Alcohol use and sexual risk behaviors in the Armed Forces of the Democratic Republic of the Congo

Abstract

BackgroundAlcohol misuse is an important contributor to sexual acquisition and transmission of HIV in military communities. This cross-sectional study quantified the prevalence of probable problematic alcohol use among male service members in the Armed Forces of the Democratic Republic of the Congo (FARDC), identified associated factors, and investigated associations of alcohol misuse with risky sexual behaviors.MethodsParticipants included 2549 active duty male soldiers ≥ 18 years old. Data were collected via computer-assisted personal-interview from October 2013–April 2014. The Alcohol Use Disorders Identification Test (AUDIT) was used to identify probable problematic alcohol use (AUDIT score ≥ 8) compared to no/low-risk alcohol use (AUDIT score ≤ 7). Bivariate logistic regressions were used to identify factors associated with probable problematic alcohol use. Several multivariable logistic regressions (adjusted for age, marital status, education level) were used to examine associations of probable problematic alcohol use with risky sexual behaviors. Tests were two sided; statistical significance was defined as p < 0.05.ResultsFifteen percent of men screened positive for probable problematic alcohol use. The odds of probable problematic alcohol use were elevated among men who were single and living with a partner (OR = 1.66; 95% CI = 1.24–2.21), ranked as a non-commissioned officer [NCO] (OR = 1.40; 95% CI = 1.10–1.77), and in the 30–39 and 40–49 age groups (OR 30–39 age group = 2.17; 95% CI = 1.56–3.02; OR 40–49 age group = 1.79; 95% CI = 1.26–2.55). Probable problematic alcohol use was associated with increased odds of having sex with a sex worker (SW), having multiple sexual partners, and participating in transactional sex (aOR sex with a SW = 2.36; 95% CI = 1.78–3.13; aOR multiple sexual partners = 2.08; 95% CI = 1.66–2.60; aOR transactional sex = 1.99; 95% CI = 1.59–2.50).ConclusionsResults emphasize the need to address alcohol use in the FARDC and integrate alcohol abuse education into HIV prevention programs among male service members. Alcohol abuse prevention efforts should target men who are 30–49 years of age, unmarried, and ranked as a NCO. Messages and interventions to reduce alcohol misuse in relation to risky sexual behaviors are needed.

Consistent Condom Use and Associated Factors among sexually active Military Personnel in Eastern Ethiopia: Cross-Sectional Study Design

“… 29 Lower condom use was associated with the perception that condoms make sex less enjoyable, as well as negative attitudes toward condoms, according to a study conducted among the Republic of Congo Defense Force. 11 Personal factors such as aversion to the condom, as well as anxiety and depression, were also found to be negatively associated with condom use in a review study. 38 …”

“…8 Risky sexual behaviors such as unprotected sex, multiple partnerships, no or inconsistent condom use, and drug abuse are extremely detrimental to adolescents' health, putting them at high risk for HIV/AIDS and other sexually transmitted infections (STIs). 10,11 In terms of behavioral variables, many men have sex while under the influence of alcohol or other drugs. These substances are sometimes consumed before sexual intercourse, and in other cases, they are consumed during sexual activity.…”

“… 8 Risky sexual behaviors such as unprotected sex, multiple partnerships, no or inconsistent condom use, and drug abuse are extremely detrimental to adolescents’ health, putting them at high risk for HIV/AIDS and other sexually transmitted infections (STIs). 10 , 11 …”