Abstract

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.