Objectives Sexual partner concurrency and hazardous alcohol consumption patterns both lead to accelerated transmission of HIV/STIs. While there has been considerable research undertaken documenting the correlation of alcohol and HIV risk behaviours, there is less research examining the association of hazardous and harmful drinking patterns and concurrent sexual relationships.

Methods A 2012 cross section of 483 (49%) males and 501 (51%) females, aged 18–35 years, in rural Bushbuckridge, South Africa, were surveyed. Hazardous and harmful patterns of alcohol consumption were identified using Alcohol Use Disorders Identification Test (AUDIT) score ≥ 8. Having concurrent sexual partners was determined as more than one ongoing, sexual partnership reported on the day of the interview. Prevalence ratios were estimated using log-binomial regression to assess the relationship between alcohol consumption patterns and sexual partnership concurrency.

Results Among 984 sexually active respondents, the median age was 23 years, with a majority having never married (N = 705, 72%), received some high school education (N = 546, 55%), did not receive any income in past 3 months (N = 621, 63%), and had spent the past 7 nights at home (N = 905, 92%). Approximately 25% (N = 123) of men reported at least one ongoing, overlapping relationship and 26% (N = 131) had an AUDIT score ≥ 8. Among women, 28 (6%) reported concurrent sexual partners and only 6 (1%) reported hazardous alcohol consumption patterns. For males, the prevalence ratio of hazardous alcohol consumption and sexual partner concurrency was 3.44 (95% CI: 2.26, 5.23). Given the low prevalence of hazardous drinking among women we could not assess the relationship with sexual partner concurrency.

Conclusions Hazardous drinking among men was associated with sexual partner concurrency was associated with hazardous alcohol drinkers. Sexual risk reduction interventions and alcohol education are strongly needed for men in this setting.