Abstract
ObjectiveTo examine alcohol use and subsequent HIV risky behaviors among a sample of predominately ethnic minority people living with HIV/AIDS (PLWHA) in a rural community in Yunnan Province, China.MethodA cross-sectional study with a face-to-face questionnaire interview was conducted among eligible participants.ResultsIn total, 455 (94.4%) out of 482 eligible HIV patients participated in the study. Of them, 82.6% were ethnic minorities; 15.4% were never married; 96.5% were sexually experienced; 55.4% had used drugs, 67% were receiving antiretroviral therapy (ART). Over 65% were ever drinkers; of whom 61.5% were current drinkers. Among current drinkers, 32.4% drank daily and 41.2% were hazardous drinkers. Chinese white wine was the preferred choice. Higher level of alcohol use among drinkers in the preceding month was positively associated with being males (OR = 2.76, 95%CI: 1.03–7.43), ethnic minorities (OR Jingpo = 2.21, 95%CI: 1.06–4.59; OR other minorities = 3.20, 95%CI: 1.34–7.62), higher education (OR1–6 = 1.98, 95%CI: 0.99–3.96; OR≥7 = 2.35, 95%CI: 1.09–5.06) and being ART-naive (OR = 2.69, 95%CI: 1.67–4.32). About 39% of ever drinkers reported having engaged in sex after drinking since HIV diagnosis. Those who were younger than 46 years (OR16–25 = 7.77, 95%CI: 1.22–49.60, OR26–35 = 2.79, 95%CI: 1.06–7.35, OR36–45 = 2.96, 95%CI: 1.57–7.58), hazardous drinkers (OR = 1.99, 95%CI: 1.00–3.97) and drug users (OR = 3.01, 95%CI: 1.19–7.58) were more likely to have had sex after drinking. Approximately 56% of drug users had used drugs after drinking.ConclusionsHigh prevalence of alcohol use and subsequent risky behaviors including sexual engagement and drug use among HIV patients in rural Yunnan require tremendous and integrated efforts for prevention and control of alcohol and drug abuse and HIV spreading.
Highlights
In spite of substantial efforts aimed at reducing the spread of HIV, HIV incidence continues to remain at a high level throughout many parts of the world, with 2.5 million people being newly infected with HIV in 2011 only [1]
Higher level of alcohol use among drinkers in the preceding month was positively associated with being males (OR = 2.76, 95% confidence interval (95%CI): 1.03–7.43), ethnic minorities (OR Jingpo = 2.21, 95%CI: 1.06–4.59; odds ratio (OR) other minorities = 3.20, 95%CI: 1.34–7.62), higher education (OR1–6 = 1.98, 95%CI: 0.99–3.96; OR$7 = 2.35, 95%CI: 1.09–5.06) and being antiretroviral therapy (ART)-naive (OR = 2.69, 95%CI: 1.67–4.32)
Literature has showed that over 70% of people living with HIV/AIDS (PLWHA) remains sexually active after diagnosis with HIV infection [2], and that one-third of them engage in unprotected sexual behavior [3]
Summary
In spite of substantial efforts aimed at reducing the spread of HIV, HIV incidence continues to remain at a high level throughout many parts of the world, with 2.5 million people being newly infected with HIV in 2011 only [1]. Literature has showed that over 70% of people living with HIV/AIDS (PLWHA) remains sexually active after diagnosis with HIV infection [2], and that one-third of them engage in unprotected sexual behavior [3]. Since the middle 1980s, the global literature suggests that alcohol consumption is associated with a number of sexual risk behaviors including premarital intercourse, multiple sexual partners, unprotected sex, sexual violence, as well as outcomes such as unwanted pregnancy, HIV/AIDS and other sexually transmitted infections (STIs) [7,8,9]. Heavy alcohol consumption tends to be more prevalent among PLWHA than among the general population [10] In this context, alcohol-related problems and co-occurred unsafe sex further amplify considerable contributions of alcohol to the global burden of diseases [11]
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