Abstract

BackgroundAs reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience.MethodsA cross-sectional survey was carried out in 2010 among 1954 students at Mbarara University of Science and Technology, Uganda, using a self-administered questionnaire. Alcohol use was measured as consumption over the previous 12 months, during situations related to sexual activity and on the most recent occasion of sexual intercourse. Risky sexual behavior was defined as having two or more sexual partners in the previous 12 months or inconsistent condom use with new partners. Bivariate and multivariate logistic regression was performed to analyze the association between alcohol use and risky sexual behavior separately for males and females.ResultsEven after adjusting for confounders, the odds ratio (OR) of having two or more sexual partners in the past year indicated a statistically significant association with alcohol use on all levels (global, situational, and event) for both males and females. The ORs of inconsistent condom use with a new partner were significant for males who often consumed alcohol in relation to sexual activity—even after adjusting for potential confounders (OR, 1.75; confidence interval, 1.01–3.08). The risk of inconsistent condom use with a new partner was twice as high for females who often consumed alcohol in relation to sexual activity, although this association was not statistically significant.ConclusionsThe study supports previous research that alcohol consumption is associated with having multiple sexual partners. Inconsistent condom use was associated with the situational use of alcohol in relation to sexual activity and was similar for both genders. Interventions to reduce alcohol-related risky sexual behavior should target both male and female drinkers, particularly subgroups of students, who often consume alcohol in relation to sexual activity.

Highlights

  • As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students

  • The current study aims to analyze the association between alcohol use and risky sexual behavior at the global, situational, and event level among Ugandan university students with sexual experience

  • Our study found a significant association between alcohol use in general, alcohol consumption in relation to sexual activity, and alcohol use on the last occasion of sexual intercourse with having multiple sexual partners

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Summary

Introduction

As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. In 2010, a survey conducted at six universities in Uganda estimated the HIV prevalence among students there to be 1.2%, which was lower than the national average [7]. The survey indicated that the prevalence of all sexually transmitted infections (STIs) over the previous 12 months was 10%, which was somewhat higher than the estimated national average for that period [7]. There is a lack of information about STIs, including HIV prevalence and contraceptive use within such subpopulations as university students, since routine sources of data (such as HIV surveillance and national population-based AIDS indicator surveys) do not provide this kind of detail [7]. Research is necessary to identify the risk factors in these subpopulations and generate evidence to guide interventions toward preventing the transmission of STIs, including HIV infection

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