Objective: To examine alcohol use and subsequent HIV risky behaviors among a sample of predominately ethnic minority people living with HIV/AIDS (PLWHA) in a rural community in Yunnan Province, China.
Method: A cross-sectional study with a face-to-face questionnaire interview was conducted among eligible participants.
Results: In total, 455 (94.4%) out of 482 eligible HIV patients participated in the study. Of them, 82.6% were ethnic minorities; 15.4% were never married; 96.5% were sexually experienced; 55.4% had used drugs, 67% were receiving antiretroviral therapy (ART). Over 65% were ever drinkers; of whom 61.5% were current drinkers. Among current drinkers, 32.4% drank daily and 41.2% were hazardous drinkers. Chinese white wine was the preferred choice. Higher level of alcohol use among drinkers in the preceding month was positively associated with being males (OR = 2.76, 95%CI: 1.03-7.43), ethnic minorities (OR Jingpo = 2.21, 95%CI: 1.06-4.59; OR other minorities = 3.20, 95%CI: 1.34-7.62), higher education (OR1-6 = 1.98, 95%CI: 0.99-3.96; OR≥7 = 2.35, 95%CI: 1.09-5.06) and being ART-naive (OR = 2.69, 95%CI: 1.67-4.32). About 39% of ever drinkers reported having engaged in sex after drinking since HIV diagnosis. Those who were younger than 46 years (OR16-25 = 7.77, 95%CI: 1.22-49.60, OR26-35 = 2.79, 95%CI: 1.06-7.35, OR36-45 = 2.96, 95%CI: 1.57-7.58), hazardous drinkers (OR = 1.99, 95%CI: 1.00-3.97) and drug users (OR = 3.01, 95%CI: 1.19-7.58) were more likely to have had sex after drinking. Approximately 56% of drug users had used drugs after drinking.
Conclusions: High prevalence of alcohol use and subsequent risky behaviors including sexual engagement and drug use among HIV patients in rural Yunnan require tremendous and integrated efforts for prevention and control of alcohol and drug abuse and HIV spreading.