title: Alcohol abuse, sexual risk behaviors, and sexually transmitted infections in women in Moshi urban district, northern Tanzania.
abstract: BACKGROUND
  To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs).
  
  
  METHODS
  Two thousand and nineteen women aged 20 to 44 were randomly selected in a 2-stage sampling from the Moshi urban district of northern Tanzania. Participant's demographic and socio-economic characteristics, alcohol use, sexual behaviors, and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas, and mycoplasma genitalium infections.
  
  
  RESULTS
  Adjusted analyses showed that a history of physical (OR = 2.05; 95% CI: 1.06-3.98) and sexual violence (OR = 1.63; 95% CI: 1.05-2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR = 1.66; 95% CI: 1.01-2.73). Women who abused alcohol were more likely to report STIs symptoms (OR = 1.61; 95% CI: 1.08-2.40). Women who had multiple sexual partners were more likely to have an STI (OR = 2.41; 95% CI: 1.46-4.00) compared to women with 1 sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR = 0.86; 95% CI: 0.55-1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners.
  
  
  CONCLUSIONS
  The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs.
authors.affiliation: Harvard University School of Public Health, Boston, Massachusetts, USA. musie@jimmy.harvard.edu
authors.forename: Musie
authors.initials: M
authors.lastname: Ghebremichael
authors.forename: Elijah
authors.initials: E
authors.lastname: Paintsil
authors.forename: Ulla
authors.initials: U
authors.lastname: Larsen
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult