MMed, Epidemiology and Biostatistics,University of the Witwatersrand, 2009 / Background: South Africa is one of the countries with the highest Human Immunodeficiency
Virus (HIV) prevalence in the world. The main mode of transmission in South Africa is via
heterosexual intercourse. Thus there is the need to identify factors associated with HIV high risk
sexual behaviour to inform future intervention programmes.
Objective: To determine the association between alcohol consumption and high risk sexual
behaviour in South African adults in 2006.
Methods: Secondary data analysis of cross sectional study involving 1544 adult males and
females, between 16-65 years interviewed in the Soul City National Survey. A multi-stage,
stratified and clustered probability sampling technique was used. Univariate and multivariate
analysis was done using student t test, chi square test and logistic regression models.
Results: The prevalence of alcohol consumption in the week prior to the survey was 24.4%
(95%CI: 22.2-26.6). The prevalence of heavy episodic drinking in last one month was 17.5%
(95%CI: 15.5-19.4). There was an association between broad socioeconomic conditions and
sexual behaviour particularly age, sex and race (P<0.05). The mean age at sexual debut was
17.13 (SD 2.61) years in the males and 17.91 (2.45 SD) years in females (P<0.001). Of the
sexually active respondents, 12.7% and 4.2% of the men and women respectively had multiple
partners currently (P<0.001). Generally consistent condom use was more in men although, only
10.3% of the men and 5.6% of the women used the condoms consistently with their casual
partners (P=0.28). Multivariate regression showed that alcohol use predicted having multiple
partners (AOR 2.37; 95%CI 1.19-4.69 and AOR 4.15; 95%CI 1.37-11.97) for moderate and
problem drinkers respectively. Also, heavy episodic drinking predicted having multiple partners
by three times (AOR 3.21; 95%CI 1.69-6.39). There was a significant dose response relationship
for having multiple partners (P<0.05). As regards unprotected sexual intercourse, although not
significant, female drinkers were found to be protected from inconsistent condom use with a
casual partner. Male drinkers on the other hand, were found to be at a higher risk of having
unprotected sex with casual partners. Perceptions of susceptibility to HIV (AOR 0.31; 95%CI
0.17-0.56), and alcohol related harm (AOR 0.17; 95%CI; 0.22-0.71) influenced consistent
condom use with casual partners. Also regards gender differences, women who drank alcohol
(AOR 9.68; 95%CI 1.31-17.45 vs. 1.17; 0.28-4.89) or were heavy episodic drinkers (AOR 4.45;
95%CI 1.46-3.55 vs. 2.43; 1.03-5.92) had a higher probability of having multiple partners than
men.
Conclusion: There is a strong association between risky alcohol use and high risk sexual
behaviours. HIV prevention programmes need to address reduction in alcohol intake and changes
in drinking pattern. Further research to disentangle the relationship between condom use and
alcohol use is needed.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/7666 |
| Date | 15 March 2010 |
| Creators | Fawole, Olufunmilayo I |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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