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. 2021 Apr;25(4):1144-1158.
doi: 10.1007/s10461-020-03069-9. Epub 2020 Oct 30.

Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda

Amanda P Miller  1 , Eileen V Pitpitan  2 , Dorean Nabukalu  3 , Fred Nalugoda  3 , Gertrude Nakigozi  3 , Godfrey Kigozi  3 , Mary Kate Grabowski  4   5 , Caitlin E Kennedy  6 , Jennifer A Wagman  7
Affiliations

Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda

Amanda P Miller et al. AIDS Behav. 2021 Apr.

Abstract
in English, Spanish

Transactional sex (TS) is prevalent in sub-Saharan Africa. Women's engagement in TS is linked with HIV infection; little is known about the relationship between TS, intimate partner violence (IPV) and alcohol use-established HIV risk behaviors. Using modified Poisson regression, we assessed associations between TS and physical, verbal and sexual IPV among 8248 women (15-49 years) who participated in the Rakai Community Cohort Study across forty communities in Uganda. An interaction term assessed moderation between alcohol use and TS and no significant interaction effects were found. In adjusted analysis, alcohol use and TS were significantly associated with all forms of IPV. In stratified analysis, TS was only associated with IPV in agrarian communities; alcohol use was not associated with physical IPV in trade communities or sexual IPV in trade and fishing communities. Identifying differences in IPV risk factors by community type is critical for the development of tailored interventions.

El sexo transaccional (ST) es frecuente en África subsahariana. La participación de las mujeres en el ST está relacionada con la infección por VIH; Se sabe poco sobre la relación entre el ST, la violencia de pareja íntima (VPI) y el consumo de alcohol: conductas de riesgo establecidas para el VIH. Utilizando la regresión de Poisson modificada, evaluamos las asociaciones entre el ST y la VPI física, verbal y sexual entre 8,248 mujeres (15-49 años) que participaron en el Estudio de cohorte de la comunidad Rakai en cuarenta comunidades de Uganda. Un término de interacción evaluó la moderación entre el consumo de alcohol y el ST y no se encontraron efectos de interacción significativos. En el análisis ajustado, el consumo de alcohol y el ST se asociaron significativamente con todas las formas de VPI. En el análisis estratificado, el ST solo se asoció con la VPI en las comunidades agrarias; El consumo de alcohol no se asoció con la VPI física en las comunidades comerciales ni con la VPI sexual en las comunidades comerciales y pesqueras. Identificar las diferencias en los factores de riesgo de la violencia de género por tipo de comunidad es fundamental para el desarrollo de intervenciones personalizadas.

Keywords: Alcohol use; HIV; Intimate partner violence; Sub-Saharan Africa; Transactional sex; Uganda.

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Conflict of interest statement

Conflict of interests: the authors declare that there are no conflicts of interest.

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