Alcohol use and high risk sexual behavior among female sex workers in Nairobi, Kenya
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Introduction: Substance use influences acquisition and transmission of HIV among female sex workers. The objective of this study was to determine the prevalence of alcohol use and correlates of alcohol use/abuse among female sex workers in Nairobi, Kenya. Methods: By August 2009, 3012 female sex workers had been enrolled at the Sex Workers Outreach Program (SWOP) clinic, Nairobi. Data on substance use, socio-demographic factors, sexually transmitted diseases and high risk behavior was abstracted from the existing database. Statistical analysis included descriptive statistics, univariate and multivariate analysis. Results: The prevalence of alcohol use was 74.3 percent. Among the alcohol users 35.9 percent were abusing alcohol. Alcohol users and abusers were more likely to have had sex with a known or suspected HIV positive partner in the last six months (95 percent CI 1.12, 1.63 and 0.971, 1.698 respectively). Prevalence of HIV among alcohol users was 31.4 percent. Among the alcohol abusers, HIV prevalence was 35.8percent. Trichomonas vaginalis infection was 1.3 times more likely among alcohol abusers (95 percent CI 0.556,0.993). Conclusions: In this population the prevalence of alcohol use was high (74.3 percent). Alcohol use was associated with high risk sexual behavior and higher HIV /STI rates. Targeted interventions that assist female sex workers shun substance use or adopt safe alcohol drinking practices could potentially contribute to HIV prevention in this group.