Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244, USA.
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Arch Sex Behav. 2018 Oct;47(7):1937-1948. doi: 10.1007/s10508-017-1131-1. Epub 2018 Jan 11.
While alcohol is a known risk factor for HIV infection in sub-Saharan Africa (SSA), studies designed to investigate the temporal relationship between alcohol use and unprotected sex are lacking. The purpose of this study was to determine whether alcohol used at the time of a sexual event is associated with unprotected sex at that same event. Data for this study were collected as part of two longitudinal studies of HIV-infected Ugandan adults. A structured questionnaire was administered at regularly scheduled cohort study visits in order to assess the circumstances (e.g., alcohol use, partner type) of the most recent sexual event (MRSE). Generalized estimating equation logistic regression models were used to examine the association between alcohol use (by the participant, the sexual partner, or both the participant and the partner) and the odds of unprotected sex at the sexual event while controlling for participant gender, age, months since HIV diagnosis, unhealthy alcohol use in the prior 3 months, partner type, and HIV status of partner. A total of 627 sexually active participants (57% women) reported 1817 sexual events. Of these events, 19% involved alcohol use and 53% were unprotected. Alcohol use by one's sexual partner (aOR 1.70; 95% CI 1.14, 2.54) or by both partners (aOR 1.78; 95% CI 1.07, 2.98) during the MRSE significantly increased the odds of unprotected sex at that same event. These results add to the growing event-level literature in SSA and support a temporal association between alcohol used prior to a sexual event and subsequent unprotected sex.
虽然在撒哈拉以南非洲（SSA），酒精是艾滋病毒感染的已知风险因素，但缺乏旨在调查饮酒与无保护性行为之间时间关系的研究。本研究的目的是确定在性行为发生时饮酒是否与同一事件中的无保护性行为有关。本研究的数据是作为两项乌干达艾滋病毒感染者纵向研究的一部分收集的。定期在队列研究访问中进行结构化问卷调查，以评估最近一次性行为（MRSE）的情况（例如，饮酒，伴侣类型）。使用广义估计方程逻辑回归模型来检查参与者、性伴侣或参与者和性伴侣双方饮酒（参与者、性伴侣或双方）与性行为时无保护性行为的可能性之间的关联，同时控制参与者的性别、年龄、艾滋病毒诊断后月份数、过去 3 个月的不健康饮酒情况、伴侣类型和伴侣的艾滋病毒状况。共有 627 名活跃的性参与者（57%为女性）报告了 1817 次性行为。在这些事件中，19%涉及饮酒，53%为无保护性行为。性伴侣饮酒（优势比 1.70；95%置信区间 1.14，2.54）或双方都饮酒（优势比 1.78；95%置信区间 1.07，2.98）显著增加了同一事件中无保护性行为的可能性。这些结果增加了 SSA 中不断增长的事件水平文献，并支持性行为前饮酒与随后的无保护性行为之间的时间关联。
