Citation

Bonner CP, Browne FA, Ndirangu JW, Howard B, Zule WA, Speizer IS, Kline T, Wechsberg WM. AIDS Care 2019; ePub(ePub): 1-7.

Affiliation

Psychiatry and Behavioral Sciences , Duke University School of Medicine , Durham , NC , USA.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/09540121.2019.1595512

PMID

30939899

Abstract

OBJECTIVE: South Africa has the highest prevalence of HIV among women, the highest prevalence of gender-based violence (GBV), and the highest rates of per capita alcohol consumption in the world. The nuanced associations between GBV, alcohol misuse, and HIV must be explored and protective factors identified. This study examines the associations between physical and sexual GBV and HIV infection and explores how alcohol misuse and sexual agency may mediate the GBV-HIV association.

METHOD: Participants were 361 Black African women (Mean age=28.39, SD = 7.92) who reported using alcohol and/or drugs weekly in the past 3 months, engaging in condomless sex, and having a boyfriend. Women were recruited from disadvantaged communities in Pretoria, South Africa. Individuals who met the eligibility criteria and enrolled in the study consented and completed a computer-assisted personal interview assessing GBV, alcohol misuse, and sexual agency and underwent HIV testing (i.e., blood test).

RESULTS: The indirect effect of physical assault on HIV status at enrollment through alcohol misuse was significant (log odds = 0.23, SE = 0.12, 95% CI [0.0151, 0.4998]).

CONCLUSIONS: HIV prevention efforts focusing on reducing alcohol misuse may be more effective, which might reduce the HIV burden among this group of vulnerable South African women.

Language: en

Keywords

Alcohol abuse; HIV; South Africa; empowerment; protective factors; sexual negotiation; women