Alcohol-related risk behavior among VCT clients in Kenya: Results of a baseline survey

Background The link between alcohol misuse and HIV infection makes VCT services an important venue for discussing this risk behavior, and for helping clients formulate risk-reduction plans. However, it is not known to what extent VCT counselors encounter clients who need advice about alcohol. We present the alcohol-using behavior of VCT clients in Kenya, and its implications for HIV counseling and testing. Methods Exit interviews were conducted among a random sample of 1073 VCT clients from 20 sites in 2006. Alcohol use was assessed by WHO's AUDIT scale. 53% of the respondents were male, mean age 30 years, and 77% had a sex partner. Results 29% of males and 12% of females were current alcohol drinkers and among these, 68% of males and 59% of females were hazardous drinkers (AUDIT >=8 points). Compared to nondrinkers, current drinkers were more likely to have had sex in the previous 12 months (AOR=7.4 males, 4.4 females). Current drinkers were also more likely to report multiple partners (AOR=3.2 males, 6.2 females) but less likely to always use condoms (AOR=0.6 males, 0.5 females). Compared to harmless drinkers, hazardous drinkers were more likely to have perpetrated violence towards their partner (AOR 5.4 males, 3.3 females). Conclusions Alcohol-using VCT clients engage in multiple behaviors that elevate their risk for HIV. There is need for strategies to explore how alcohol risk reduction can be addressed in VCT settings.