LʼEngle Kelly L, Mwarogo Peter, Kingola Nzioki, Sinkele William, Weiner Debra H
*Social and Behavioral Health Sciences, FHI 360, Durham, NC; †FHI 360, Nairobi, Kenya; ‡International Center for Reproductive Health, Mombasa, Kenya; §Support for Addiction Prevention and Treatment in Africa (SAPTA), Nairobi, Kenya; and ‖Biostatistics, FHI 360, Durham, NC.
J Acquir Immune Defic Syndr. 2014 Dec 1;67(4):446-53. doi: 10.1097/QAI.0000000000000335.
We assessed whether a brief alcohol intervention would lead to reduced alcohol use and sexually transmitted infection (STI)/HIV incidence and related sexual risk behaviors among moderate drinking female sex workers.
A randomized controlled intervention trial was conducted with 818 female sex workers affiliated with the AIDS, Population, Health, and Integrated Assistance II project in Mombasa, Kenya. Eligible women were hazardous or harmful drinkers who scored between 7 and 19 (full range, 1-40) on the Alcohol Use Disorders Identification Test. Intervention participants received 6 counseling sessions approximately monthly. The equal-attention control group received 6 nutrition sessions. Participants were followed for 6 and 12 months after the intervention, with at least 86% retention at both time points. We used general linear models in intention-to-treat analyses, adjusting for recruitment setting and HIV status at enrollment.
There was a statistically significant reduction in alcohol use and binge drinking at 6 and 12 months, with intervention participants reporting less than one third of the odds of higher levels of drinking than the control group. The intervention did not impact laboratory-confirmed STI/HIV incidence, self-reported condom use, or sexual violence from nonpaying partners. However, the odds of reporting sexual violence from clients was significantly lower among intervention than control participants at both 6 and 12 months.
We found that a brief alcohol intervention can reduce self-reported alcohol consumption among a nondependent and non-treatment-seeking population most at risk for HIV. More attention is needed to understand the pathway from drinking to sexual behavior and STI/HIV acquisition.
我们评估了简短的酒精干预措施是否会减少中度饮酒的女性性工作者的酒精使用量、性传播感染（STI）/艾滋病毒发病率以及相关的性风险行为。
对肯尼亚蒙巴萨艾滋病、人口、健康与综合援助II项目的818名女性性工作者进行了一项随机对照干预试验。符合条件的女性为危险或有害饮酒者，她们在酒精使用障碍识别测试中的得分在7至19分之间（满分范围为1 - 40分）。干预组参与者大约每月接受6次咨询。同等关注的对照组接受6次营养咨询。干预后对参与者进行了6个月和12个月的随访，两个时间点的保留率均至少为86%。我们在意向性分析中使用了一般线性模型，并对招募地点和入组时的艾滋病毒感染状况进行了调整。
在6个月和12个月时，酒精使用量和暴饮情况有统计学意义的显著减少，干预组参与者报告的饮酒量高于对照组的几率不到三分之一。该干预措施并未影响实验室确诊的性传播感染/艾滋病毒发病率、自我报告的避孕套使用情况或来自非付费伴侣的性暴力。然而，在6个月和12个月时，干预组参与者报告来自客户的性暴力的几率均显著低于对照组。
我们发现，简短的酒精干预可以减少在艾滋病毒感染风险最高的非依赖酒精且未寻求治疗人群中自我报告的酒精消费量。需要更多关注来了解从饮酒到性行为以及性传播感染/艾滋病毒感染的途径。
