Rosenberg Molly, Pettifor Audrey, Lippman Sheri A, Thirumurthy Harsha, Emch Michael, Miller William C, Selin Amanda, Gómez-Olivé Francesc Xavier, Hughes James P, Laeyendecker Oliver, Tollman Stephen, Kahn Kathleen
From the *Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA; †Department of Epidemiology, Gillings School of Global Public Health, and ‡Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; §MRC/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; ¶Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA; ∥Department of Health Policy and Management, Gillings School of Global Public Health, **Department of Geography, and ††Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; ‡‡INDEPTH Network, Accra, Ghana; §§Department of Biostatistics, University of Washington, Seattle, WA; ¶¶Laboratory of Immunoregulation, NIAID, NIH, Baltimore, MD; ∥∥Department of Medicine, Johns Hopkins University, Baltimore MD; and ***Centre for Global Health Research, Umeå University, Umeå, Sweden.
Sex Transm Dis. 2015 May;42(5):259-65. doi: 10.1097/OLQ.0000000000000263.
Exposure to alcohol outlets may influence sexual health outcomes at the individual and community levels. Visiting alcohol outlets facilitates alcohol consumption and exposes patrons to a risky environment and network of potential partners, whereas the presence of alcohol outlets in the community may shift social acceptance of riskier behavior. We hypothesize that living in communities with more alcohol outlets is associated with increased sexual risk.
We performed a cross-sectional analysis in a sample of 2174 South African schoolgirls (ages 13-21 years) living across 24 villages in the rural Agincourt subdistrict, underpinned by long-term health and sociodemographic surveillance. To examine the association between number of alcohol outlets in village of residence and individual-level prevalent herpes simplex virus type 2 (HSV-2) infection, we used generalized estimating equations with logit links, adjusting for individual- and village-level covariates.
The median number of alcohol outlets per village was 3 (range, 0-7). Herpes simplex virus type 2 prevalence increased from villages with no outlets (1.4% [95% confidence interval, 0.2-12.1]), to villages with 1 to 4 outlets (4.5% [3.7-5.5]), and to villages with more than 4 outlets (6.3% [5.6, 7.1]). An increase of 1 alcohol outlet per village was associated with an 11% increase in the odds of HSV-2 infection (adjusted odds ratio [95% confidence interval], 1.11 [0.98-1.25]).
Living in villages with more alcohol outlets was associated with increased prevalence of HSV-2 infection in young women. Structural interventions and sexual health screenings targeting villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.
接触售酒场所可能会在个体和社区层面影响性健康结果。光顾售酒场所会促使人们饮酒，使顾客置身于危险环境以及潜在性伴侣网络之中，而社区中售酒场所的存在可能会改变社会对更危险行为的接受程度。我们假设，生活在有更多售酒场所的社区与性风险增加有关。
我们对居住在阿金库尔农村分区24个村庄的2174名南非女学生（年龄在13至21岁之间）进行了横断面分析，该分析以长期健康和社会人口监测为基础。为了研究居住村庄中售酒场所数量与个体层面2型单纯疱疹病毒（HSV-2）感染流行率之间的关联，我们使用了带有logit链接的广义估计方程，并对个体和村庄层面的协变量进行了调整。
每个村庄售酒场所的中位数为3个（范围为0至7个）。2型单纯疱疹病毒感染率从没有售酒场所的村庄（1.4%[95%置信区间，0.2 - 12.1]），到有1至4个售酒场所的村庄（4.5%[3.7 - 5.5]），再到有4个以上售酒场所的村庄（6.3%[5.6, 7.1]）呈上升趋势。每个村庄售酒场所增加1个与HSV-2感染几率增加11%相关（调整后的优势比[95%置信区间]，1.11[0.98 - 1.25]）。
生活在有更多售酒场所的村庄与年轻女性HSV-2感染率增加有关。针对售酒场所环境广泛的村庄进行结构性干预和性健康筛查，可能有助于预防性传播感染的传播。
