title: Bringing it home: community survey of HIV risks to primary sex partners of men and women in alcohol-serving establishments in Cape Town, South Africa.
abstract: BACKGROUND
  Concurrent sexual relationships facilitate the spread of HIV infection, and sex with non-primary partners may pose particularly high risks for HIV transmission to primary partners.
  
  
  OBJECTIVE
  We examined the sexual and alcohol-related risks associated with sex partners outside of primary relationships among South African men and women in informal drinking establishments.
  
  
  METHODS
  Men (n=4959) and women (n=2367) with primary sex partners residing in a Xhosa-speaking South African township completed anonymous surveys. Logistic regressions tested associations between having outside partners and risks for sexually transmitted infections (STI)/HIV.
  
  
  RESULTS
  Forty-four percent of men and 26% women with primary sex partners reported also having outside sex partners in the previous month. Condom use with outside partners was inconsistent for men and women; only 19% of men and 12% of women used condoms consistently with outside sex partners. Multivariable regressions for men and women showed that having outside partners was significantly associated with having been diagnosed with an STI, consuming alcohol in greater frequency and quantity, alcohol use during sex, meeting sex partners in alcohol-serving venues, and higher rates of unprotected sex.
  
  
  CONCLUSIONS
  Having outside sex partners was associated with multiple risk factors for HIV infection among South African shebeen patrons. Social and structural interventions that encourage condom use are needed for men and women with outside partners who patronise alcohol-serving venues.
authors.affiliation: Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT 06269, USA. seth.k@uconn.edu
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Eileen
authors.initials: E
authors.lastname: Pitpitan
authors.forename: Lisa
authors.initials: L
authors.lastname: Eaton
authors.forename: Demetria
authors.initials: D
authors.lastname: Cain
authors.forename: Kate B
authors.initials: KB
authors.lastname: Carey
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carey
authors.forename: Ofer
authors.initials: O
authors.lastname: Harel
authors.forename: Vuyelwa
authors.initials: V
authors.lastname: Mehlomakhulu
authors.forename: Leickness Chisamu
authors.initials: LC
authors.lastname: Simbayi
authors.forename: Kelvin
authors.initials: K
authors.lastname: Mwaba
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012725:Sexual Behavior; D013019:South Africa; D011795:Surveys and Questionnaires; D055815:Young Adult