Alcohol Consumption, Risky Sexual Behaviors, and HIV in Nigeria: A Meta-Analytic Review

Abstract

Background: Alcohol consumption is associated with risky sex, which increases the risk of acquiring and transmitting HIV. Objective: To examine the prevalence of, and associations among alcohol, risky sex, and HIV, in Nigeria. Methods: We searched electronic databases and reviewed reference sections of relevant papers to locate studies that sampled people living in Nigeria and assessed both alcohol and sexual risk behavior. We calculated effect sizes to determine (a) prevalence of alcohol and sex behaviors and (b) associations between alcohol consumption and risky sex, and examined moderators to determine if sample characteristics predicted behavioral or biological outcomes. Results: Of the 696 unique records identified, 35 manuscripts reporting on 42 separate studies met the inclusion criteria. Participants in these studies (N = 83,350; M age = 26 years; 48% women; 10% HIV-infected) reported high rates of heavy drinking (63%) and low rates of consistent condom use (24%). One-third of participants (30%) also reported using alcohol before sexual activity. Participants who consumed alcohol were more likely to report sexual activity (OR = 3.66, 95% CI = 3.09, 4.33), multiple partners (OR = 3.22, 95% CI = 2.38, 4.36), and condomless sex or inconsistent use of condoms (OR = 2.30, 95% CI = 1.54, 3.43). Conclusion: High rates of heavy drinking and low rates of condom use have been well-documented in Nigeria. Results from this meta-analysis can be used to inform critically needed alcohol-related HIV interventions.