Intoxication before last sexual intercourse and HIV risk behavior among men and women in Uganda: Evidence from a nationwide survey.
AIMS: To establish the prevalence of intoxication before sex and its association with risky sexual behavior.  DESIGN: The data were from the 2006 Uganda Demographic and Health Survey which had been designed for a cross-sectional descriptive study.  SETTING: The study covered the whole country-Uganda.  PARTICIPANTS: The respondents were 6,253 women and 1,804 men who had ever had sex.  MEASUREMENTS: The key independent variable was intoxication before last sexual intercourse while the major outcome variables were condom use and sex with non-regular partners. Weighted prevalence of intoxication was computed and multivariable logistic regression was applied to assess the independent association of intoxication with risky sexual behavior.  FINDINGS: Twelve percent of men and 16% of women reported having been intoxicated before last sexual intercourse. Of the women who reported intoxication before last sexual intercourse, 78% said it was their partners who were intoxicated. Of the men who reported intoxication, 83% said it was they themselves who were intoxicated. Intoxication of the men was associated with having sex with non-regular partners (OR=1.78, 95%CI: 1.04-3.03) and having unprotected sex (OR=1.71, 95%CI: 1.07-2.73). Women who were intoxicated were less likely to have been with non-regular partners (OR=0.55, 95%CI: 0.32-0.95). The women whose partners were intoxicated before last sexual intercourse were more likely to report having had unprotected sex (OR=1.55, 95%CI: 1.12-2.15).  CONCLUSION: HIV prevention mechanisms should address intoxication before sex. More effort is needed to find ways of helping women avoid unprotected sex with intoxicated partners.
Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences.
Nazarius Mbona
NM
Tumwesigye
Rhoda K
RK
Wanyenze
Tom K
TK
Greenfield