Department of Community Health and Health Behavior, University at Buffalo, 3435 Main Street, Buffalo, NY, 14214, USA.
Department of Psychology, Rochester Institute of Technology, Rochester, NY, USA.
Arch Sex Behav. 2018 Jul;47(5):1351-1366. doi: 10.1007/s10508-017-1050-1. Epub 2017 Oct 3.
While observational studies have found that alcohol consumption is associated with serodiscordant condomless sex among people living with HIV (PLHIV), no meta-analysis has yet examined this trend. We conducted a meta-analysis to synthesize empirical evidence on the association between alcohol and condomless sex with partners at risk of HIV acquisition. To meet inclusion criteria, studies: (1) specifically targeted PLHIV or provided stratified data for HIV-infected participants; (2) provided a quantitative measure of alcohol use; (3) provided a quantitative measure of condomless sex with serodiscordant partners; and (4) reported the results of statistical tests examining the relationship between alcohol use and serodiscordant condomless sex. Using random-effects models, weighted effect sizes were calculated. Three separate analyses were conducted to examine serodiscordant condomless sex in association with any alcohol consumption, binge/problematic drinking, and alcohol in a sexual context. A total of 36 independent effect sizes from 27 studies (including 25,065 HIV-infected participants) were pooled in the meta-analysis. Any alcohol consumption, binge/problematic drinking, and alcohol use in a sexual context were each associated with condomless sex with serodiscordant partners [OR 1.64 (95% CI 1.46-1.85); OR 1.65 (95% CI 1.14-2.39); OR 2.88 (95% CI 2.01-4.12), respectively]. Meta-analytic findings demonstrate a consistent positive relationship between alcohol use and serodiscordant condomless sex among PLHIV. Future public health programming for HIV-infected individuals needs to address the role of alcohol consumption in sexual risk-taking behavior.
虽然观察性研究发现，饮酒与 HIV 感染者（PLHIV）的血清不一致的无保护性行为有关，但尚无荟萃分析检查这一趋势。我们进行了一项荟萃分析，以综合有关酒精与感染 HIV 的伴侣之间的无保护性行为风险的经验证据。为了符合纳入标准，研究：（1）专门针对 PLHIV 或为 HIV 感染参与者提供分层数据；（2）提供酒精使用的定量测量；（3）提供与血清不一致的伴侣进行无保护性行为的定量测量；（4）报告统计检验结果，检查酒精使用与血清不一致的无保护性行为之间的关系。使用随机效应模型计算加权效应量。进行了三次单独的分析，以检查与任何饮酒、狂饮/问题饮酒和性环境中的饮酒有关的血清不一致的无保护性行为。荟萃分析共纳入了 27 项研究（包括 25065 名 HIV 感染者）的 36 个独立效应量。任何饮酒、狂饮/问题饮酒和性环境中的饮酒均与与血清不一致的伴侣发生无保护性行为有关[OR 1.64（95%CI 1.46-1.85）；OR 1.65（95%CI 1.14-2.39）；OR 2.88（95%CI 2.01-4.12）]。荟萃分析结果表明，在 PLHIV 中，饮酒与血清不一致的无保护性行为之间存在一致的正相关关系。未来针对 HIV 感染者的公共卫生规划需要解决饮酒在性行为风险行为中的作用。
