Bars and nightclubs associated with higher HIV prevalence

Background: Alcohol outlet density is positively associated with alcohol consumption and a number of related risk behaviors. However, very little is known about the effects of different types of alcohol outlets on HIV prevalence. The current cross-sectional study examines associations between the number of each type of alcohol outlet and HIV prevalence within 350 cities located in 26 U.S. metropolitan statistical areas. Methods: State and local health department and U.S. Census Bureau surveillance data were analyzed from 1056 ZIP codes, where an estimated 39 million people reside. Multilevel negative binomial regression models were used to examine the association between the number of each type of alcohol outlet in ZIP codes and HIV prevalence. Results: Number of on-premise alcohol outlets within a ZIP code was associated with greater HIV prevalence. In this sample, the presence of one additional on-premise outlet in a ZIP code was associated with a 1.5% increase in the HIV prevalence rate in that location. Conclusion: This study extends previous research by examining the relationship between alcohol outlets and HIV prevalence in a large sample of U.S. ZIP codes. Research is needed to more closely examine the mechanisms by which on-premise alcohol outlets may affect HIV transmission. Effective policies to reduce HIV transmission may include limiting the density of on-premise alcohol establishments.