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Alcohol Consumption and Sexual Risk Behavior in an Aging Population in Rural South Africa

Abstract

We sought to characterize the relationship between alcohol consumption and sexual risk-taking in an aging population in rural South Africa. A cross-sectional analysis was conducted using baseline data from the Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community (HAALSI) cohort. We elicited information on sexual risk behavior and self-reported frequency of alcohol consumption among 5059 adults  ≥ 40 years old. Multivariable models showed that more frequent alcohol consumption is associated with a higher number of sexual partners (β: 1.38, p < .001) and greater odds of having sex for money (OR: 42.58, p < .001) in older adults in South Africa. Additionally, daily drinkers were more likely to have sex without a condom (OR: 2.67, p = .01). Older adults who drank more alcohol were more likely to engage in sexual risk-taking. Behavioral interventions to reduce alcohol intake should be considered to reduce STI and HIV transmission.

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Acknowledgements

The Agincourt HDSS was supported by the Welcome Trust, UK (058893/Z/99/A, 069683/Z/02/Z, 085477/Z/08/Z and085477/B/08/Z), the University of the Witwatersrand and South African Medical Research Council. We would also like to thank the field research in HAALSI and the Agincourt HDSS, including field staff, analysts, and the study participants themselves.

Funding

This work was funded by a Grant from the National Institute on Aging of the National Institutes of Health (P01 AG041710), HAALSI – Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa). The funder took no part in the study design, in the data-collection, analysis, interpretation of the results and writing the research article. The HAALSI study is located within the Agincourt Health and socio-Demographic Surveillance System site, funded by the University of the Witwatersrand and Medical Research Council, South Africa, and the Wellcome Trust, UK (058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z). TB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the Wellcome Trust; and from NICHD of NIH (R01-HD084233), NIA of NIH (P01-AG041710), NIAID of NIH (R01-AI124389 and R01-AI112339) as well as FIC of NIH (D43-TW009775). JMG was supported by Grant Number T32 AI007433 from the National Institute of Allergy and Infectious Diseases. The contents of this research are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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LM, XGO, KK, ST, TB and LB were involved in collecting the data. JMG and RV participated in the study design. RV conducted the analysis. All authors contributed regarding the writing and revision of the manuscript. All authors read and gave approval regarding the final manuscript.

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Correspondence to Rebecca A. de Vlieg.

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The authors have no conflicts of interests to declare.

Ethical Approval

Ethical approval for this study was granted by the University of Witwatersrand (#M141159), the Harvard T.H. Chan School of Public Health (#13-1608), and the Mpumalanga Provincial Research and Ethics Committee.

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de Vlieg, R.A., van Empel, E., Montana, L. et al. Alcohol Consumption and Sexual Risk Behavior in an Aging Population in Rural South Africa. AIDS Behav 25, 2023–2032 (2021). https://doi.org/10.1007/s10461-020-03132-5

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Keywords

  • Sexual risk behavior
  • Alcohol
  • HIV
  • Older adults