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Abstract：
OBJECTIVE: Hazardous drinking (HD) and substance use (SU) can lead to disinhibited behaviour and are both growing public health problems among Southern African youths. We investigated the prevalence of SU and HD and their association with risky sexual behaviour among youth in Zimbabwe.
METHODS: Data analysis from a population-based survey conducted between October 2021 and June 2022 to ascertain the outcomes of a cluster randomised trial (CHIEDZA: Trial registration number:NCT03719521). Trial Stage: Post-results.
METHODS: 24 communities in three provinces in Zimbabwe.
METHODS: Youth aged 18-24 years living in randomly selected households.
METHODS: HD was defined as an Alcohol Use Disorders Identification Test score ≥8, SU was defined as ever use of ≥1 commonly used substances in the local setting.
RESULTS: Of 17 585 participants eligible for this analysis, 61% were women and the median age was 20 (IQR: 19-22) years. Overall, 4.5% and 7.0% of participants reported HD and SU, respectively. Men had a substantially higher prevalence than women of HD (8.2% vs 1.9%) and SU (15.1% vs 1.5%). Among men, after adjusting for socio-demographic factors, we found increased odds of having >1 sexual partner in those who engaged in SU (adjusted OR (aOR)=2.67, 95% CI: 2.21 to 3.22), HD (aOR=3.40, 95% CI: 2.71 to 4.26) and concurrent HD and SU (aOR=4.57,95% CI: 3.59 to 5.81) compared with those who did not engage in HD or SU. Similarly, there were increased odds of receiving/providing transactional sex among men who engaged in SU (aOR=2.51, 95% CI: 1.68 to 3.74), HD (aOR=3.60, 95% CI: 2.24 to 5.79), and concurrent HD and SU (aOR=7.74, 95% CI: 5.44 to 11.0). SU was associated with 22% increased odds of inconsistent condom use in men (aOR=1.22, 95% CI: 1.03 to 1.47). In women, the odds of having >1 sexual partner and having transactional sex were also increased among those who engaged in SU and HD.
CONCLUSIONS: SU and HD are associated with sexual behaviours that increase the risk of HIV acquisition in youth. Sexual and reproductive health interventions must consider HD and SU as potential drivers of risky sexual behaviour in youths.
METHODS: Data analysis from a population-based survey conducted between October 2021 and June 2022 to ascertain the outcomes of a cluster randomised trial (CHIEDZA: Trial registration number:NCT03719521). Trial Stage: Post-results.
METHODS: 24 communities in three provinces in Zimbabwe.
METHODS: Youth aged 18-24 years living in randomly selected households.
METHODS: HD was defined as an Alcohol Use Disorders Identification Test score ≥8, SU was defined as ever use of ≥1 commonly used substances in the local setting.
RESULTS: Of 17 585 participants eligible for this analysis, 61% were women and the median age was 20 (IQR: 19-22) years. Overall, 4.5% and 7.0% of participants reported HD and SU, respectively. Men had a substantially higher prevalence than women of HD (8.2% vs 1.9%) and SU (15.1% vs 1.5%). Among men, after adjusting for socio-demographic factors, we found increased odds of having >1 sexual partner in those who engaged in SU (adjusted OR (aOR)=2.67, 95% CI: 2.21 to 3.22), HD (aOR=3.40, 95% CI: 2.71 to 4.26) and concurrent HD and SU (aOR=4.57,95% CI: 3.59 to 5.81) compared with those who did not engage in HD or SU. Similarly, there were increased odds of receiving/providing transactional sex among men who engaged in SU (aOR=2.51, 95% CI: 1.68 to 3.74), HD (aOR=3.60, 95% CI: 2.24 to 5.79), and concurrent HD and SU (aOR=7.74, 95% CI: 5.44 to 11.0). SU was associated with 22% increased odds of inconsistent condom use in men (aOR=1.22, 95% CI: 1.03 to 1.47). In women, the odds of having >1 sexual partner and having transactional sex were also increased among those who engaged in SU and HD.
CONCLUSIONS: SU and HD are associated with sexual behaviours that increase the risk of HIV acquisition in youth. Sexual and reproductive health interventions must consider HD and SU as potential drivers of risky sexual behaviour in youths.
摘要：
目标：危险饮酒（HD）和物质使用（SU）会导致不受约束的行为，并且都是南部非洲青年中日益严重的公共卫生问题。我们调查了津巴布韦青年中SU和HD的患病率及其与危险性行为的关系。
方法：来自2021年10月至2022年6月进行的基于人群的调查的数据分析，以确定集群随机试验的结果（CHIEDZA：试验登记号：NCT03719521）。试验阶段：结果后。
方法：津巴布韦三个省的24个社区。
方法：生活在随机选择的家庭中的18-24岁青年。
方法：HD被定义为酒精使用障碍鉴定测试得分≥8，SU被定义为在当地使用≥1种常用物质。
结果：在符合此分析条件的17585名参与者中，61%为女性，中位年龄为20岁(IQR:19-22)。总的来说,4.5%和7.0%的参与者报告HD和SU，分别。男性的HD患病率明显高于女性（8.2％vs1.9％）和SU（15.1％vs1.5％）。在男性中,在调整了社会人口因素后，我们发现在从事SU的人中拥有>1个性伴侣的几率增加（调整后的OR（aOR）=2.67，95％CI：2.21至3.22），HD（aOR=3.40，95％CI：2.71至4.26）以及并发HD和SU（aOR=4.57，95％CI：3.59至5.81）与未从事HD或SU的人相比。同样，在从事SU的男性中接受/提供性交易的可能性增加（aOR=2.51，95％CI：1.68至3.74），HD(AOR=3.60，95%CI：2.24至5.79)，并并发HD和SU（aOR=7.74，95%CI：5.44至11.0）。SU与男性避孕套使用不一致的几率增加22％相关（aOR=1.22，95％CI：1.03至1.47）。在女性中，在从事SU和HD的人群中,拥有>1个性伴侣和性交易的几率也增加.
结论：SU和HD与增加青少年感染HIV风险的性行为有关。性健康和生殖健康干预措施必须将HD和SU视为青少年危险性行为的潜在驱动因素。
方法：来自2021年10月至2022年6月进行的基于人群的调查的数据分析，以确定集群随机试验的结果（CHIEDZA：试验登记号：NCT03719521）。试验阶段：结果后。
方法：津巴布韦三个省的24个社区。
方法：生活在随机选择的家庭中的18-24岁青年。
方法：HD被定义为酒精使用障碍鉴定测试得分≥8，SU被定义为在当地使用≥1种常用物质。
结果：在符合此分析条件的17585名参与者中，61%为女性，中位年龄为20岁(IQR:19-22)。总的来说,4.5%和7.0%的参与者报告HD和SU，分别。男性的HD患病率明显高于女性（8.2％vs1.9％）和SU（15.1％vs1.5％）。在男性中,在调整了社会人口因素后，我们发现在从事SU的人中拥有>1个性伴侣的几率增加（调整后的OR（aOR）=2.67，95％CI：2.21至3.22），HD（aOR=3.40，95％CI：2.71至4.26）以及并发HD和SU（aOR=4.57，95％CI：3.59至5.81）与未从事HD或SU的人相比。同样，在从事SU的男性中接受/提供性交易的可能性增加（aOR=2.51，95％CI：1.68至3.74），HD(AOR=3.60，95%CI：2.24至5.79)，并并发HD和SU（aOR=7.74，95%CI：5.44至11.0）。SU与男性避孕套使用不一致的几率增加22％相关（aOR=1.22，95％CI：1.03至1.47）。在女性中，在从事SU和HD的人群中,拥有>1个性伴侣和性交易的几率也增加.
结论：SU和HD与增加青少年感染HIV风险的性行为有关。性健康和生殖健康干预措施必须将HD和SU视为青少年危险性行为的潜在驱动因素。
