ArticleGlobalization and health2014
Effects of hazardous and harmful alcohol use on HIV incidence and sexual behaviour: a cohort study of Kenyan female sex workers.
Article in Globalization and health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 4 of them syntheses that pooled it.
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The trial behind it
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Who cites it
61 citing papers in PubMed, 4 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis.The Lancet. Global health · 2024Pooled it
- [Risk factors for the acquisition of Sexually Transmitted Infections in sex workers: a systematic review].Revista espanola de salud publica · 2024Pooled it
- Pooled it
- Pooled it
- How Can Programs Better Support Female Sex Workers to Avoid HIV Infection in Zimbabwe? A Prevention Cascade Analysis.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Vaginal washing and lubrication among female sex workers in the Mexico-US border region: implications for the development of vaginal PrEP for HIV prevention.BMC public health · 2018Trial
- The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial.Drug and alcohol dependence · 2016Trial
- Determinants of gender-based violence among female sex workers in Berbérati, Central African Republic.BMC research notes · 2025Article
- Review
- Lost Life at an Early Age: Life-threatening Consequences Faced by Children of Female Sex Workers in Rwanda.Rwanda journal of medicine and health sciences · 2025Article
- Epidemiological Profile and Risk Factors Related to Sexually Transmitted Infections in Sex Workers in Granada (Spain).Nursing reports (Pavia, Italy) · 2025Article
- Article
- Examining HIV Knowledge and Sexually Risky Behaviors among Female Sex Workers in Kampala, Uganda.International journal of environmental research and public health · 2024Article
- Violence Against Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review.Trauma, violence & abuse · 2024Article
- HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2023Article
- Relationships Between Stigma and Intimate Partner Violence Among Female Sex Workers Living With HIV: Social and Economic Exclusion.Violence against women · 2023Article
- Alcohol use and associated risk factors among female sex workers in low- and middle-income countries: A systematic review and meta-analysis.PLOS global public health · 2023Article
- Harmful Alcohol Use and Associated Socio-Structural Factors among Female Sex Workers Initiating HIV Pre-Exposure Prophylaxis in Dar es Salaam, Tanzania.International journal of environmental research and public health · 2022Article
- Digital Health Screening in People With HIV in Uganda to Increase Alcohol Use Reporting: Qualitative Study on the Development and Testing of the Self-administered Digital Screener for Health.JMIR formative research · 2022Article
- Harmful Alcohol and Drug Use Is Associated with Syndemic Risk Factors among Female Sex Workers in Nairobi, Kenya.International journal of environmental research and public health · 2022Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo investigate putative links between alcohol use, and unsafe sex and incident HIV infection in sub-Saharan Africa.
methodsA cohort of 400 HIV-negative female sex workers was established in Mombasa, Kenya. Associations between categories of the Alcohol Use Disorders Identification Test (AUDIT) and the incidence at one year of unsafe sex, HIV and pregnancy were assessed using Cox proportional hazards models. Violence or STIs other than HIV measured at one year was compared across AUDIT categories using multivariate logistic regression.
resultsParticipants had high levels of hazardous (17.3%, 69/399) and harmful drinking (9.5%, 38/399), while 36.1% abstained from alcohol. Hazardous and harmful drinkers had more unprotected sex and higher partner numbers than abstainers. Sex while feeling drunk was frequent and associated with lower condom use. Occurrence of condom accidents rose step-wise with each increase in AUDIT category. Compared with non-drinkers, women with harmful drinking had 4.1-fold higher sexual violence (95% CI adjusted odds ratio [AOR] = 1.9-8.9) and 8.4 higher odds of physical violence (95% CI AOR = 3.9-18.0), while hazardous drinkers had 3.1-fold higher physical violence (95% CI AOR = 1.7-5.6). No association was detected between AUDIT category and pregnancy, or infection with Syphilis or Trichomonas vaginalis. The adjusted hazard ratio of HIV incidence was 9.6 comparing women with hazardous drinking to non-drinkers (95% CI = 1.1-87.9).
conclusionsUnsafe sex, partner violence and HIV incidence were higher in women with alcohol use disorders. This prospective study, using validated alcohol measures, indicates that harmful or hazardous alcohol can influence sexual behaviour. Possible mechanisms include increased unprotected sex, condom accidents and exposure to sexual violence. Experimental evidence is required demonstrating that interventions to reduce alcohol use can avert unsafe sex.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.