Event-based analysis of the association between alcohol use and unsafe sex in seven sub-Saharan African countries

Shireen Assaf, Lindsay Mallick


Aims: To examine the association between alcohol consumption at last sex and unsafe sex in seven countries in sub-Saharan Africa.
Design: Multivariable logistic regression of unsafe sex was performed using cross-sectional data with a stratified sample design from seven countries.
Setting: The study uses data from the Demographic and Health Surveys of Lesotho, Kenya, Mozambique, Swaziland, Uganda, Zambia, and Zimbabwe.
Participants: Men and women age 15–49 years with data available on alcohol consumption and who have had sex in the last 12 months were included in the analysis.
Measures: The main independent variable is alcohol consumption at last sex with a non-cohabiting partner.
Findings: The analysis has shown that alcohol consumption was a strong predictor of unsafe sex for all surveys except for women in Kenya. Age and number of sexual partners were also strong predictors of unsafe sex.
Conclusions: The findings indicate that there is a positive link between alcohol consumption and unsafe sex in all countries except for Kenya among women. The inconsistent finding in Kenya requires further study. One of the main limitations of the analysis is the low number of observations found for women and men who reported drinking at last sex with a non-cohabiting partner.


condom use; risky sexual behavior; event-based; alcohol consumption at last sex; sub-Saharan Africa

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DOI: http://dx.doi.org/10.7895/ijadr.245


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