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Alcohol and Cannabis Use and Sexual Risk Behaviors in the Malawi Defence Force
Bonnie Robin Tran1,2, Anthony Davis3,4, Stanley I Ito3,4
1Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, Sylvester Road, San Diego, CA, 92106-3521, USA. bonnie.r.tran.ctr@mail.mil.
AIDS and Behavior
|June 6, 2018
Summary
Substance abuse, including hazardous drinking and cannabis use, is linked to increased risky sexual behaviors like transactional sex and multiple partners in the Malawi Defence Force. This highlights the need for integrated HIV and substance use prevention programs in military settings.
Area of Science:
- Public Health
- Epidemiology
- Military Health
Background:
- Substance abuse poses a significant public health challenge, particularly within military communities facing the HIV epidemic.
- Understanding the relationship between substance use and sexual behaviors is crucial for effective HIV prevention strategies.
Purpose of the Study:
- To quantify alcohol and cannabis use within the Malawi Defence Force.
- To investigate the association between substance use and sexual risk behaviors, including condom use, transactional sex, multiple sexual partners, and sexual violence.
Main Methods:
- A cross-sectional study involving 944 male and female service members (≥18 years old) in the Malawi Defence Force.
- Data collected in 2013 via computer-assisted self-interviews.
- Analysis included screening for hazardous drinking (Alcohol Use Disorders Identification Test [AUDIT] score ≥8) and past/prior year cannabis use.
Main Results:
- 24% screened positive for hazardous/harmful drinking; 6% reported recent cannabis use.
- Men with AUDIT scores ≥8 or who reported ever using cannabis showed increased odds of transactional sex and multiple sexual partners.
- Men reporting cannabis use also had elevated odds of experiencing sexual violence.
Conclusions:
- Substance use, specifically hazardous drinking and cannabis use, is associated with increased sexual risk behaviors in the Malawi Defence Force.
- These findings suggest that substance use may exacerbate the HIV epidemic in Sub-Saharan Africa.
- Military HIV prevention efforts should incorporate substance use education, screening, and treatment.
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