Abstract
Disinhibition due to alcohol may induce intimate partner violence and sexual coercion and increased risk of HIV infection. In a sample of 3,422 women aged 15–24 from the Rakai cohort, Uganda, we examined the association between self-reported alcohol use before sex, physical violence/sexual coercion in the past and prevalent HIV, using adjusted odds ratios (Adj OR) and 95% confidence intervals (95% CI). During the previous year, physical violence (26.9%) and sexual coercion (13.4%) were common, and alcohol use before sex was associated with a higher risk of physical violence/sexual coercion. HIV prevalence was significantly higher with alcohol consumption before sex (Adj OR = 1.45, 95% CI: 1.06–1.98) and especially when women reported both prior sexual coercion and alcohol use before sex (Adj OR = 1.79, 95% CI: 1.25–2.56). Alcohol use before sex was associated with physical violence and sexual coercion, and both are jointly associated with HIV infection risk in young women.
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Acknowledgements
The authors wish to thank the Rakai project team for their efforts in study design, implementation, data collection and management, and special thanks to the study participants for providing extensive information for this research.
Contributors
Iryna B. Zablotska contributed to formulating research issue and design of this analysis, assumed principal responsibility for data analysis and preparation of the paper. Ronald. H. Gray (co-principal investigator of the Rakai Project) contributed to data collection and assisted with the analysis design, interpretation of results and preparation of the paper. Michael A. Koenig contributed to interpretation of results and preparation of the paper. David Servadda, Fred Nalugoda, Godfrey Kigozi, Nelson Sewankambo, Tom Lutalo Fred Wabire Mangen, and Maria Wawer contributed to the design and conduct of the data collection and preparation of this report. All authors have seen and approved the final version of this paper.
Funding
The Rakai study was funded through the Department of the Army, United States Army Medical Research and Material Command Cooperative Agreement DAMD17-98-2-8007; grants R01 A134826 and R01 A134265 from the National Institute of Allergy and Infectious Diseases; grant 5P30HD06826 from the National Institute of Child and Health Development; the World Bank STI Project, Uganda; the Henry M. Jackson Foundation; a grant 5D43TW00010 from the Fogarty Foundation; and the Bill and Melinda Gates Institute for Population and Reproductive Health.
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Zablotska, I.B., Gray, R.H., Koenig, M.A. et al. Alcohol Use, Intimate Partner Violence, Sexual Coercion and HIV among Women Aged 15–24 in Rakai, Uganda. AIDS Behav 13, 225–233 (2009). https://doi.org/10.1007/s10461-007-9333-5
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DOI: https://doi.org/10.1007/s10461-007-9333-5