title: Factors associated with problem drinking among women employed in food and recreational facilities in northern Tanzania.
abstract: BACKGROUND
  There is growing evidence that alcohol consumption is associated with increased risk of HIV infection. To determine factors associated with problem drinking, we analyzed data collected in two prospective cohorts of at-risk female food and recreational facility workers in northern Tanzania.
  
  
  METHODS
  We enrolled HIV seronegative women aged 18-44 years and employed in the towns of Geita, Kahama, Moshi, and Shinyanga. At enrolment, women were interviewed to obtain information about alcohol use, using CAGE and AUDIT screening scales, and risk factors for HIV infection. Blood and genital samples were collected for detection of HIV and sexually transmitted infections (STIs). We characterized alcohol use, concordance, and agreement of the scales, and examined the associations between characteristics of participants and problem drinking as defined by both scales using logistic regression. Lastly, we assessed problem drinking as a risk factor for recent sexual behavior and prevalent STIs.
  
  
  RESULTS
  Among enrollees, 68% women reported ever drinking alcohol; of these 76% reported drinking alcohol in the past 12 months. The prevalence of problem drinking was 20% using CAGE and 13% using AUDIT. Overall concordance between the scales was 75.0% with a Kappa statistic of 0.58. After adjusting for age, independent factors associated with problem drinking, on both scales, were marital status, occupation, facility type, increasing number of lifetime sexual partners, and transactional sex in the past 12 months. In addition, women who were problem drinkers on either scale were more likely to report having ≥ 1 sexual partner (CAGE: aOR = 1.56, 95% confidence interval, CI: 1.10-2.23;
  aOR = 2.00, 95% CI: 1.34-3.00) and transactional sex (CAGE: aOR = 1.79, 95% CI: 1.26-2.56;
  aOR = 1.51, 95% CI: 1.04-2.18), in the past 3 months.
  
  
  CONCLUSIONS
  These findings suggest that interventions to reduce problem drinking in this population may reduce high-risk sexual behaviors and contribute in lowering the risk of HIV infection.
authors.affiliation: Mwanza Intervention Trials Unit, Mwanza, Tanzania.
authors.forename: Aika S
authors.initials: AS
authors.lastname: Mongi
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.affiliation: Mwanza Intervention Trials Unit, Mwanza, Tanzania ; London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Trong Thanh-Hoang
authors.initials: TT
authors.lastname: Ao
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: Joseph
authors.initials: J
authors.lastname: Chilongani
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Aura
authors.initials: A
authors.lastname: Aguirre-Andreasen
authors.affiliation: Mwanza Intervention Trials Unit, Mwanza, Tanzania ; London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Suzanna C
authors.initials: SC
authors.lastname: Francis
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Shao
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Hayes
authors.affiliation: Mwanza Intervention Trials Unit, Mwanza, Tanzania ; London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Saidi
authors.initials: S
authors.lastname: Kapiga
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000503:physiopathology; D000437:Alcoholism / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D019649:Food Industry; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011446:Prospective Studies; D011998:Recreation; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology*; D013636:Tanzania / Q000453:epidemiology