A systematic review on the impact of alcohol use on sexually transmitted infections

Abstract

Alcohol use has been associated with multiple types of sexual risk behaviors, such as condomless sex or having multiple sexual partners, behaviors that are linked to the risk of sexually transmitted infections (STIs). The aim of this review was to present updated evidence to demonstrate an association between alcohol consumption and STIs and evaluate the causal nature of this link, as well as to present interventions that reduce alcohol consumption and its effect on STIs. We conducted a systematic review according to the PRISMA guidelines using PubMed and Embase databases. Cohort studies and case-control studies were included. Any level of alcohol use served as the exposure variable, with the outcome restricted to non-HIV STIs, as reviews on alcohol use and HIV already exist. In total, 11 publications satisfied the inclusion criteria. The evidence suggests that there is an association between alcohol use, especially heavy drinking occasions, and STIs, with eight articles finding a statistically significant association. In addition to these results, there is indirect causal evidence from policy studies, and from the field of decision-making and sexual behavior with experimental evidence, that alcohol use increases the likelihood of risk-taking sexual behavior. It is important to have a deeper understanding of the association to develop effective prevention programs at community and individual levels. Preventive interventions should be implemented targeting the general population, in addition to specific campaigns directed at vulnerable subpopulations in order to reduce the risks.