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Alcohol Use and High-Risk Sexual Behavior in Sub-Saharan Africa: A Narrative Review

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Abstract

Sub-Saharan Africa (SSA) contains 10% of the world’s population and 60% of all people living with AIDS. Consequently, research investigating risk factors associated with HIV acquisition is a public health priority and one such risk factor is alcohol consumption. This article is a review of empirical studies on the association of alcohol and high-risk sexual behavior in SSA, with a focus on measurable outcomes generated from quantitative data. A critique of the literature is provided, with attention to methodological concerns. Empirically based theoretical orientations were used to interpret the reviewed research and to stimulate discussion about how to improve the state of the current literature. Based on this discussion, a model of alcohol and high-risk sexual behavior in an African context is proposed in order to integrate the existing literature and highlight areas in need of continued research.

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Notes

  1. The AUDIT is a 10-item self report measure that is commonly used to assess quantity and frequency of alcohol use to reliably identify individuals who are at risk of developing, or are currently experiencing, alcohol problems and has been validated in several countries (Saunders, Aasland, Baror, De la Fuente, & Grant, 1993).

References

  • Abbey, A., Zawacki, T., Buck, P. O., Testa, M., Parks, K., Norris, J., et al. (2002). How does alcohol contribute to sexual assault? Explanations from laboratory survey data. Alcoholism, Clinical and Experimental Research, 26, 575–581.

    Article  PubMed  Google Scholar 

  • Abrahams, N., Jewkes, R., Hoffman, M., & Laubsher, R. (2004). Sexual violence against partners in Cape Town: Prevalence and risk factors reported by men. Bulletin of the World Health Organization, 82, 330–337.

    PubMed  Google Scholar 

  • Abramson, J. H. (1990). Meta-analysis: A review of pros and cons. Public Health Review, 18, 1–47.

    Google Scholar 

  • Adih, W. K., & Alexander, C. S. (1999). Determinants of condom use to prevent HIV infection among youth in Ghana. Journal of Adolescent Heath, 24, 63–72.

    Article  Google Scholar 

  • Akarro, R. R. (2008). Some factors associated with condom use among bar maids in Tanzania. Journal of Biosocial Science, 41, 125–137.

    Article  PubMed  Google Scholar 

  • Alemu, H., Mariam, D. H., Belay, K. A., & Davey, G. (2007). Factors predisposing out-of-school youths to HIV/AIDS-related risky sexual behaviour in Northwest Ethiopia. The Journal of Health, Population, and Nutrition, 25, 344–350.

    Google Scholar 

  • Ali, M. M., Cleland, J. G., & Carael, M. (2001). Sexual risk behavior in urban populations of Northeastern Africa. AIDS and Behavior, 5, 343–352.

    Article  Google Scholar 

  • Allen, J. P., Reinert, D. F., & Volk, R. J. (2001). The Alcohol Use Disorders Identification Test: An aid to recognition of alcohol problems in primary care patients. Preventive Medicine, 33, 428–433.

    Article  PubMed  Google Scholar 

  • Allen, S., Tice, J., Ven de Perre, P., Serufilira, A., Hudes, E., Nsengumuremyi, F., et al. (1992). Effect of serotesting with counseling on condom use and seroconversion among HIV discordant couples in Africa. British Medical Journal, 304, 1605–1610.

    Article  PubMed  Google Scholar 

  • Ashley, J. W., Levine, B., & Needle, R. (2006). Summary of the proceedings of meeting on alcohol, HIV risk behaviours, and transmission in Africa: Developing programmes for the United States President’s Emergency Plan for AIDS Relief (PEPFAR). African Journal of Drug & Alcohol Studies, 5, 192–200.

    Google Scholar 

  • Ayisi, J. G., van Eijk, A. M., ter Kuile, F. O., Kolczak, M. S., Otieno, J. A., Misore, A. O., et al. (2000). Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya. International Journal of STD and AIDS, 11, 393–401.

    Article  PubMed  Google Scholar 

  • Babalola, S. (2006). Gender differences in the factors influencing consistent condom use among young people in Tanzania. International Journal of Adolescent Medical Health, 18, 287–298.

    Google Scholar 

  • Bassett, M. T., McFarland, W. C., Ray, S., Mbizvo, M. T., Machekano, R., van de Wijgert, J. H., et al. (1996). Risk factors for HIV infection at enrollment in an urban male factory cohort in Harare, Zimbabwe. Journal of Acquired Immune Deficiency Syndrome, 13, 287–293.

    Google Scholar 

  • Bing, E. G., Ortiz, D. J., Ovalle-Bahamon, R. E., Cheng, K. G., Huang, F. H., Ernesto, F., et al. (2008). HIV/AIDS behavioral surveillance among Angolan military men. AIDS and Behavior, 12, 578–584.

    Article  PubMed  Google Scholar 

  • Bryant, K. J. (2006). Expanding research on the role of alcohol consumption and related risks in the prevention and treatment of HIV/AIDS. Substance Use and Misuse, 41, 1465–1507.

    Article  PubMed  Google Scholar 

  • Buseh, A. G. (2004). Patterns of sexual behavior among secondary school students in Swaziland, southern Africa. Culture, Health, and Sexuality, 6, 355–367.

    Article  Google Scholar 

  • Campbell, C., Williams, B., & Gilgen, D. (2002). Is social capital a useful conceptual tool for exploring community level influences on HIV infection? An exploratory case study from South Africa. AIDS Care, 14, 41–54.

    Article  PubMed  Google Scholar 

  • Campbell, E. K. (2003). A note on alcohol consumption and sexual behavior of youths in Botswana. African Sociological Review, 7, 146–161.

    Google Scholar 

  • Clift, S., Anemona, A., Watson-Jones, D., Kanga, Z., Ndeki, L., Changalucha, J., et al. (2003). Variations of HIV and STI prevalences within communities neighboring new goldmines in Tanzania: Importance for intervention design. Sexually Transmitted Infections, 79, 307–313.

    Article  PubMed  Google Scholar 

  • Coldiron, M. E., Stephenson, R., Chomba, E., Vwalika, C., Karita, E., Kayitenkore, K., et al. (2008). The relationship between alcohol consumption and unprotected sex among known HIV-discordant couples in Rwanda and Zambia. AIDS and Behavior, 12, 594–603.

    Article  PubMed  Google Scholar 

  • Cook, R. L., & Clark, D. B. (2005). Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sexually Transmitted Diseases, 32, 156–164.

    Article  PubMed  Google Scholar 

  • Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol , Suppl 14, 101–117.

    Google Scholar 

  • Corey, L., Wald, A., Celum, C., & Quinn, T. (2004). The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: A review of two overlapping epidemics. Journal of Acquired Immune Deficiency Syndrome, 35, 435–445.

    Article  Google Scholar 

  • Dingle, G. A., & Oei, T. P. (1997). Is alcohol a cofactor of HIV and AIDS? Evidence from immunological and behavioral studies. Psychological Bulletin, 122, 56–71.

    Article  PubMed  Google Scholar 

  • Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntryre, J. A., & Harlow, S. D. (2004a). Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet, 363, 1415–1421.

    Article  PubMed  Google Scholar 

  • Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntryre, J. A., & Harlow, S. D. (2004b). Transactional sex among women in Soweto, South Africa: Prevalence, risk factors, and associated with HIV infection. Social Science and Medicine, 59, 1581–1592.

    Article  PubMed  Google Scholar 

  • Dunkle, K. L., Jewkes, R. K., Nduna, M., Jama, N., Levin, J., Sikweyiya, Y., et al. (2007). Transactional sex with casual and main partners among young South Africa men in the rural Eastern Cape: Prevalence, predictors, and associations with gender-based violence. Social Science and Medicine, 65, 1235–1248.

    Article  PubMed  Google Scholar 

  • Feinstein, A. R. (1995). Meta-analysis: Statistical alchemy for the 21st century. Journal of Clinical Epidemiology, 48, 71–79.

    Article  PubMed  Google Scholar 

  • Fisher, J. C., Bang, H., & Kapiga, S. H. (2007). The association between HIV infection and alcohol use: A systematic review and meta-analysis of African studies. Sexually Transmitted Diseases, 34, 856–863.

    Article  PubMed  Google Scholar 

  • Fisher, J. C., Cook, P. A., Sam, N. E., Kapiga, S. H., & Saidi, H. (2008). Patterns of alcohol use, problem drinking, and HIV infection among high-risk African women. Sexually Transmitted Diseases, 35, 537–544.

    Article  PubMed  Google Scholar 

  • Fox, A. M., Jackson, S. S., Hansen, N. B., Gasa, N., Crewe, M., & Sikkema, K. J. (2007). In their own voices: A qualitative of women’s risk for intimate partner violence and HIV in South Africa. Violence Against Women, 13, 583–602.

    Article  PubMed  Google Scholar 

  • Fritz, K. E., Woelk, G. B., Bassett, M. T., McFarland, W. C., Routh, J. A., Tobaiwa, O., et al. (2002). The association between alcohol use, sexual risk behavior, and HIV infection among men attending beer halls in Harare, Zimbabwe. AIDS and Behavior, 6, 221–228.

    Article  Google Scholar 

  • Geibel, S., Luchters, S., King’ola, N., Nzioki, M. A., Esu-Williams, E., Rinyiru, A. B., et al. (2008). Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya. Sexually Transmitted Diseases, 35, 746–752.

    Article  PubMed  Google Scholar 

  • George, W. H., & Stoner, S. A. (2000). Understanding acute alcohol effects on sexual behavior. Annual Review of Sex Research, 11, 92–123.

    PubMed  Google Scholar 

  • Greig, F. E., & Koopman, C. (2003). Multilevel analysis of women’s empowerment and HIV prevention: Quantitative survey results from a preliminary study in Botswana. AIDS and Behavior, 7, 195–208.

    Article  PubMed  Google Scholar 

  • Gwati, B., Guli, A., & Todd, C. H. (1995). Risk factors for sexually transmitted disease amongst men in Harare, Zimbabwe. Central African Journal of Medicine, 41, 179–181.

    PubMed  Google Scholar 

  • Hargreaves, J. R., Morison, L. A., Chege, J., Rutenburg, N., Kahindo, M., Weiss, H. A., et al. (2002). Socioeconomic status and risk of HIV infection in an urban population in Kenya. Tropical Medicine & International Health, 7, 793–802.

    Article  Google Scholar 

  • Izugbara, C. O. (2005). ‘Ashawo suppose shine her eyes’: Female sex workers and sex work risks in Nigeria. Health, Risk, & Society, 7, 141–159.

    Article  Google Scholar 

  • Kalichman, S. C., & Simbayi, L. C. (2004). Sexual assault history and risks for sexually transmitted infections among women in an African township in Cape Town, South Africa. AIDS Care, 16, 681–689.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Cain, D., & Jooste, S. (2007). Alcohol expectancies and risky drinking among men and women at high-risk for HIV infection in Cape Town South Africa. Addictive Behaviors, 32, 2304–2310.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Jooste, S., & Cain, D. (2007). Frequency, quantity, and contextual use of alcohol among sexually transmitted infection clinic patients in Cape Town, South Africa. American Journal of Drug and Alcohol Abuse, 33, 687–698.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Jooste, S., Cain, D., & Cherry, C. (2006). Sensation seeking, alcohol use, and sexual behaviors among sexually transmitted infection clinic patients in Cape Town, South Africa. Psychology of Addictive Behaviors, 20, 298–304.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Kagee, A., Toefy, Y., Cain, D., & Cherry, C. (2006). Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Social Science and Medicine, 62, 1641–1649.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., Cherry, C., Jooste, S., et al. (2005). Gender attitudes, sexual violence, and HIV/AIDS risks among men and women in Cape Town, South Africa. Journal of Sex Research, 42, 299–305.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007). Alcohol use and sexual risks for HIV/AIDS in Sub-Saharan Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Vermaak, R., Jooste, S., & Cain, D. (2008). HIV/AIDS risks among men and women who drink at informal alcohol serving establishments (shebeens) in Cape Town, South Africa. Prevention Science, 9, 55–62.

    Google Scholar 

  • Kapiga, S. H., Lyamuya, E. F., Lwihula, G. K., & Hunter, D. J. (1998). The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania. AIDS, 12, 75–84.

    Article  PubMed  Google Scholar 

  • Kapiga, S. H., Sam, N. E., Mlay, J., Aboud, S., Ballard, R. C., Shao, J. F., et al. (2006). The epidemiology HIV-1 infection in northern Tanzania: Results from a community-based study. AIDS Care, 18, 379–387.

    Article  PubMed  Google Scholar 

  • Kapiga, S. H., Sam, N. E., Shao, J. F., Masenga, E. J., Renjifo, B., Kiwelu, I. E., et al. (2003). Herpes Simplex Virus Type 2 infection among bar and hotel workers in northern Tanzania: Prevalence and risk factors. Sexually Transmitted Diseases, 30, 187–192.

    Article  PubMed  Google Scholar 

  • Kapiga, S. H., Sam, N. E., Shao, J. F., Renjifo, B., Masenga, E. J., Kiwelu, I. E., et al. (2002). HIV-1 epidemic among female bar and hotel workers in Northern Tanzania: Risk factors and opportunities for prevention. Journal of Acquired Immune Deficiency Syndrome, 29, 409–417.

    Google Scholar 

  • Karamagi, C. A., Tumwine, J. K., Tylleskar, T., & Heggenhougen, K., (2006). Intimate partner violence against women in eastern Uganda: Implications for HIV prevention. BMC Public Health, 6, 284–296.

    Google Scholar 

  • Kayembe, K. P., Mapatano, M. A., Busangu, F. A., Nyandwe, K. J., Mashinda, K. D., Musema, M. G., et al. (2008). Correlates of ever had sex and recent sex among teenagers and young unmarried adults in the Democratic Republic of Congo. AIDS and Behavior, 12, 585–593.

  • Kiene, S. M., Simbayi, L. C., Abrams, A., Cloete, A., Tennen, H., & Fisher, J. D. (2008). High rates of unprotected sex occurring among HIV-positive individuals in a daily diary study in South Africa: The role of alcohol use. Journal of Acquired Immune Deficiency Syndrome, 42, 219–226.

    Article  Google Scholar 

  • King, G., Flisher, A. J., Noubary, F., Reece, R., Marais, A., & Lombard, C. (2004). Substance abuse and behavioral correlates of sexual assault among South African adolescents. Child Abuse and Neglect, 28, 683–696.

    Article  PubMed  Google Scholar 

  • Koenig, M. A., Lutaol, T., Zhao, F., Nalugoda, F., Kiwanuka, N., Wabwire-Managen, F., et al. (2004). Coercive sex in rural Uganda: Prevalence and associated risk factors. Social Science and Medicine, 58, 787–798.

    Article  PubMed  Google Scholar 

  • Lane, T., Shade, S. B., McIntyre, J., & Morin, S. F. (2008). Alcohol and sexual risk behavior among men who have sex with men in South African township communities. AIDS and Behavior, 12, 78–85.

    Google Scholar 

  • Langeni, T. (2003). Male circumcision and sexually transmitted infections in Botswana. Journal of Biosocial Science, 37, 75–88.

    Article  Google Scholar 

  • Leigh, B. C., & Stall, R. D. (1993). Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation, and prevention. American Psychologist, 48, 1035–1045.

    Article  PubMed  Google Scholar 

  • Lewis, J. J., Garnett, G. P., Mhlanga, S., Nyamukapa, C. A., Donnely, C. A., & Gregson, S. (2005). Beer halls as a focus for HIV prevention activities in rural Zimbabwe. Sexually Transmitted Diseases, 32, 364–369.

    Article  PubMed  Google Scholar 

  • Lugalla, J., Emmelin, M., Mutembei, A., Sima, M., Kwesigabo, G., Killewo, J., et al. (2004). Social, cultural, and sexual behavioral determinants of observed decline in HIV infection trends: Lessons from the Kagera region, Tanzania. Social Science and Medicine, 59, 185–198.

    Article  PubMed  Google Scholar 

  • Lugoe, W. L., & Klepp, K. I. (1996). Sexual debut and predictors of condom use among secondary school students in Arusha, Tanzania. AIDS Care, 8, 443–452.

    Article  PubMed  Google Scholar 

  • Lurie, M., Pronyk, P., de Moor, E., Heyer, A., de Bruyn, G., Struthers, H., et al. (2008). Sexual behavior and reproductive health among HIV-infection patients in urban and rural South Africa (2008). Journal of Acquired Immune Deficiency Syndrome, 47, 484–493.

    Google Scholar 

  • MacAndrew, C., & Edgerton, R. (1969). Drunken comportment: A social explanation. Oxford, England: Aldine. Retrieved July 22, 2009, from PsycINFO database.

  • Marandu, E. E., & Chamme, M. A. (2004). Attitudes towards condom use for prevention of HIV infection in Botswana. Social Behavior and Personality, 32, 491–510.

    Article  Google Scholar 

  • Mataure, P., McFarland, W., Fritz, K., Kim, A., Woelk, G., Ray, S., et al. (2002). Alcohol use and high-risk sexual behavior among adolescents and young adults in Harare, Zimbabwe. AIDS and Behavior, 6, 211–219.

    Article  Google Scholar 

  • Mbulaiteye, S. M., Ruberantwari, A., Nakiyingi, J. S., Carpenter, L. M., Kamali, A., & Whitworth, J. A. (2000). Alcohol and HIV: A study among sexually active adults in rural southwest Uganda. International Journal of Epidemiology, 29, 911–915.

    Article  PubMed  Google Scholar 

  • Mnyika, K. S., Klepp, K. I., Kvale, G., & Ole-Kinq’ori, N. (1997). Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania. International Journal of STD and AIDS, 8, 176–183.

    Article  PubMed  Google Scholar 

  • Moatti, J., Prudhomme, J., Traore, D. C., Julliet-Amari, A., Akribi, H. A., Msellati, P., et al. (2003). Access to antiretroviral treatment and sexual behaviors of HIV-infected patients aware of their serostatus in Cote d’Ivoire. AIDS, 17, S69–S77.

    Article  PubMed  Google Scholar 

  • Moore, S., Gullone, E., & McArthur, C. (2004). Risk taking and HIV/AIDS among people in Cameroon: Prediction of vulnerability using the Adolescent Risk-Taking Questionnaire. Social Behavior and Personality, 32, 209–222.

    Google Scholar 

  • Morojele, N. K., Kachieng’a, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D., Nkowane, A. M., et al. (2006). Alcohol use and sexual behavior among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science and Medicine, 62, 217–227.

    Article  PubMed  Google Scholar 

  • Morris, C. N., Levine, B., Goodridge, G., Luo, N., & Ashley, J. (2006). Three-country assessment of alcohol-HIV related policy and programmatic responses in Africa. African Journal of Drug & Alcohol Studies, 5, 170–184.

    Google Scholar 

  • Morrison, C. S., Sunkutu, M. R., & Glover, L. H. (1997). Sexually transmitted disease among married Zambian women: The role of male and female sexual behavior in prevention and management. Genitourintological Medicine, 73, 555–557.

    Google Scholar 

  • Msuya, S. E., Mbizvo, E., Hussain, A., Uriyo, J., Sam, N. E., & Stray-Pedersen, B. (2006). HIV among pregnant women in Moshi, Tanzania: The role of sexual behavior, male partner characteristics and sexually transmitted infections. AIDS Research and Therapy, 3. Retrieved November 5, 2006, from http://www.aidsrestherapy.com/content/3/1/27.

  • Mugisha, F., & Zulu, E. M. (2004). The influence of alcohol, drugs, and sexual relationships and perception of risk to HIV infection among adolescents in the informal settlements of Nairobi. Journal of Youth Studies, 7, 279–293.

    Article  Google Scholar 

  • Myer, L., Mathews, C., & Little, F. (2002). Condom use and sexual behaviors among individuals procuring free male condoms in South Africa: A prospective study. Sexually Transmitted Diseases, 29, 239–241.

    Article  PubMed  Google Scholar 

  • Ndinya-Achola, J. O., Ghee, A. E., Kihara, A. N., Krone, M. R., Plummer, F. A., Fisher, L. D., et al. (1997). High HIV prevalence, low condom use and gender differences in sexual behavior among patients with STD-related complaints at a Nairobi primary health care clinic. International Journal of STD and AIDS, 8, 506–514.

    Article  PubMed  Google Scholar 

  • Ortiz, D. J., Bing, E. G., Boyer, C., Russak, S. M., DeDues, F. J., & Ernesto, F. (2005). Evidence-based recommendations for prevention of human immunodeficiency virus and sexually transmitted infections in the Angolan armed forces: Challenges and opportunities at the end of 30 years of war. Military Medicine, 170, 327–332.

    PubMed  Google Scholar 

  • Saunders, J. B., Aasland, O. G., Baror, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791–804.

    Article  PubMed  Google Scholar 

  • Sawyer, K. M., Wechsberg, W. M., & Myers, B. J. (2006). Cultural similarities and differences between a sample of Black/African and Colored women in South Africa: Convergence of risk related to substance use, sexual behavior, and violence. Women and Health, 43, 73–92.

    Article  Google Scholar 

  • Sebit, M. B., Tombe, M., Siziya, S., Balus, S., Nkomo, S. D., & Maramba, P. (2003). Prevalence of HIV/AIDS and psychiatric disorders and their related risk factors among adults in Epworth, Zimbabwe. East African Medical Journal, 80, 503–512.

    Google Scholar 

  • Seloilwe, E. S. (2005). Factors that influence the spread of HIV/AIDS among students of the University of Botswana. JANAC: Journal of the Association of Nurses in AIDS Care, 16, 3–10.

    PubMed  Google Scholar 

  • Simbayi, L. C., Kalichman, S. C., Cain, D., Cherry, C., Jooste, S., & Mathiti, V. (2006). Alcohol and risks for HIV/AIDS among sexually transmitted infection clinic patients in Cape Town, South Africa. Substance Abuse, 27, 37–43.

    Article  PubMed  Google Scholar 

  • Simbayi, L. C., Kalichman, S. C., Jooste, S., Cherry, C., Mfecane, S., & Cain, D. (2005). Risk factors for HIV/AIDS among youth in Cape Town, South Africa. AIDS and Behavior, 9, 53–61.

    Article  PubMed  Google Scholar 

  • Simbayi, L. C., Kalichman, S. C., Jooste, S., Mathiti, V., Cain, D., & Cherry, C. (2004). Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Town, South Africa. Journal of Studies on Alcohol, 65, 434–442.

    PubMed  Google Scholar 

  • Simbayi, L. C., Mwaba, K., & Kalichman, S. C. (2006). Perceptions of the combination of HIV AIDS and alcohol as a risk factor among STI clinic attenders in South Africa: Implications for HIV prevention. Social Behavior and Personality, 34, 535–544.

    Article  Google Scholar 

  • Sorrell, J. B., & Raffaelli, M. (2005). An exploratory study of constructions of masculinity, sexuality, and HIV/AIDS in Namibia, Southern Africa. Culture, Health, and Sexuality, 7, 585–598.

    Article  Google Scholar 

  • Steele, C. M., & Josephs, R. A. (1990). Alcohol myopia: Its prized and dangerous effects. American Psychologist, 45, 921–933.

    Article  PubMed  Google Scholar 

  • St. Lawrence, J. S., Klaskala, W., Kankasa, C., West, J. T., Mitchell, C. D. & Wood, C. (2006). Factors associated with HIV prevalence in a pre-partum cohort of Zambian women. International Journal of STD and AIDS, 17, 607–613.

  • Taffa, N., Klepp, K. I., Sundby, J., & Bjune, G. (2002). Psychosocial determinants of sexual activity and condom use intention among youth in Addis Ababa, Ethiopia. International Journal of STD and AIDS, 10, 714–719.

    Google Scholar 

  • Talbot, E. A., Kenyon, T. A., Moeti, T. L., Hsin, G., Dooley, L., El-Halabi, S., et al. (2002). HIV risk factors among patients with tuberculosis-Botswana 1999. International Journal of STD and AIDS, 13, 311–317.

    Article  PubMed  Google Scholar 

  • Tassiopoulos, K. K., Seage, G. R., Sam, N. E., Ao, T. T., Masenga, E. J., Highes, M. D., et al. (2006). Sexual behavior, psychosocial and knowledge differences between consistent, inconsistent and non-users of condoms: A study of female bar and hotel workers in Moshi, Tanzania. AIDS and Behavior, 10, 405–413.

    Article  PubMed  Google Scholar 

  • Tassiopoulos, K. K., Seage, G. R., Sam, N. E., Kiwelu, I., Shao, J., Ao, T. T., et al. (2007). Predictors of herpes simplex virus type 2 prevalence and incidence among bar and hotel workers in Moshi, Tanzania. Journal of Infectious Diseases, 195, 493–501.

    Article  PubMed  Google Scholar 

  • Taylor, M., Dlamini, S. B., Kaogoro, H., Jinabhai, C. C., & de Vries, H. (2003). Understanding high school students’ risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu, South Africa. Journal of School Health, 73, 97–100.

    Article  PubMed  Google Scholar 

  • Tengia-Kessy, A., Msamanga, G. I., & Moshiro, C. S. (1998). Assessment of behavioural risk factors associated with HIV infection among youth in Moshi Rural District, Tanzania. East African Medical Journal, 75, 528–532.

    PubMed  Google Scholar 

  • UNAIDS. (2006). 2006 Report on the global AIDS epidemic. Retrieved September 22, 2006, from http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp.

  • Van der Straten, A., King, R., Grinstead, O., Vittinghoff, E., Serufilira, A., & Allen, S. (1998). Sexual coercion, physical violence, and HIV infection among women in steady relationships in Kigali, Rwanda. AIDS and Behavior, 2, 61–73.

    Article  Google Scholar 

  • Weinhardt, L. S., & Carey, M. P. (2000). Does alcohol lead to sexual risk behavior? Findings from event-level research. Annual Review of Sex Research, 11, 125–157.

    PubMed  Google Scholar 

  • Weiser, S. D., Leiter, K., Heisler, M., McFarland, W., Percy-de Korte, F., DeMonner, S. M., et al. (2006). A population-based study on alcohol and high-risk sexual behaviors in Botswana. PLoS Medicine, 10, e392–e401. Retrieved November 5, 2006, from http://medicine.plosjournals.org/perlserv/?request=getdocument&doi=10.1371/journal.pmed.0030392.

  • WHO Global Status Report on Alcohol: Africa Region (2004). Retrieved February 18, 2007, from http://www.who.int/substance_abuse/publications/globalstatusreportalcoholprofiles/en/index.html.

  • Wilsnack, R. W., Vogeltanz, N. D., Wilsnack, S. C., & Harris, T. R. (2000). Gender differences in alcohol consumption and adverse drinking consequences: Cross-cultural patterns. Addiction, 95, 251–265.

    Article  PubMed  Google Scholar 

  • Wilson, D., Sibanda, B., Mboyi, L., Msimanga, S., & Dube, G. (1990). A pilot study for an HIV prevention programme among commercial sex workers in Bulawayo, Zimbabwe. Social Science and Medicine, 31(5), 609–618.

    Google Scholar 

  • Wojcicki, J. (2002). “She drank his money”: Survival sex and the problem of violence in taverns in Gauteng province, South Africa. Medical Anthropology Quarterly, 16, 267–293.

    Article  PubMed  Google Scholar 

  • Wolff, B., Busza, J., Bufumbo, L., & Whitworth, J. (2006). Women who fall by the roadside: Gender, sexual risk, and alcohol in rural Uganda. Addiction, 101, 1277–1284.

    Article  PubMed  Google Scholar 

  • Wong, F., Huang, Z., DiGangi, J., Thompson, E., & Smith, B. (2008). Gender differences in intimate partner violence on substance abuse, sexual risks, and depression among a sample of South Africans in Cape Town, South Africa. AIDS Education and Prevention, 20(1), 56–64.

    Google Scholar 

  • Woolf, S. E., & Maisto, S. A. (2008). Alcohol use and risk of HIV infection among men who have sex with men. AIDS and Behavior. doi: 10.1007/s10461-007-9354-0.

  • Yadav, G., Saskin, R., Ngugi, E., Kimani, J., Keli, F., Fonck, K., et al. (2005). Associations of sexual risk taking among Kenyan female sex workers after enrollment in an HIV-1 prevention trial. Journal of Acquired Immune Deficiency Syndrome, 38, 329–334.

    Google Scholar 

  • Zablotska, I. B., Gray, R. H., Koenig, M. A., Serwadda, D., Nalugoda, F., Kigozi, G., et al. (2007). Alcohol use, intimate partner violence, sexual coercion and HIV among women aged 15-24 in Rakai, Uganda. AIDS and Behavior, 13, 225–233.

  • Zablotska, I. B., Gray, R. H., Serwadda, D., Nalugoda, F., Kigozi, G., Sewankambo, N., et al. (2006). Alcohol use before sex and HIV acquisition: A longitudinal study in Rakai, Uganda. AIDS, 20, 1191–1196.

    Article  PubMed  Google Scholar 

  • Zachariah, R., Spielmann, M. P., Harries, A. D., Nkhoma, W., Chantulo, A., & Arendt, V. (2003). Sexually transmitted infections and sexual behavior among commercial sex workers in a rural district of Malawi. International Journal of STD and AIDS, 14, 185–188.

    Article  PubMed  Google Scholar 

  • Zimba, R. F. (1995). Secondary school students’ risks that may promote HIV infection and the spread of AIDS: A Namibian study. School Psychology International, 16, 67–78.

    Article  PubMed  Google Scholar 

  • Zuma, K., Gouws, E., Williams, B., & Lurie, M. (2003). Risk factors for HIV infection among women in Carletonville, South Africa: Migration, demography and sexually transmitted diseases. International Journal of STD and AIDS, 14, 814–817.

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported in part by National Research Service Award F31 AA017076 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and Senior Scientist Research and Mentoring Award K05 AA16928, also from NIAAA.

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  1. Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244, USA

    Sarah E. Woolf-King & Stephen A. Maisto

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  1. Sarah E. Woolf-King
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  2. Stephen A. Maisto
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Correspondence to Sarah E. Woolf-King.

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Woolf-King, S.E., Maisto, S.A. Alcohol Use and High-Risk Sexual Behavior in Sub-Saharan Africa: A Narrative Review. Arch Sex Behav 40, 17–42 (2011). https://doi.org/10.1007/s10508-009-9516-4

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