Objectives: Only a small number of studies have examined the association between alcohol use and risky sexual behaviour among women living with HIV, particularly African-American women. The present study examined the association between alcohol problems, sexual behaviour and biologically confirmed sexually transmitted infections (STI) among a sample of predominantly African-American women living with HIV.
Methods: A sample of 366 women living with HIV between the ages of 18 and 50 years participated in the study. The majority of women were African-American (84.2%). Participants completed a face-to-face interview assessing sociodemographics, sexual behaviour, other substance use and alcohol problems using the CAGE (Cut down, Annoyed, Guilty, Eye opener), a screening measure for alcohol abuse. Participants also provided self-collected vaginal swab specimens that were assayed for STI.
Results: The prevalence of high scores on the CAGE was 54.5% and 15% of women tested positive for Trichomonas vaginalis. Multivariate logistic regression analyses, with age and other substance use as covariates, indicated that women who scored higher on the CAGE, relative to those who scored lower, were more likely to test positive for T vaginalis, have sex with their spouse or steady partner when only they had been drinking and have sex with their spouse or steady partner when they had both been drinking.
Conclusions: These findings suggest that alcohol assessment should be included in regular healthcare maintenance among women living with HIV. Intervention programmes should be tailored to address alcohol use/abuse among African-American women living with HIV.
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Funding: This research was supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health (1R01MH54412), a grant from the University of Alabama Center for AIDS Research (AI027767) and was partly supported by funds from the Emory Center for AIDS Research (P30 AI050409) and a supplement from the National Institute of Drug Abuse awarded to the second author.
Competing interests: None declared.
Ethics approval: Ethics approval was obtained.
Contributors: PS conceived this paper, conducted data analyses and interpretation, and led the writing. GMW contributed to the conceptualisation, design, acquisition of data, as well as taking part in the editing. RJD contributed to the conceptualisation, design and acquisition of data, as well taking part in the editing.
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