Alcohol Use and Risky Sex Among HIV-Infected Female Sex Workers and Clients in India

Unprotected heterosexual transactional sex plays a central role in the spread of HIV in India. Given alcohol’s association with risky sex in other populations and alcohol’s role in HIV disease progression, researchers from BUSM and BUSPH investigated patterns of alcohol use in HIV-infected FSWs and HIV-infected male clients of FSWs in Mumbai.

Their analyses identified factors associated with heavy alcohol use and evaluated the relationship between alcohol use and risky sex. They surveyed 211 female and 205 male individuals; 80/211 FSWs (38 percent) and 127/205 male clients (62 percent) drank alcohol in the last 30 days. Among females, 32 and 11 percent drank heavily and were alcohol-dependent, respectively; among males the respective proportions were 44 and 29 percent. According to the researchers men’s heavy alcohol use was significantly associated with inconsistent condom use over the last year, however a comparable association was not seen in women.

“These findings suggest a need to address alcohol use both to avoid the medical complications of its heavy use in this population and to mitigate inconsistent condom use, the latter issue possibly requiring gender specific approaches,” said lead author Jeffrey Samet, MD, MA, MPH, a professor of medicine at BUSM. “Such efforts to reduce drinking could be an important dimension to secondary HIV prevention in India,” he added. These findings currently appear on-line in AIDS and Behavior.

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