Relationship between Community-Level Alcohol Outlet Accessibility and Individual-Level HSV-2 Infection among Young Women in South Africa

Molly S. Rosenberg, Harvard University
Audrey Pettifor, University of North Carolina at Chapel Hill
Sheri A. Lippman, University of California, San Francisco
Harsha Thirumurthy, University of North Carolina at Chapel Hill
Michael Emch, University of North Carolina at Chapel Hill
Amanda Selin, University of North Carolina at Chapel Hill
F. Xavier Gómez-Olivé, University of the Witwatersrand
Jim Hughes, University of Washington
Oliver Laeyendecker, Johns Hopkins University
Kathleen Kahn, University of the Witwatersrand

Introduction: Exposure to alcohol outlets may influence sexual health outcomes at the individual- and community-level. Methods: In a sample of 2,174 South African schoolgirls living across 24 villages in rural South Africa, we performed a cross-sectional analysis to examine the association between number of alcohol outlets in home village and individual-level prevalent HSV-2 infection, using generalized estimating equations logistic regression models and a marginal modeling approach. Results: Young women who lived in villages with more alcohol outlets were more likely to be infected with HSV-2 [OR (95% CI): 1.08 (1.01, 1.15)]. Adjustment did not change the magnitude of the association but yielded a less precise estimate [OR (95% CI): 1.11 (0.98, 1.25)]. Conclusions: Living in villages with more alcohol outlets was associated with increased prevalent HSV-2 infection. Structural interventions and sexual health screenings targeted at villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.