Relationship between community-level alcohol outlet accessibility and individual-level HSV-2 infection among young women in South Africa
Identifieur interne : 001B92 ( Pmc/Corpus ); précédent : 001B91; suivant : 001B93Relationship between community-level alcohol outlet accessibility and individual-level HSV-2 infection among young women in South Africa
Auteurs : Molly Rosenberg ; Audrey Pettifor ; Sheri A. Lippman ; Harsha Thirumurthy ; Michael Emch ; William C. Miller ; Amanda Selin ; F. Xavier G Mez-Olivé ; James P. Hughes ; Oliver Laeyendecker ; Stephen Tollman ; Kathleen KahnSource :
- Sexually transmitted diseases [ 0148-5717 ] ; 2015.
Abstract
Exposure to alcohol outlets may influence sexual health outcomes at the individual- and community-level. Visiting alcohol outlets facilitates alcohol consumption and exposes patrons to a risky environment and network of potential partners, while presence of alcohol outlets in the community may shift social acceptance of riskier behavior. We hypothesize that living in communities with more alcohol outlets is associated with increased sexual risk.
We performed a cross-sectional analysis in a sample of 2,174 South African schoolgirls (ages 13–21) living across 24 villages in the rural Agincourt sub-district, underpinned by long-term health and socio-demographic surveillance. To examine the association between number of alcohol outlets in village of residence and individual-level prevalent HSV-2 infection, we used generalized estimating equations with logit links, adjusting for individual- and village-level covariates.
The median number of alcohol outlets per village was three (range zero to seven). HSV-2 prevalence increased from villages with no outlets [1.4%, (95% CI: 0.2, 12.1)], to villages with one to four outlets [4.5% (3.7, 5.5)], to villages with more than four outlets [6.3% (5.6, 7.1)]. An increase of one alcohol outlet per village was associated with an 11% increase in odds of HSV-2 infection [adjusted odds ratio (95% CI): 1.11 (0.98, 1.25)].
Living in villages with more alcohol outlets was associated with increased prevalence of HSV-2 infection in young women. Structural interventions and sexual health screenings targeting villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.
Url:
DOI: 10.1097/OLQ.0000000000000263
PubMed: 25868138
PubMed Central: 4436694
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PMC:4436694Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Relationship between community-level alcohol outlet accessibility and individual-level HSV-2 infection among young women in South Africa</title><author><name sortKey="Rosenberg, Molly" sort="Rosenberg, Molly" uniqKey="Rosenberg M" first="Molly" last="Rosenberg">Molly Rosenberg</name><affiliation><nlm:aff id="A1">Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Pettifor, Audrey" sort="Pettifor, Audrey" uniqKey="Pettifor A" first="Audrey" last="Pettifor">Audrey Pettifor</name><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation></author><author><name sortKey="Lippman, Sheri A" sort="Lippman, Sheri A" uniqKey="Lippman S" first="Sheri A." last="Lippman">Sheri A. Lippman</name><affiliation><nlm:aff id="A4">Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America</nlm:aff></affiliation><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation></author><author><name sortKey="Thirumurthy, Harsha" sort="Thirumurthy, Harsha" uniqKey="Thirumurthy H" first="Harsha" last="Thirumurthy">Harsha Thirumurthy</name><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A5">Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Emch, Michael" sort="Emch, Michael" uniqKey="Emch M" first="Michael" last="Emch">Michael Emch</name><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Department of Geography, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C." last="Miller">William C. Miller</name><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Selin, Amanda" sort="Selin, Amanda" uniqKey="Selin A" first="Amanda" last="Selin">Amanda Selin</name><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="G Mez Olive, F Xavier" sort="G Mez Olive, F Xavier" uniqKey="G Mez Olive F" first="F. Xavier" last="G Mez-Olivé">F. Xavier G Mez-Olivé</name><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A9">INDEPTH Network, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Hughes, James P" sort="Hughes, James P" uniqKey="Hughes J" first="James P." last="Hughes">James P. Hughes</name><affiliation><nlm:aff id="A10">Department of Biostatistics, University of Washington, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Laeyendecker, Oliver" sort="Laeyendecker, Oliver" uniqKey="Laeyendecker O" first="Oliver" last="Laeyendecker">Oliver Laeyendecker</name><affiliation><nlm:aff id="A11">Laboratory of Immunoregulation, NIAID, NIH, Baltimore MD</nlm:aff></affiliation><affiliation><nlm:aff id="A12">Department of Medicine, Johns Hopkins University, Baltimore MD</nlm:aff></affiliation></author><author><name sortKey="Tollman, Stephen" sort="Tollman, Stephen" uniqKey="Tollman S" first="Stephen" last="Tollman">Stephen Tollman</name><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A9">INDEPTH Network, Accra, Ghana</nlm:aff></affiliation><affiliation><nlm:aff id="A13">Centre for Global Health Research, Umeå University, Umeå, Sweden</nlm:aff></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A9">INDEPTH Network, Accra, Ghana</nlm:aff></affiliation><affiliation><nlm:aff id="A13">Centre for Global Health Research, Umeå University, Umeå, Sweden</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25868138</idno><idno type="pmc">4436694</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436694</idno><idno type="RBID">PMC:4436694</idno><idno type="doi">10.1097/OLQ.0000000000000263</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001B92</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001B92</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Relationship between community-level alcohol outlet accessibility and individual-level HSV-2 infection among young women in South Africa</title><author><name sortKey="Rosenberg, Molly" sort="Rosenberg, Molly" uniqKey="Rosenberg M" first="Molly" last="Rosenberg">Molly Rosenberg</name><affiliation><nlm:aff id="A1">Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Pettifor, Audrey" sort="Pettifor, Audrey" uniqKey="Pettifor A" first="Audrey" last="Pettifor">Audrey Pettifor</name><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation></author><author><name sortKey="Lippman, Sheri A" sort="Lippman, Sheri A" uniqKey="Lippman S" first="Sheri A." last="Lippman">Sheri A. Lippman</name><affiliation><nlm:aff id="A4">Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America</nlm:aff></affiliation><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation></author><author><name sortKey="Thirumurthy, Harsha" sort="Thirumurthy, Harsha" uniqKey="Thirumurthy H" first="Harsha" last="Thirumurthy">Harsha Thirumurthy</name><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A5">Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Emch, Michael" sort="Emch, Michael" uniqKey="Emch M" first="Michael" last="Emch">Michael Emch</name><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Department of Geography, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C." last="Miller">William C. Miller</name><affiliation><nlm:aff id="A2">Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="Selin, Amanda" sort="Selin, Amanda" uniqKey="Selin A" first="Amanda" last="Selin">Amanda Selin</name><affiliation><nlm:aff id="A3">Carolina Population Center, University of North Carolina-Chapel Hill</nlm:aff></affiliation></author><author><name sortKey="G Mez Olive, F Xavier" sort="G Mez Olive, F Xavier" uniqKey="G Mez Olive F" first="F. Xavier" last="G Mez-Olivé">F. Xavier G Mez-Olivé</name><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A9">INDEPTH Network, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Hughes, James P" sort="Hughes, James P" uniqKey="Hughes J" first="James P." last="Hughes">James P. Hughes</name><affiliation><nlm:aff id="A10">Department of Biostatistics, University of Washington, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Laeyendecker, Oliver" sort="Laeyendecker, Oliver" uniqKey="Laeyendecker O" first="Oliver" last="Laeyendecker">Oliver Laeyendecker</name><affiliation><nlm:aff id="A11">Laboratory of Immunoregulation, NIAID, NIH, Baltimore MD</nlm:aff></affiliation><affiliation><nlm:aff id="A12">Department of Medicine, Johns Hopkins University, Baltimore MD</nlm:aff></affiliation></author><author><name sortKey="Tollman, Stephen" sort="Tollman, Stephen" uniqKey="Tollman S" first="Stephen" last="Tollman">Stephen Tollman</name><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A9">INDEPTH Network, Accra, Ghana</nlm:aff></affiliation><affiliation><nlm:aff id="A13">Centre for Global Health Research, Umeå University, Umeå, Sweden</nlm:aff></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation><nlm:aff id="A8">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A9">INDEPTH Network, Accra, Ghana</nlm:aff></affiliation><affiliation><nlm:aff id="A13">Centre for Global Health Research, Umeå University, Umeå, Sweden</nlm:aff></affiliation></author></analytic><series><title level="j">Sexually transmitted diseases</title><idno type="ISSN">0148-5717</idno><idno type="eISSN">1537-4521</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Exposure to alcohol outlets may influence sexual health outcomes at the individual- and community-level. Visiting alcohol outlets facilitates alcohol consumption and exposes patrons to a risky environment and network of potential partners, while presence of alcohol outlets in the community may shift social acceptance of riskier behavior. We hypothesize that living in communities with more alcohol outlets is associated with increased sexual risk.</p></sec><sec id="S2"><title>Methods</title><p id="P2">We performed a cross-sectional analysis in a sample of 2,174 South African schoolgirls (ages 13–21) living across 24 villages in the rural Agincourt sub-district, underpinned by long-term health and socio-demographic surveillance. To examine the association between number of alcohol outlets in village of residence and individual-level prevalent HSV-2 infection, we used generalized estimating equations with logit links, adjusting for individual- and village-level covariates.</p></sec><sec id="S3"><title>Results</title><p id="P3">The median number of alcohol outlets per village was three (range zero to seven). HSV-2 prevalence increased from villages with no outlets [1.4%, (95% CI: 0.2, 12.1)], to villages with one to four outlets [4.5% (3.7, 5.5)], to villages with more than four outlets [6.3% (5.6, 7.1)]. An increase of one alcohol outlet per village was associated with an 11% increase in odds of HSV-2 infection [adjusted odds ratio (95% CI): 1.11 (0.98, 1.25)].</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Living in villages with more alcohol outlets was associated with increased prevalence of HSV-2 infection in young women. Structural interventions and sexual health screenings targeting villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7705941</journal-id><journal-id journal-id-type="pubmed-jr-id">7382</journal-id><journal-id journal-id-type="nlm-ta">Sex Transm Dis</journal-id><journal-id journal-id-type="iso-abbrev">Sex Transm Dis</journal-id><journal-title-group><journal-title>Sexually transmitted diseases</journal-title></journal-title-group><issn pub-type="ppub">0148-5717</issn><issn pub-type="epub">1537-4521</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25868138</article-id><article-id pub-id-type="pmc">4436694</article-id><article-id pub-id-type="doi">10.1097/OLQ.0000000000000263</article-id><article-id pub-id-type="manuscript">NIHMS665030</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Relationship between community-level alcohol outlet accessibility and individual-level HSV-2 infection among young women in South Africa</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Rosenberg</surname><given-names>Molly</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Pettifor</surname><given-names>Audrey</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Lippman</surname><given-names>Sheri A.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A4">4</xref><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Thirumurthy</surname><given-names>Harsha</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Emch</surname><given-names>Michael</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Miller</surname><given-names>William C.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Selin</surname><given-names>Amanda</given-names></name><degrees>MHS</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Gómez-Olivé</surname><given-names>F. Xavier</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A8">8</xref><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Hughes</surname><given-names>James P.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A10">10</xref></contrib><contrib contrib-type="author"><name><surname>Laeyendecker</surname><given-names>Oliver</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A11">11</xref><xref ref-type="aff" rid="A12">12</xref></contrib><contrib contrib-type="author"><name><surname>Tollman</surname><given-names>Stephen</given-names></name><degrees>MMed, PhD</degrees><xref ref-type="aff" rid="A8">8</xref><xref ref-type="aff" rid="A9">9</xref><xref ref-type="aff" rid="A13">13</xref></contrib><contrib contrib-type="author"><name><surname>Kahn</surname><given-names>Kathleen</given-names></name><degrees>MBBCh, PhD</degrees><xref ref-type="aff" rid="A8">8</xref><xref ref-type="aff" rid="A9">9</xref><xref ref-type="aff" rid="A13">13</xref></contrib></contrib-group><aff id="A1"><label>1</label>Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA</aff><aff id="A2"><label>2</label>Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</aff><aff id="A3"><label>3</label>Carolina Population Center, University of North Carolina-Chapel Hill</aff><aff id="A4"><label>4</label>Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America</aff><aff id="A5"><label>5</label>Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill</aff><aff id="A6"><label>6</label>Department of Geography, University of North Carolina-Chapel Hill</aff><aff id="A7"><label>7</label>Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill</aff><aff id="A8"><label>8</label>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa</aff><aff id="A9"><label>9</label>INDEPTH Network, Accra, Ghana</aff><aff id="A10"><label>10</label>Department of Biostatistics, University of Washington, Seattle, WA</aff><aff id="A11"><label>11</label>Laboratory of Immunoregulation, NIAID, NIH, Baltimore MD</aff><aff id="A12"><label>12</label>Department of Medicine, Johns Hopkins University, Baltimore MD</aff><aff id="A13"><label>13</label>Centre for Global Health Research, Umeå University, Umeå, Sweden</aff><author-notes><corresp id="FN1">Corresponding author information and Address for reprints: Molly Rosenberg, Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA 02138, T: (617) 495-3007, F: (617) 495-5418, <email>mrosenb@hsph.harvard.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>22</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>5</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>04</day><month>11</month><year>2015</year></pub-date><volume>42</volume><issue>5</issue><fpage>259</fpage><lpage>265</lpage><pmc-comment>elocation-id from pubmed: 10.1097/OLQ.0000000000000263</pmc-comment>
<abstract><sec id="S1"><title>Background</title><p id="P1">Exposure to alcohol outlets may influence sexual health outcomes at the individual- and community-level. Visiting alcohol outlets facilitates alcohol consumption and exposes patrons to a risky environment and network of potential partners, while presence of alcohol outlets in the community may shift social acceptance of riskier behavior. We hypothesize that living in communities with more alcohol outlets is associated with increased sexual risk.</p></sec><sec id="S2"><title>Methods</title><p id="P2">We performed a cross-sectional analysis in a sample of 2,174 South African schoolgirls (ages 13–21) living across 24 villages in the rural Agincourt sub-district, underpinned by long-term health and socio-demographic surveillance. To examine the association between number of alcohol outlets in village of residence and individual-level prevalent HSV-2 infection, we used generalized estimating equations with logit links, adjusting for individual- and village-level covariates.</p></sec><sec id="S3"><title>Results</title><p id="P3">The median number of alcohol outlets per village was three (range zero to seven). HSV-2 prevalence increased from villages with no outlets [1.4%, (95% CI: 0.2, 12.1)], to villages with one to four outlets [4.5% (3.7, 5.5)], to villages with more than four outlets [6.3% (5.6, 7.1)]. An increase of one alcohol outlet per village was associated with an 11% increase in odds of HSV-2 infection [adjusted odds ratio (95% CI): 1.11 (0.98, 1.25)].</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Living in villages with more alcohol outlets was associated with increased prevalence of HSV-2 infection in young women. Structural interventions and sexual health screenings targeting villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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