Sexual Aggression in Brazilian Nightclubs: Associations with Patron's Characteristics, Drug Use, and Environmental Factors.

Bars and nightclubs are main locations for sexual assault outcomes such as rape, attempted rape, stalking, and other forms of sexual harassment. Alcohol use is strongly associated with violence in nightlife settings. The present study aimed to identify individual and environmental factors, such as different types of nightclubs, music styles, and physical environment associated with nightclub patron's report of being victims of sexual aggression inside nightclubs in São Paulo, Brazil. Two levels of data were collected: observational data inside nightclubs and individual-level survey data of 2422 patrons at the entrance and 1822 patrons (1111 men; 711 women) at the exit of 31 nightclubs. Among patrons, 11.5% (95% CI 7.9-16.2%) reported being a victim of sexual aggression inside the venues in the night of the survey. Groping and forced kissing were the most prevalent forms of sexual aggression (9.8%; [7.2-13.1%]), which was more strongly associated with environmental factors such as crowding (OR = 2.9 [1.6-5.2%]), entrance consumption fee (OR = 4.2 [2.5-7.0%]), and music style than with individual-level factors. In funk (OR = 3.3 [1.6-6.9%]), electronic (OR = 3.2 [1.8-5.8%]), and pop dance (OR = 7.9 [2.2-29.1%]) nightclubs, patrons had higher chances of being a victim of sexual aggression compared to those ones at the eclectic nightclubs. Presence of reserved areas for sex increased the chances of reporting sexual aggression (OR = 1.8 [1.2-2.8%]). No significant gender differences for sexual aggression were detected. Results suggest a requirement of security improvement where environmental characteristics are potential predictors of victimization.

Typology of Nightclubs in São Paulo, Brazil: Alcohol and Illegal Drug Consumption, Sexual Behavior and Violence in the Venues.

BACKGROUND: Nightclubs are venues in which excessive alcohol use and illegal drug consumption occur in addition to other high-risk behaviors, such as violence and sexual risk behaviors. Environmental factors common in nightclubs and the personal characteristics of patrons might increase the risk of these events. To better understand the relationship between these factors, typologies were formulated that clustered nightclubs according to definite profiles to identify differences to be taken into consideration in preventive interventions. OBJECTIVES: The present study aim was to construct a typology of nightclubs in São Paulo, Brazil. METHODS: This typology was constructed using mixed methods research through the triangulation of several data sources as follows: 307 hours of ethnographic observation at 31 nightclubs, 8 focus group sessions with nightclub patrons (n = 34) and 30 semi-structured interviews with nightclub employees. Content analysis and qualitative typology were used. RESULTS: Four nightclub types were defined based on four analyzed thematic axes (Intoxicating, Violent, Dancing and Highly Sexualized nightclubs). Excessive alcohol use was detected in almost all of the investigated nightclubs, and drug use was observed in approximately one-third of them. Triangulation of the data revealed a relationship among environmental factors (especially alcohol sales strategies and promotion and the availability of areas for sex) and a more considerable presence of high-risk behaviors. CONCLUSIONS: The study shows that nightclubs are settings in which high-risk behaviors are potentiated by facilitating environmental factors as well as by the lack of laws restricting excessive alcohol use stimulated by the promotion strategies applied at these venues.

Classification of alcohol use disorders among nightclub patrons: associations between high-risk groups, sociodemographic factors and illicit drug use.

BACKGROUND: Nightclubs are favorable environments for alcohol abuse and the use of other drugs among patrons. OBJECTIVE: To identify patterns of alcohol use in a high-risk population and their relationship with sociodemographic factors and illicit drug use. METHODS: A portal survey technique was used to recruit patrons in 31 nightclubs in the city of São Paulo, Brazil. A two stage sampling method allowed the selection of nightclubs and patrons within a nightclub. A total of 1057 patrons answered to a three stages-survey (nightclub entrance and exit face-to-face interviews and a day-after online questionnaire). Entrance survey offered information on sociodemographic data and history of drug use. The day-after survey used the Alcohol Use Disorders Identifications Test (AUDIT) that identified patterns of alcohol abuse disorders. Data were modeled using an ordered logit regression analysis, considering sample weights. RESULTS: Almost half of the nightclub patrons presented any alcohol use disorder (AUDIT score ≥8). Being male (OR = 1.68; 95% CI = 1.09-2.60) and single (OR = 1.71; 95% CI = 1.05-2.76) increased the chances for more severe alcohol use disorders. Having a graduate degree (OR = 0.57; 95% CI = 0.38-0.87) and age ≥35 years (OR = 0.48; 95% CI = 0.27-0.85) decreased the chances of patrons' alcohol use disorders. The prevalence rates of past-year marijuana, cocaine and inhalants use increased with the increased level of alcohol use disorders. CONCLUSIONS: Patrons of nightclubs show higher prevalence rates for any alcohol use disorders than the general population. Patrons could benefit from governmental brief intervention or referral to treatment for alcohol used disorders disclosed in nightclubs.

Dark rooms in Brazilian nightclubs: a matter of concern for STD/HIV policymakers.

A mixed methods study in Brazil identified patterns of drug use, violence and sexual behaviours in a representative sample of nightclubs and patrons. Ethnographic observations were performed inside the nightclubs and showed the existence of "dark rooms" - areas reserved for sexual intercourse - in nightclubs targeting men who have sex with men. The letter describes characteristics of the sexual behaviour in these areas.

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex.

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously.

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously. .

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously. .(AU)

Childhood alcohol use may predict adolescent binge drinking: a multivariate analysis among adolescents in Brazil.

OBJECTIVES: To test the hypothesis that first alcohol use during childhood is associated with heavy drinking patterns during adolescence and with parental drinking patterns and parental rules about alcohol consumption. STUDY DESIGN: A national cross-sectional survey of 17,371 high-school students. Students were drawn from 789 public and private schools in all the Brazilian state capitals using a multistage probabilistic sampling method and a self-report questionnaire. Weighted data were analyzed through logistic regression testing for differences on the associated factors for first use of alcohol during childhood. Survival analysis and Cox proportional hazard models were used to confirm results. RESULTS: Among the 82% alcohol lifetime users, 11% had first used alcohol before age 12 years. The lack of perception of possible punishment by parents is associated with childhood alcohol use (OR 2.22, 95% CI 1.67-2.95). Adolescents who first used alcohol during childhood compared with those who only used alcohol at later ages are more likely to engage in binge drinking behaviors (OR 1.57, 95% CI 1.17-2.10), to have a pattern of heavy alcohol use (OR 1.98, 95% CI 1.26-3.09), and to have recently used illegal drugs (OR 1.74, 95% CI 1.39-2.16). According to hazard ratios, students with an earlier age of onset were more likely to have used tobacco and any illegal drug in the past year. CONCLUSIONS: Childhood alcohol may be a risk factor for the most dangerous patterns of alcohol use in adolescence and is associated with parental alcohol use. Parental rules about child alcohol use must be clear because perception of punishment might delay the age of first alcohol use.