Abstract
Background:
Hazardous alcohol use and in particular binge drinking has become a significant problem for New Zealand youth and results in considerable harm. The burden of Sexually Transmitted Infections (STIs) is also disproportionately high in this group. Both of these issues are of considerable public health significance. Previous research supports a link between increasing levels of alcohol use and increasing rates of STIs.
Aims:
This research aimed to determine if young people (aged 16-24 years) attending an urban New Zealand Sexual Health service for STI screening differ from the wider New Zealand population in the same age group with respect to rates of hazardous alcohol use and diagnosed STIs. The study also aimed to investigate the relationship between hazardous alcohol use and diagnosed STIs.
Methods:
A quantitative cross sectional design was used. All 16-24 year old attendees at the Christchurch Sexual Health Centre between 5 November 2010 and 3 June 2011 were asked to participate. Participants were asked to complete an anonymous written questionnaire which included demographics, the Alcohol Use Disorder Identification Test (AUDIT), STI risk factors and other drug use. Questionnaires contained a unique identifier which linked them to STI screening test results for each participant.
Results:
Data from 255 attendees were included in the analysis, the response rate was 47%. AUDIT scores revealed hazardous alcohol consumption in 71.4% of the participants, with binge drinking common (34% hinged weekly and 31% monthly). Highest rates were observed in young males. Comparisons with other New Zealand population based surveys showed younger initiation to alcohol and more hazardous consumption patterns in the study sample. A significant association was observed between hazardous alcohol use and both cannabis (p<0.001) and other drug use (p<0.001). The prevalence of chlamydia and/or gonorrhoea in this study was 13 .5%. Significant associations were found between a confirmed chlamydia and/or gonorrhoea diagnosis and increasing number of sexual partners (p=0.04) and inconsistent condom use with new partners (p=0.03). No significant association was demonstrated between AUDIT scores and diagnosed STIs (p=0.66). Nearly half of participants (48.8%) confirmed having unprotected sexual intercourse related to alcohol in the past 12 months, and 13.4% usually or always consumed alcohol before sexual intercourse with a new partner. Attendance at the clinic was identified by 20% of participants to be related in some way to alcohol.
Conclusion:
Youth attending the Christchurch Sexual Health Centre have high rates of hazardous alcohol consumption that warrant screening and preventative strategies. This study did not find a direct association between AUDIT scores and STI diagnosis, however there were high rates of alcohol consumption prior to sexual intercourse and unprotected intercourse related to alcohol. The results indicate targeting alcohol use in this population is important to overall sexual health care and prevention of STIs.