Objectives: Only a small number of studies have examined the association between alcohol use and risky sexual behavior among women living with HIV, specifically African-American women. The present study examined the association between alcohol problems, sexual behavior, and biologically-confirmed STIs among a sample of predominantly African-American women living with HIV.
Methods: A sample of 366 women living with HIV between the ages of 18-50 participated in the study. The majority of women were African-American (84.2%). Participants completed a face-to-face interview assessing sociodemographics, sexual behavior, other substance use, and alcohol problems via the CAGE, a screening measure for alcohol abuse. Participants also provided self-collected vaginal swab specimens that were assayed for STIs.
Results: The prevalence of high scores on the CAGE was 54.5% and 15% of women tested positive for Trichomonas vaginalis (TV). 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 TV, 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 both had been drinking.
Conclusions: These findings suggest that alcohol assessment should be included in regular health care maintenance among women living with HIV. Intervention programs should be tailored to address alcohol use/abuse among African-American women living with HIV.