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High Rates of Unprotected Sex occurring among HIV-Positive Individuals in a Daily Diary Study in South Africa: The Role of Alcohol Use

Identifieur interne : 000F86 ( Pmc/Corpus ); précédent : 000F85; suivant : 000F87

High Rates of Unprotected Sex occurring among HIV-Positive Individuals in a Daily Diary Study in South Africa: The Role of Alcohol Use

Auteurs : Susan M. Kiene ; Leickness C. Simbayi ; Amber Abrams ; Allanise Cloete ; Howard Tennen ; Jeffrey D. Fisher

Source :

Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2008.

RBID : PMC:2631279

Abstract

Objective

To assess the prevalence of unprotected sex and examine the association between alcohol consumption before sex and unprotected sex among HIV+ individuals in Cape Town, South Africa.

Methods

For 42-days daily phone interviews assessed daily sexual behaviour and alcohol consumption. Logistic and Poisson GEE models were used to examine associations between alcohol consumption before sex and subsequent unprotected sex.

Results

During the study which yielded 3,035 data points, the 58 HIV+ women and 24 HIV+ men drank an average of 6.13 drinks when they drank, and reported 4,927 sex events, of which 80.17% were unprotected. Over half (58%) of unprotected sex events were with HIV-negative or HIV-status-unknown partners. Extrapolating from the data using likelihood of infection per act estimates we calculated that an estimated 2.95 incident HIV-infections occurred during the study. Drinking alcohol before sex by the female, the male, or by both partners, increased the proportion and number of subsequent unprotected sex events. However, these associations held only when the quantity of alcohol consumed corresponded to moderate or higher risk drinking.

Conclusions

Among HIV-positives engaging in moderate or higher risk drinking prior to sex increases the likelihood and rate of unprotected sex. Prevention efforts need to address reducing alcohol-involved unprotected sex among HIV-positive persons.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631279

DOI: 10.1097/QAI.0b013e318184559f
PubMed: 18769345
PubMed Central: 2631279

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PMC:2631279

Le document en format XML

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<author><name sortKey="Kiene, Susan M" sort="Kiene, Susan M" uniqKey="Kiene S" first="Susan M." last="Kiene">Susan M. Kiene</name>
<affiliation><nlm:aff id="A1">Departments of Medicine and Community Health, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, USA</nlm:aff>
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<author><name sortKey="Simbayi, Leickness C" sort="Simbayi, Leickness C" uniqKey="Simbayi L" first="Leickness C." last="Simbayi">Leickness C. Simbayi</name>
<affiliation><nlm:aff id="A2">Human Sciences Research Council, Cape Town, South Africa</nlm:aff>
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<author><name sortKey="Abrams, Amber" sort="Abrams, Amber" uniqKey="Abrams A" first="Amber" last="Abrams">Amber Abrams</name>
<affiliation><nlm:aff id="A3">Department of Social Anthropology, University of Cape Town, South Africa</nlm:aff>
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<author><name sortKey="Cloete, Allanise" sort="Cloete, Allanise" uniqKey="Cloete A" first="Allanise" last="Cloete">Allanise Cloete</name>
<affiliation><nlm:aff id="A2">Human Sciences Research Council, Cape Town, South Africa</nlm:aff>
</affiliation>
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<author><name sortKey="Tennen, Howard" sort="Tennen, Howard" uniqKey="Tennen H" first="Howard" last="Tennen">Howard Tennen</name>
<affiliation><nlm:aff id="A4">Department of Community Medicine and Health Care, University of Connecticut Health Center, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fisher, Jeffrey D" sort="Fisher, Jeffrey D" uniqKey="Fisher J" first="Jeffrey D." last="Fisher">Jeffrey D. Fisher</name>
<affiliation><nlm:aff id="A5">Center for Health, Intervention & Prevention, University of Connecticut, USA</nlm:aff>
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<author><name sortKey="Kiene, Susan M" sort="Kiene, Susan M" uniqKey="Kiene S" first="Susan M." last="Kiene">Susan M. Kiene</name>
<affiliation><nlm:aff id="A1">Departments of Medicine and Community Health, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, USA</nlm:aff>
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<author><name sortKey="Simbayi, Leickness C" sort="Simbayi, Leickness C" uniqKey="Simbayi L" first="Leickness C." last="Simbayi">Leickness C. Simbayi</name>
<affiliation><nlm:aff id="A2">Human Sciences Research Council, Cape Town, South Africa</nlm:aff>
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<author><name sortKey="Abrams, Amber" sort="Abrams, Amber" uniqKey="Abrams A" first="Amber" last="Abrams">Amber Abrams</name>
<affiliation><nlm:aff id="A3">Department of Social Anthropology, University of Cape Town, South Africa</nlm:aff>
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<author><name sortKey="Cloete, Allanise" sort="Cloete, Allanise" uniqKey="Cloete A" first="Allanise" last="Cloete">Allanise Cloete</name>
<affiliation><nlm:aff id="A2">Human Sciences Research Council, Cape Town, South Africa</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tennen, Howard" sort="Tennen, Howard" uniqKey="Tennen H" first="Howard" last="Tennen">Howard Tennen</name>
<affiliation><nlm:aff id="A4">Department of Community Medicine and Health Care, University of Connecticut Health Center, USA</nlm:aff>
</affiliation>
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<author><name sortKey="Fisher, Jeffrey D" sort="Fisher, Jeffrey D" uniqKey="Fisher J" first="Jeffrey D." last="Fisher">Jeffrey D. Fisher</name>
<affiliation><nlm:aff id="A5">Center for Health, Intervention & Prevention, University of Connecticut, USA</nlm:aff>
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<series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To assess the prevalence of unprotected sex and examine the association between alcohol consumption before sex and unprotected sex among HIV+ individuals in Cape Town, South Africa.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">For 42-days daily phone interviews assessed daily sexual behaviour and alcohol consumption. Logistic and Poisson GEE models were used to examine associations between alcohol consumption before sex and subsequent unprotected sex.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">During the study which yielded 3,035 data points, the 58 HIV+ women and 24 HIV+ men drank an average of 6.13 drinks when they drank, and reported 4,927 sex events, of which 80.17% were unprotected. Over half (58%) of unprotected sex events were with HIV-negative or HIV-status-unknown partners. Extrapolating from the data using likelihood of infection per act estimates we calculated that an estimated 2.95 incident HIV-infections occurred during the study. Drinking alcohol before sex by the female, the male, or by both partners, increased the proportion and number of subsequent unprotected sex events. However, these associations held only when the quantity of alcohol consumed corresponded to moderate or higher risk drinking.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Among HIV-positives engaging in moderate or higher risk drinking prior to sex increases the likelihood and rate of unprotected sex. Prevention efforts need to address reducing alcohol-involved unprotected sex among HIV-positive persons.</p>
</sec>
</div>
</front>
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  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21821</journal-id>
<journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title>
<issn pub-type="ppub">1525-4135</issn>
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<article-meta><article-id pub-id-type="pmid">18769345</article-id>
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<article-id pub-id-type="doi">10.1097/QAI.0b013e318184559f</article-id>
<article-id pub-id-type="manuscript">NIHMS85508</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>High Rates of Unprotected Sex occurring among HIV-Positive Individuals in a Daily Diary Study in South Africa: The Role of Alcohol Use</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Kiene</surname>
<given-names>Susan M.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
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<contrib contrib-type="author"><name><surname>Simbayi</surname>
<given-names>Leickness C.</given-names>
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<degrees>DPhil</degrees>
<xref ref-type="aff" rid="A2">2</xref>
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<contrib contrib-type="author"><name><surname>Abrams</surname>
<given-names>Amber</given-names>
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<degrees>MPhil</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cloete</surname>
<given-names>Allanise</given-names>
</name>
<degrees>MA</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tennen</surname>
<given-names>Howard</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fisher</surname>
<given-names>Jeffrey D.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Departments of Medicine and Community Health, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, USA</aff>
<aff id="A2"><label>2</label>
Human Sciences Research Council, Cape Town, South Africa</aff>
<aff id="A3"><label>3</label>
Department of Social Anthropology, University of Cape Town, South Africa</aff>
<aff id="A4"><label>4</label>
Department of Community Medicine and Health Care, University of Connecticut Health Center, USA</aff>
<aff id="A5"><label>5</label>
Center for Health, Intervention & Prevention, University of Connecticut, USA</aff>
<author-notes><corresp id="CR1"><bold>Address correspondence and reprint requests to:</bold>
 Susan M. Kiene, Ph.D. Division of General Internal Medicine Research Rhode Island Hospital 593 Eddy Street, Plain St. Bldg. Providence, RI 02903 USA <email>susan_kiene@brown.edu</email>
 +1 401 444 3365 (office) +1 401 444 5040 (fax)</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>2</day>
<month>1</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>10</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>10</month>
<year>2009</year>
</pub-date>
<volume>49</volume>
<issue>2</issue>
<fpage>219</fpage>
<lpage>226</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To assess the prevalence of unprotected sex and examine the association between alcohol consumption before sex and unprotected sex among HIV+ individuals in Cape Town, South Africa.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">For 42-days daily phone interviews assessed daily sexual behaviour and alcohol consumption. Logistic and Poisson GEE models were used to examine associations between alcohol consumption before sex and subsequent unprotected sex.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">During the study which yielded 3,035 data points, the 58 HIV+ women and 24 HIV+ men drank an average of 6.13 drinks when they drank, and reported 4,927 sex events, of which 80.17% were unprotected. Over half (58%) of unprotected sex events were with HIV-negative or HIV-status-unknown partners. Extrapolating from the data using likelihood of infection per act estimates we calculated that an estimated 2.95 incident HIV-infections occurred during the study. Drinking alcohol before sex by the female, the male, or by both partners, increased the proportion and number of subsequent unprotected sex events. However, these associations held only when the quantity of alcohol consumed corresponded to moderate or higher risk drinking.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Among HIV-positives engaging in moderate or higher risk drinking prior to sex increases the likelihood and rate of unprotected sex. Prevention efforts need to address reducing alcohol-involved unprotected sex among HIV-positive persons.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV seropositivity</kwd>
<kwd>alcohol drinking</kwd>
<kwd>prevention</kwd>
<kwd>condoms</kwd>
<kwd>sexual partners</kwd>
<kwd>prospective cohort study</kwd>
<kwd>South Africa</kwd>
</kwd-group>
<contract-num rid="MH1">F31 MH072547-03</contract-num>
<contract-sponsor id="MH1">National Institute of Mental Health : NIMH</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>

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High Rates of Unprotected Sex occurring among HIV-Positive Individuals in a Daily Diary Study in South Africa: The Role of Alcohol Use

High Rates of Unprotected Sex occurring among HIV-Positive Individuals in a Daily Diary Study in South Africa: The Role of Alcohol Use

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Abstract

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