性行为的预测因子。评估了伴侣类型、艾滋病毒检测结果和其他变量作为该关系的调节因素。
在上次性行为时醉酒对男性使用安全套的可能性有负面影响（AOR 0.84，95%CI 0.72-0.99），对女性的影响具有边缘统计学意义（AOR 0.87，95%CI 0.59-1.02），这主要出现在南部非洲。然而，对于南部非洲的男性，这种影响主要与稳定伴侣有关。与预测相反，在南部和东部非洲，男性与偶然伴侣发生性行为时醉酒反而增加了使用安全套的几率。
这些数据表明，需要实施艾滋病毒预防工作，考虑到饮酒在导致无保护性行为中的作用以及其如何根据伴侣类型而变化。
