Multiple Recent Sexual Partnerships and Alcohol Use Among Sexually Transmitted Infection Clinic Patients, Cape Town, South Africa

Background: Multiple recent sex partners promote the rapid spread of sexually transmitted infections (STI), including human immunodeficiency virus. Alcohol use is also closely associated with unprotected sexual behavior, but its use has not been investigated in relation to multiple recent sex partners in southern Africa. Purpose: To examine the combined risks of multiple recent sex partners and alcohol use among people seeking treatment for identified STI in Cape Town, South Africa. Methods: Men (n = 529) and women (n = 210) receiving STI clinic services completed anonymous surveys of sexual behaviors and substance use over a two-month retrospective period. Sexual risk was defined by frequencies of unprotected intercourse and drinking alcohol before sexual intercourse. Results: A total of 264 (31%) participants reported 2 or more sex partners in the previous 2 months; 87% of these partnerships occurred within 1 month of each other. Substantially greater multiple recent partners, including a greater fraction of sexual relationships estimated concurrently, were observed among men than women. Alcohol use was common in the sample, and drinking in sexual contexts was associated with multiple partners. Moderator analyses failed to show that alcohol use played a significant role in unprotected sex with multiple recent partners. Conclusions: Multiple recent partners and drinking appear independently related to unprotected sex, and both multiple partners and alcohol use should be targeted in human immunodeficiency virus risk reduction interventions.