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Randomized Controlled Trial
. 2014 Jul 1:140:198-204.
doi: 10.1016/j.drugalcdep.2014.04.022. Epub 2014 May 5.

Alcohol use disorder, contexts of alcohol use, and the risk of HIV transmission among South African male patrons of shebeens

Lori A J Scott-Sheldon  1 , Kate B Carey  2 , Michael P Carey  3 , Demetria Cain  4 , Leickness C Simbayi  5 , Seth C Kalichman  4
Affiliations
Randomized Controlled Trial

Alcohol use disorder, contexts of alcohol use, and the risk of HIV transmission among South African male patrons of shebeens

Lori A J Scott-Sheldon et al. Drug Alcohol Depend. .

Abstract

Background: Shebeens in South Africa are settings in which alcohol use and sexual behavior often co-occur. The prevalence of alcohol use disorder (AUD), and the association between AUD, situations and settings, and sexual risk behavior, in shebeens remains unknown.

Methods: Men (n=763; mean age=30; 98% Black African) were recruited from townships in Cape Town, South Africa and completed a self-administered survey that assessed alcohol use, sexual risk behaviors, and situations and settings of alcohol use. The Alcohol Use Disorder and Associated Disabilities Interview Schedule DSV-IV Version (AUDADIS-IV) was used to identify the likelihood of AUD. Bivariate regression analyses assessed whether screening for AUD predicted sexual risk behaviors. Multivariate regression analyses examined whether AUD and/or situations/settings predicted risk behaviors.

Results: Nearly two-thirds of men (62%) endorsed sufficient criteria for AUD; 25%, 17%, and 20% were classified as having a mild, moderate, or severe AUD, respectively. AUD was associated with HIV risk such that men with AUD reported more unprotected sex than men without AUD. Analyses indicated that (a) individual (i.e., AUD) and (b) settings (i.e., frequency of having sex with a partner in a shebeen, tavern, or bottle store) interacted to predict unprotected sex.

Conclusions: The prevalence of AUD among shebeen patrons was high and was associated with unprotected sex. Findings suggest the need to integrate both individual and situational/setting factors to prevent HIV among patrons of shebeens.

Keywords: Alcohol use disorder; HIV; Risky sex; Shebeens; South Africa; Unprotected sex.

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Conflict of interest statement

Conflict of Interest

All authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Proportion of Unprotected Sex by AUD Severity
Figure 2
Figure 2
Proportion of Unprotected Sex by AUD and Setting
See this image and copyright information in PMC

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