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The influence of alcohol, drugs and substance abuse on sexual relationships and perception of risk to HIV infection among adolescents in the informal settlements of Nairobi

This study explores the impact of alcohol, drug and substance abuse on HIV‐related sexual risk behavior and the risk perception of HIV infection among the adolescents of Nairobi slums. Using the Nairobi Cross‐sectional Slum Survey, a representative sample of adolescent boys and girls from Nairobi slums, the results suggest that alcohol and drugs have a positive effect on having been forced or having forced anyone to have sexual intercourse, having a boyfriend/girlfriend, and risk perception of HIV infection. In addition, boys are at increased risk of forcing others to have sexual intercourse, while girls are at increased risk of being forced. Being in school is protective, and those in school perceive themselves less at risk of HIV infection. Increasing urbanization, with the majority living in the slums and without substantial investment in addressing factors that predispose the adolescents to alcohol and drugs, is likely to increase the proportion of the population at increased risk of HIV infection.