Patterns of Alcohol Use, Problem Drinking, and HIV Infection Among High-Risk African Women

Fisher, Joseph C. PhD, MPH*; Cook, Peter A. MS*; Sam, Noel E. MD†; Kapiga, Saidi H. MD, ScD‡

Sexually Transmitted Diseases: June 2008 - Volume 35 - Issue 6 - pp 537-544
doi: 10.1097/OLQ.0b013e3181677547

Objectives: To examine the relationship between patterns of alcohol use and HIV infection and to assess the association between problem drinking and the prevalence of risk factors for HIV among a sample of high-risk African women.

Methods: Baseline data were collected between 2002 and 2003 during enrollment of 1050 women in a prospective cohort study designed to assess risk factors for HIV. Information about demographic and employment characteristics, sexual behaviors, and drinking patterns were obtained by interviews. The CAGE questionnaire was used to assess problem drinking. The association between measures of alcohol use and HIV/STDs and sexual behaviors were summarized using odds ratios, adjusted odds ratios (AOR), and 95% confidence intervals (CI).

Results: HIV prevalence was 19.0% (95% CI, 16.6%–21.4%). Overall 73.9% of the women drank alcohol whereas 34.6% were classified as problem drinkers. After adjusting for demographic and employment variables, drinkers were at increased risk to be HIV+ when compared with nondrinkers (AOR, 2.10; 95% CI, 1.29–3.42). Greater involvement with alcohol, as indicated by recency, frequency and quantity consumed, was associated with increased risk. Problem drinkers were at greater risk to be HIV+ than nonproblem drinkers (AOR, 1.79; 95% CI, 1.06–3.04 vs. AOR, 2.43; 95% CI, 1.45–4.06). Problem drinkers were also more likely to have engaged in several types of high-risk sexual behaviors and to have other STD infections including HSV-2.

Conclusion: Programs aiming at limiting alcohol use or promoting abstinence from alcohol might help to reduce high-risk behaviors and lower the burden of HIV/STDs in this population.

Alcohol use and problem drinking were associated with HIV infection among a sample of high-risk African women, while problem drinking was also related to HIV risk factors.

From the *Interdata Inc., Sanibel, Florida; †Department of Clinical Laboratories, Kilimanjaro Christian Medical Center, Moshi, Tanzania; and ‡Department of Population and International Health, Harvard School of Public Health, Boston, Massachusetts

The authors thank women who participated in this study; research and administrative staff for their efforts in the implementation of the study; and Kilimanjaro Christian Medical Centre and Moshi Municipal Council for providing institutional support. The authors are especially indebted to Tony Ao, Mary Solomon, Coleta Mbuya, Rose Mushi, Grace Mhango, Basidi Bamba, Ireen Kiwelu, John Shao, and Christopher Mtamakaya for their efforts during data collection and processing.

This project was funded by the Rockefeller Foundation, New York (Grant Number 2002 HE 036).

The Rockefeller Foundation was not involved in the study design, data collection and analysis, and writing of this report.

Correspondence: Joseph C. Fisher, PhD, MPH, Interdata Inc., P.O. Box 129, Sanibel, FL 33957. E-mail:

Received for publication June 18, 2007, and accepted January 7, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association