Berhan Yifru, Hailu Dejene, Alano Abraham
Hawassa University, College of Medicine and Health Sciences P.O.Box: 1560 Hawassa, Ethiopia.
Ethiop Med J. 2013 Jan;51(1):13-23.
Despite the high prevalence of polysubstance use in low income countries, little has been done to investigate the linkage between polysubstance use and risky sexual behaviors.
To assess the association of polysubstance use with risky sexual behaviors, economic, educational and geographic factors.
A cross-sectional study on aspects of risky behavior towards HIV-infection was conducted on a sample of 1220 university students. Logistic regression analysis was applied to examine the linkage between polysubstance use and risky sexual behavior--having sex with multiple partners, commercial sex workers and failure to use condom.
About one fourth of study participants reported to use one or more types of substance (mainly cigarette, alcohol and khat) in one year period. Of these students, more than three-fifths started using the substance before joining university and more than two-fifths were polysubstance users. Students from urban areas were more likely to be polysubstance users and to engage in sexual practice. Logistic regression analysis demonstrated a strong association of polysubstance use with male gender, being born and growing up in urban areas, good income, taught in private school, academically senior and born to more educated parents (P < 0.05 each). The majority (42%) of polysubstance users was also practicing sex with multiple partners and commercial sex workers, had sex without condoms and developed active sexually transmitted infection (STI) symptoms (P < 0.0001 for each).
This analysis unveils the strong association of polysubstance use with better socioeconomic circumstances, better education and risky sexual behaviors. Primary prevention strategies should target students in elementary and secondary schools, mainly in the urban setting, and preferably by involving their parents.
尽管低收入国家中多物质使用的患病率很高，但在调查多物质使用与危险性行为之间的联系方面所做的工作很少。
评估多物质使用与危险性行为、经济、教育和地理因素之间的关联。
对1220名大学生样本进行了一项关于艾滋病病毒感染危险行为方面的横断面研究。应用逻辑回归分析来检验多物质使用与危险性行为（与多个性伴侣发生性行为、与商业性工作者发生性行为以及未使用避孕套）之间的联系。
约四分之一的研究参与者报告在一年内使用一种或多种物质（主要是香烟、酒精和巧茶）。在这些学生中，超过五分之三在进入大学之前就开始使用这些物质，超过五分之二是多物质使用者。来自城市地区的学生更有可能成为多物质使用者并参与性行为。逻辑回归分析表明，多物质使用与男性性别、在城市地区出生和成长、收入良好、在私立学校就读、学业年级较高以及父母受教育程度较高密切相关（每项P<0.05）。大多数（42%）多物质使用者也与多个性伴侣和商业性工作者发生性行为，不使用避孕套进行性行为并出现活动性性传播感染症状（每项P<0.0001）。
该分析揭示了多物质使用与更好的社会经济状况、更好的教育以及危险性行为之间的密切关联。初级预防策略应主要针对城市地区中小学的学生，最好让他们的父母参与进来。
