Density of Drinking Establishments and HIV Prevalence in a Migrant Town in Namibia

Nichols, Brooke E; Nkalamo, Davies; Whitcomb, Brian W.

doi:10.1007/s10461-011-9956-4

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…This finding is consistent with previous studies linking alcohol outlet density to prevalent STI among adults (13–16), and to risk factors for STI, like binge drinking and intimate partner violence. (33, 34) Further, the use of individual-level HSV-2 biological data strengthens inference over prior ecological studies (13–15) and studies with self-reported STI outcomes. (16) We also estimated the predicted population-level HSV-2 prevalence across a range of alcohol outlet exposure levels, exploring the potential benefits of interventions to limit exposure to alcohol outlets.…”

Section: Discussionsupporting

confidence: 60%

“…Alcohol outlet accessibility is associated with increased measures of population-level (13–15) and individual-level (16) sexually transmitted infections (STIs). However, the relationship between alcohol outlet accessibility and sexual risk has been underexplored in areas outside of the United States and entirely unexplored in adolescent-specific populations that are at heightened risk for STI.…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Community-Level Alcohol Outlet Accessibility and Individual-Level Herpes Simplex Virus Type 2 Infection Among Young Women in South Africa

Rosenberg¹,

Pettifor²,

Lippman³

et al. 2015

Sexually Transmitted Diseases

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Background Exposure to alcohol outlets may influence sexual health outcomes at the individual- and community-level. Visiting alcohol outlets facilitates alcohol consumption and exposes patrons to a risky environment and network of potential partners, while presence of alcohol outlets in the community may shift social acceptance of riskier behavior. We hypothesize that living in communities with more alcohol outlets is associated with increased sexual risk. Methods We performed a cross-sectional analysis in a sample of 2,174 South African schoolgirls (ages 13–21) living across 24 villages in the rural Agincourt sub-district, underpinned by long-term health and socio-demographic surveillance. To examine the association between number of alcohol outlets in village of residence and individual-level prevalent HSV-2 infection, we used generalized estimating equations with logit links, adjusting for individual- and village-level covariates. Results The median number of alcohol outlets per village was three (range zero to seven). HSV-2 prevalence increased from villages with no outlets [1.4%, (95% CI: 0.2, 12.1)], to villages with one to four outlets [4.5% (3.7, 5.5)], to villages with more than four outlets [6.3% (5.6, 7.1)]. An increase of one alcohol outlet per village was associated with an 11% increase in odds of HSV-2 infection [adjusted odds ratio (95% CI): 1.11 (0.98, 1.25)]. Conclusions Living in villages with more alcohol outlets was associated with increased prevalence of HSV-2 infection in young women. Structural interventions and sexual health screenings targeting villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Relationship Between Community-Level Alcohol Outlet Accessibility and Individual-Level Herpes Simplex Virus Type 2 Infection Among Young Women in South Africa

Rosenberg¹,

Pettifor²,

Lippman³

et al. 2015

Sexually Transmitted Diseases

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“…One study across neighborhoods in Namibia showed that higher density of drinking establishments was associated with higher prevalence of HIV (6). Similar to disparities in HIV, research suggests that alcohol venues are concentrated in disadvantaged minority and lower-income neighborhoods (7).…”

Section: What Are the Hiv Risk Factors In Alcohol Venues?mentioning

confidence: 99%

Reducing HIV Risks in the Places Where People Drink: Prevention Interventions in Alcohol Venues

Pitpitan

Kalichman

2015

AIDS Behav

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Apart from individual alcohol drinking behavior, the context or places where people drink play a significant role in HIV transmission risk. In this paper, we review the research that has been conducted on alcohol venues to identify the social and structural factors (e.g., social norms, sexual behavior) that are associated with HIV risk in these places, to review HIV prevention interventions based in alcohol venues, and to discuss appropriate methodologies for alcohol venue research. Alcohol venues are defined here as places that sell or serve alcohol for onsite consumption, including bars, bottle stores, nightclubs, wine shops, and informal shebeens. Despite the many established HIV risk factors at play in alcohol venues, limited prevention strategies have been implemented in such places. A total of 11 HIV prevention interventions or programs were identified. HIV prevention interventions in alcohol venues may be conducted at the individual, social, or structural level. However, multilevel interventions that target more than one level appear to lead to the most sustainable behavior change. Strategies to incorporate alcohol venues in biomedical prevention strategies including antiretroviral therapy for alcohol users are also discussed.

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“…Similarly, there is a high prevalence of HIV in areas that have a high density of bars 24 . It is likely that the prevalence of HIV among bar customers, employees and neighbours of bars in slums is high due to the high risk sexual behaviour, low risk perception of sex with commercial sex workers and inconsistent condom use observed among individuals at bars in slums 21 , 25 , 26 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of HIV infection and bacteriologically confirmed tuberculosis among individuals found at bars in Kampala slums, Uganda

Baluku

Anguzu

Nassozi

et al. 2020

Sci Rep

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Individuals found at bars in slums have several risk factors for HIV and tuberculosis (TB). To determine the prevalence of HIV and TB among individuals found at bars in slums of Kampala, Uganda, we enrolled adults found at bars that provided written informed consent. Individuals with alcohol intoxication were excluded. We performed HIV testing using immunochromatographic antibody tests (Alere Determine HIV-1/2 and Chembio HIV 1/2 STAT-PAK). TB was confirmed using the Xpert MTB/ RIF Ultra assay, performed on single spot sputum samples. We enrolled 272 participants from 42 bars in 5 slums. The prevalence of HIV and TB was 11.4% (95% CI 8.1-15.8) and 15 (95% CI 6-39) per 1,000 population respectively. Predictors of HIV were female sex (aOR 5.87, 95% CI 2.05-16.83), current cigarette smoking (aOR 3.23, 95% CI 1.02-10.26), history of TB treatment (aOR 10.19, 95% CI 3.17-32.82) and CAGE scores of 2-3 (aOR 3.90, 95% CI 1.11-13.70) and 4 (aOR 4.77, 95% CI 1.07-21.35). The prevalence of HIV and TB was twice and four times the national averages respectively. These findings highlight the need for concurrent programmatic screening for both HIV and TB among high risk populations in slums. HIV and tuberculosis (TB) interact at an epidemiological, clinical, cellular, and molecular level to create a coepidemic 1. In 2018, HIV contributed 251,000 of the 1.2 million TB deaths while TB was the leading cause of death among HIV positive individuals 2,3. Notwithstanding, an estimated 3 million TB cases were missed in 2018 and only 79% of HIV-positive individuals knew their HIV status 2,3. To increase the detection of TB and HIV, it is important to target high risk and vulnerable populations through active community based screening strategies 4-6. Slum dwellers have a higher risk for HIV, TB and HIV/TB co-infection than the national averages 7,8. However, slum dwellers are less likely to utilise health services for HIV and TB diagnosis and have a low level of knowledge regarding prevention strategies for either disease 9,10. The low utilisation is partly attributed to the perceived poor quality of services at public facilities and thus high risk groups are not covered by facility based screening strategies 11,12. Within slum settlements, bars and social drinking places carry the highest risk for TB transmission than other social gathering places such as churches, clinics, hospitals, taxis, community halls, schools, and supermarkets 13-16. As such, bars and social alcohol drinking groups are avenues for TB transmission to bar customers, employees and neighbours, and they propagate outbreaks from an index case 17-21. Moreover, alcohol consumption is an established risk factor for tuberculosis in a dose dependent fashion, and exacerbates TB infection by blunting CD4 and CD8 T-lymphocyte cellular responses 22,23 .

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Density of Drinking Establishments and HIV Prevalence in a Migrant Town in Namibia

Cited by 9 publications

References 8 publications

Relationship Between Community-Level Alcohol Outlet Accessibility and Individual-Level Herpes Simplex Virus Type 2 Infection Among Young Women in South Africa

Relationship Between Community-Level Alcohol Outlet Accessibility and Individual-Level Herpes Simplex Virus Type 2 Infection Among Young Women in South Africa

Reducing HIV Risks in the Places Where People Drink: Prevention Interventions in Alcohol Venues

Prevalence of HIV infection and bacteriologically confirmed tuberculosis among individuals found at bars in Kampala slums, Uganda

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