Alcohol and condom use among HIV-positive and HIV-negative female sex workers in Nagaland, India

Abstract

This study examines the relationship between alcohol use, HIV status, and condom use among female sex workers in Nagaland, India. We analyzed data from a cross-sectional survey undertaken in 2009, using descriptive and multivariate statistics. Out of 417 female sex workers, one-fifth used alcohol daily and one-tenth were HIV-positive. HIV-positive female sex workers were more likely than HIV-negative female sex workers to consume alcohol daily (30.2% vs. 18.0%). HIV-positive daily alcohol users reported lower condom use at last sex with regular clients compared to HIV-positive non-daily alcohol users (46.2% vs. 79.3%), a relationship not evident among HIV-negative female sex workers. There is a need to promote awareness of synergies between alcohol use and HIV, and to screen for problematic alcohol use among female sex workers in order to reduce the spread of HIV.

HIV, Hepatitis C, and Abstinence from Alcohol Among Injection and Non-injection Drug Users

“…However, HIV was associated with reduced likelihood of abstinence (i.e., greater risk of drinking) in the sample of non-injection drug users. Although we are not aware of any prior studies assessing the association between HIV and abstinence from alcohol among non-injection drug users, this association between HIV infection and higher likelihood of drinking is consistent with several studies in non-drug using samples [21–23]. This suggests that non-injection drug users with HIV may be particularly at risk for drinking-related medical problems (e.g., impaired liver function, reduced medication adherence).…”

“…However, whether drug users with HIV or HCV are more likely to limit drinking due to these risks remains unclear. Several studies not focused on drug users [17–23] and one study in injection drug users [24] suggest that individuals with HIV drink as much or more than those without HIV. Although some studies not targeting drug users show that HCV patients reduce drinking after being informed that they have HCV [25, 26], others show that they are still more likely to drink [27] and have alcohol use disorders [28] than those without HCV.…”

Correlates of HIV prevalence among female sex workers in four north and east Indian states: findings of a national bio-behavioural survey

“…9 High levels of consistent condom use and last time condom use by FSWs in the study states could be attributed to the growing awareness of HIV prevention because of the NACP's and the civil society's interventions in this regard. 28 Although both alcohol consumption and migration are linked to HIV positivity, as they promote high-risk behaviours and reduced condom use, 29,30 this study did not find similar linkages. In addition to the possibility of FSWs not following these practices in conformance to the patriarchal social structures and the tabooed nature of these practices in the study states, low reported levels of these behaviours could also be due to social desirability bias during the survey process.…”

Alcohol Use and Experiences of Partner Violence Among Female Sex Workers in Coastal Andhra Pradesh, India

“…Previous research in Africa (Pack, L’engle, Mwarogo, & Kingola, 2013; Schwitters et al, 2015), China (Zhang et al, 2013; Zhang et al, 2015), and Mongolia (Carlson et al, 2012) has shown that alcohol consumption by FSWs or their sexual partners contributes to higher rates of physical abuse. Although only about 2% of the general female population in India drinks alcohol (International Institute for Population Sciences & Macro International, 2007), alcohol consumption is more common among FSWs (Alexander et al, 2014; Nuken, Kermode, Saggurti, Armstrong, & Medhi, 2013; Samet et al, 2010). In four South Indian states with high HIV prevalence, including Andhra Pradesh, 62% of FSWs reported drinking alcohol in the past month, often prior to having sex (Verma, Saggurti, Singh, & Swain, 2010).…”