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01-06-2007 | Review Paper

Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings

Authors: Seth C. Kalichman, Leickness C. Simbayi, Michelle Kaufman, Demetria Cain, Sean Jooste

Published in: Prevention Science | Issue 2/2007

Abstract

Alcohol consumption is associated with risks for sexually transmitted infections (STI), including HIV/AIDS. In this paper, we systematically review the literature on alcohol use and sexual risk behavior in southern Africa, the region of the world with the greatest HIV/AIDS burden. Studies show a consistent association between alcohol use and sexual risks for HIV infection. Among people who drink, greater quantities of alcohol consumption predict greater sexual risks than does frequency of drinking. In addition, there are clear gender differences in alcohol use and sexual risks; men are more likely to drink and engage in higher risk behavior whereas women's risks are often associated with their male sex partners' drinking. Factors that are most closely related to alcohol and sexual risks include drinking venues and alcohol serving establishments, sexual coercion, and poverty. Research conducted in southern Africa therefore confirms an association between alcohol use and sexual risks for HIV. Sexual risk reduction interventions are needed for men and women who drink and interventions should be targeted to alcohol serving establishments.

We collectively include Uganda, Kenya and Tanzania, which are East African countries, along with southern African countries as southern Africa throughout.

Abrahams, N., Jewkes, R., Hoffman, M., & Laubsher, R. (2004). Sexual violence against intimate partners in Cape Town: Prevalence and risk factors reported by men. Bulletin of the World Health Organization, 82, 330–337.PubMed

Allen, S., Tice, J., Van de Perre, P., Serufilira, A., Hudes, E., Nsengumuremyi, F. (1992). Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa. British Medical Journal, 304, 1605–1609.PubMed

Ayisi, J. G., van Eijk, A. M., ter Kuile, F. O., Kolczak, M. S., Otieno, J. A., Misore, A. O. (2000). Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya. International Journal of STD & AIDS, 11, 393–401.CrossRef

Babor, T. F., de la Fuente, J. R., Saunders, J., & Grant, M. (1992). The Alcohol Use Disorders Identification Test: Guidelines for use in primary health care. Geneva: World Health Care Organization.

Bailey, R. C., Neema, S., & Othieno, R. (1999). Sexual behaviors and other HIV risk factors in circumcised and uncircumcised men in Uganda. Journal of Acquired Immune Deficiency Syndromes, 22, 294–301.PubMed

Bhana, A., Petersen, I., Mason, A., Mahintsho, Z., Bell, C. C., McKay, M. (2003). Adaptation of the CHAMP manual for South Africa. Poster presented at NIMH Family Conference, July 27–30, 2003, Washington DC, USA.

Campbell, C., Williams, B., & Gilgen, D. (2002). Is social capital a useful conceptual tool for community level influences on HIV infection? An exploratory case study from South Africa. AIDS Care, 14, 41–54.PubMedCrossRef

Campbell, E. K. (2003). A note on alcohol consumption and sexual behaviour of youths in Botswana. African Sociological Review, 7, 146–161.

Chikwem, J. O., Ola, T. O., Gashau, W., Chikwem, S. D., Bajami, M., & Mambula, S. (1988). Impact of health education on prostitutes' awareness and attitudes to Acquire Immune Deficiency Syndrome (AIDS). Public Health, 102, 439–445.PubMedCrossRef

Clift, S., Anemona, A., Watson-Jones, D., Kanga, L., Ndeki, L., & Changalucha, J. (2003). Variations of HIV and STI prevalences within communities neighbouring new goldmines in Tanzania: Importance for intervention design. Sexually Transmitted Infections, 79, 307–312.PubMedCrossRef

Cook, R. L. & Clark, D. (2005). Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sexually Transmitted Diseases, 32, 156–164.PubMedCrossRef

Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntryre, J. A., & Harlow, S. D. (2004). Transactional sex among women in Soweto, South Africa: Prevalence, risk factors and association with HIV infection. Social Science & Medicine, 59, 1581–1592.CrossRef

Feldblum, P. J., Kuyoh, M., Omari, M., Ryan, K. A., Bwayo, J. J., & Welsh, M. (2000). Baseline STD prevalence in a community intervention trial of the female condom in Kenya. Sexually Transmitted Infections, 76, 454–456.PubMedCrossRef

Fritz, K. E., Woelk, G. B., Bassett, M. T., McFarland, W. C., Routh, J. A., & Tobaiwa, O. (2002). The association between alcohol use, sexual risk behavior, and HIV infection among men attending beer halls in Harare, Zimbabwe. AIDS and Behavior, 6, 221–228.CrossRef

Gwati, B., Guli, A., & Todd, C. H. (1995). Risk factors for sexually transmitted disease amongst men in Harare, Zimbabwe. Central African Journal of Medicine, 41, 179–181.PubMed

Hargreaves, J. R., Morison, L. A., Chege, J., Rutenburg, N., Kahindo, M., & Weiss, H. A. (2002). Socioeconomic status and risk of HIV infection in an urban population in Kenya. Tropical Medicine and International Health, 7, 793–802.PubMedCrossRef

Hoyle, R., Fejfar, M., & Miller, J. (2000). Personality and sexual risk taking: A quantitative review. Journal of Personality, 68, 1203–1231.PubMedCrossRef

Jewkes, R., Levin, J., & Penn-Kekana, L. (2002). Risk factors for domestic violence: Findings from a South African cross-sectional study. Social Science & Medicine, 55, 1603–1617.CrossRef

Jones, D. L., Ross, D., Weiss, S. M., Bhat, G., & Chitalu, N. (2005). Influence of partner participation on sexual risk behavior reduction among HIV-positive Zambian women. Journal of Urban Health, 82, iv92–iv100.PubMed

Kalichman, S. C., Simbayi, L. C., Jooste, S., Cain, D., & Cherry, C. (In press). Sensation Seeking, Alcohol Use, and Sexual Behaviors among Sexually Transmitted Infection Clinic Patients, Cape Town, South Africa. Psychology of Addictive Behaviors.

Kalichman, S. C., Simbayi, L. C., Kagee, A., Toefy, Y., Cain, D., & Cherry. C (2006). Association of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Social Science and Medicine, 62, 1641–1649.PubMedCrossRef

Kapiga, S. H., Lyamuya, E. F., Lwihula, G. K., & Hunter, D. J. (1998). The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania. AIDS, 12, 75–84.PubMedCrossRef

Kapiga, S. H., Sam, N. E., Shao, J. F., Masenga, E. J., Renjifo, B., & Kiwelu, I. E. (2003). Herpes Simplex Virus Type 2 infection among female bar and hotel workers in northern Tanzania: Prevalence and risk factors. Sexually Transmitted Diseases, 30, 187–192.PubMedCrossRef

Kapiga, S. H., Sam, N. E., Shao, J. F., Renjifo, B., Masenga, E. J., & Kiwelu, I. E. (2002). HIV-1 epidemic among female bar and hotel workers in northern Tanzania: Risk factors and opportunities for prevention. Journal of Acquired Immune Deficiency Syndromes, 29, 409–417.PubMed

Kelly, J. A., St. Lawrence, J., Stevenson, Y., Hauth, A., Kalichman, S., & Diaz, Y. (1992). Community AIDS/HIV risk reduction: The effects of endorsements by popular people in three cities. American Journal of Public Health, 82, 1483–1489.PubMed

Kelly, J. A., St. Lawrence, J., Diaz, Y., Stevenson, Y., Hauth, A., & Brasfield, T., (1991). HIV risk behavior reduction following intervention with key opinion leaders of a population: An experimental community-level analysis. American Journal of Public Health, 81, 168–171.PubMedCrossRef

King, G., Flisher, A. J., Noubary, F., Reece, R., Marais, A., & Lombard, C. (2004). Substance abuse and behavioral correlates of sexual assault among South African adolescents. Child Abuse & Neglect, 28, 683–696.CrossRef

Koenig, M. A., Lutalo, T., Zhao, F., Nalugoda, F., Kiwanuka, N., & Wabwire-Mangen, F. (2004). Coercive sex in rural Uganda: Prevalence and associated risk factors. Social Science and Medicine, 58, 787–798.PubMedCrossRef

Koenig, M. A., Lutalo, T., Zhao, F., Nalugoda, F., Wabwire-Mangen, F., & Kiwanuka, N. (2003). Domestic violence in rural Uganda: Evidence from a community-based study. Bulletin of the World Health Organization, 81, 53–60.PubMed

Lewis, J. J. C., Garnett, G. P., Mhlanga, S., Nyamukapa, C. A., Donnelly, C. A., & Gregson, S. (2005). Beer halls as a focus for HIV prevention activities in rural Zimbabwe. Sexually Transmitted Diseases, 32, 364–369.PubMedCrossRef

Mbulaiteye, S. M., Ruberantwari, A., Nakiyingi, J. S., Carpenter, L. M., Kamali, A., & Whitworth, J. A. G. (2000). Alcohol and HIV: A study among sexually active adults in rural southwest Uganda. International Journal of Epidemiology, 29, 911–915.PubMedCrossRef

Mnyika, K. S., Klepp, K. I., Kvale, G., & Ole-King'ori, N. (1997). Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania. International Journal of STD & AIDS, 8, 176–183.CrossRef

Morojele, N. K., Kachieng'a, M. A., Nkoko, M. A., Moshia, A. M., Mokoko, E., & Parry, C. D. H. (2004). Perceived effects of alcohol use on sexual encounters among adults in South Africa. African Journal of Drug and Alcohol Studies, 3, 1–20.

Morojele, N. K., Kachieng'a, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D. H., & Nkowane, A. M. (2006). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science and Medicine, 62, 217–227.PubMedCrossRef

Morrison, C. S., Sunkutu, M. R., Musaba, E., & Glover, L. H. (1997). Sexually transmitted disease among married Zambian women: The role of male and female sexual behaviour in prevention and management. Genitourinary Medicine, 73, 555–557.PubMed

Mugisha, F., & Zulu, E. M. (2004). The influence of alcohol, drugs and substance abuse on sexual relationships and perception of risk to HIV infection among adolescents in the informal settlements of Nairobi. Journal of Youth Studies, 7, 279–293.CrossRef

Myer, L., Matthews, C., & Little, F. (2002). Condom use and sexual behaviors among individuals procuring free male condoms in South Africa: A prospective study. Sexually Transmitted Diseases, 29, 239–241.PubMedCrossRef

Palepu, A., Raj, A., Horton, N., Tibbetts, N., Meli, S., & Samet, J. (2005). Substance abuse treatment and risk behaviors among HIV infected persons with alcohol problems. Journal of Substance Abuse Treatment, 25, 3–9.CrossRef

Parry, C. D. (2005). South Africa: Alcohol today. Addictions, 100, 426–429CrossRef

Parry, C. D., Myers, B., Morojele, N. K., Flisher, A. J., Bhana, A., & Donson, H. (2004). Trends in adolescent alcohol and other drug use: Findings from three sentinel sites in South Afria (1997–2001). Journal of Adolescence, 27, 429–440.PubMedCrossRef

Phorano, O. D., Nthomang, K., & Ntseane, D. (2005). Alcohol abuse, gender-based violence and HIV/AIDS in Botswana: Establishing the link based on empirical evidence. Sahara: Journal of Social Aspects of HIV/AIDS, 2, 188–202.

Saunders, J. B., Aasland, O. G., Babor, T. F., DeLaFuente, J. R., & Gran,t M. (1993) Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption II. Addiction, 88, 791–804.

Sebit, M. B., Tombe, M., Siziya, S., Balus, S., Nkomo, S. D. A., & Maramba, P. (2003). Prevalence of HIV/AIDS and psychiatric disorders and their related risk factors among adults in Epworth, Zimbabwe. East African Medical Journal, 80, 503–512.PubMed

Shaffer, D. N., Njeri, R., Justice, A. C., Odero, W. W., & Tierney, W. M. (2004). Alcohol abuse among patients with and without HIV infection attending public clinics in western Kenya. East African Medical Journal, 81, 594–598.PubMed

Shisana, O., Rehle, T., Simbayi, L., Parker, W., Bhana, A., & Zuma, K. (2005). South African National HIV Prevalence, Incidence, Behaviour And Communication Survey 2005. Cape Town: Human Sciences Research Council Press.

Simbayi, L. C., Kalichman, S. C., Jooste, S., Mathiti, V., Cain, D, & Cherry, C. (2004a). Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Twon, South Africa. Journal of Alcohol Studies, 65, 434–442.

Simbayi, L. C., Kalichman, S. C., Skinner, D., Jooste, S., Cain, D., & Cherry, C. (2004b). Theory-based HIV risk reduction counseling for sexually transmitted infection clinic patients in Cape Town, South Africa. Sexually Transmitted Diseases, 31, 727–733.PubMedCrossRef

Simbayi, L.C. Mwaba, K., & Kalichman, S. (2006). Perceptions of STI Clinic Attenders about HIV/AIDS and Alcohol as a Risk Factor with regard to HIV Infection in South Africa: Implications for HIV Prevention. Social Behavior and Personality.

Talbot, E. A., Kenyon, T. A., Moeti, T. L., Hsin, G., Dooley, L., & El-Halabi, S. (2002). HIV risk factors among patients with tuberculosis—Botswana, 1999. International Journal of STD & AIDS, 13, 311–317.CrossRef

Taylor, M., Dlamini, S. B., Kagoro, H., Jinabhai, C. C., & de Vries, H. (2003). Understanding high school students' risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa. Journal of School Health, 73, 97–100.PubMedCrossRef

Tengia-Kessy, A., Msamanga, G. I., & Moshiro, C. S. (1998). Assessment of behavioural risk factors associated with HIV infection among youth in Moshi rural district, Tanzania. East African Medical Journal, 75, 528–532.PubMed

UNAIDS. (2006). 2006 Report on the Global AIDS Epidemic. Joint United Nations Programme on HIV/AIDS.

Wechsberg, W. M. (2005). The Pretoria women's health co-op study. South African Community Epidemiology Network on Drug Use (SACENDU): Monitoring Alcohol and Drug Trends. Tygerberg, South Africa: Medical Research Council.

Wechsberg, W. M., Luseno, W. K., Lam, W. K. (2005). Violence against substance-abusing South African sex workers: Intersection with culture and HIV risk. AIDS Care, 17, S55–S64.PubMedCrossRef

Weinhardt, L. & Carey, M. P. (2001). Does alcohol lead to sexual risk behavior? Annual Review of Sex Research, 12, 125–157.

Weir, S. S., Pailman, C., Mahlalela, X., Coetzee, N., Meidany, F., & Boerma, J. T. (2003). From people to places: Focusing AIDS prevention efforts where it matters most. AIDS, 17, 895–903.PubMedCrossRef

Wilson, D., Chiroro, P., Lavelle, S., & Mutero, C. (1989). Sex worker, client sex behaviour and condom use in Harare, Zimbabwe. AIDS Care, 1, 269–280.PubMed

Yadav, G., Saskin, R., Ngugi, E., Kimani, J., Keli, F., & Fonck, K. (2005). Associations of sexual risk taking among Kenyan female sex workers after enrollment in an HIV-1 prevention trial. JAIDS, 38, 329–334.PubMed

Zachariah, R., Spielmann, M. P., Harries, A. D., Nkhoma, W., Chantulo, A., & Arendt, V. (2003). Sexually transmitted infections and sexual behaviour among commercial sex workers in a rural district in Malawi. International Journal of STD & AIDS, 14, 185–188.CrossRef

Zuckerman, M. (1994). Behavioral expressions and biological bases of sensation seeking. New York: Oxford University Press.

Zuma, K., Gouws, E., Willaims, B., & Lurie, M. (2003). Risk factors for HIV infection among women in Carletonville, South Africa: Migration, demography and sexually transmitted diseases. International Journal of STD & AIDS, 14, 814–817.CrossRef

Title: Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings
Authors: Seth C. Kalichman
Leickness C. Simbayi
Michelle Kaufman
Demetria Cain
Sean Jooste
Publication date: 01-06-2007
Publisher: Kluwer Academic Publishers-Plenum Publishers
Published in: Prevention Science / Issue 2/2007
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI: https://doi.org/10.1007/s11121-006-0061-2

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Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings

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