Introduction
Excessive alcohol consumption is associated with HIV risk. Alcohol may attenuate one’s behavioral self-censoring, leading to risky behavior such as multiple partners and unprotected sex. However, little is known about alcohol use and risk behaviors among voluntary counseling and testing (VCT) clients. Such information is important for determining the extent to which VCT providers should address this potentially modifiable HIV risk factor during counseling.

Materials and methods
In June 2006, 1,073 clients of 20 VCT centers throughout Kenya completed an exit interview. Data were collected following standard ethical procedures. The severity of alcohol use was assessed using the AUDIT scale. Fifty-three percent of the sample were male, the mean age was 30 years (range 18–85 years), 53 percent were single, and 77 percent had a sexual partner.

Results
Twenty-one percent of respondents reported currently consuming alcohol (29 percent of males and 12 percent of females). Two-thirds of current drinkers, including 68 percent of men and 59 percent of women, were hazardous drinkers based on the AUDIT scale. Regression analysis showed that compared to nondrinkers, current drinkers were six times more likely to have had sex in the previous 12 months, four times more likely to report multiple partnerships, but no more likely to always use condoms in multiple partnerships. Only 44 percent of current drinkers reported being asked about alcohol consumption during the VCT session on the day of the interview.

Conclusions
Given the HIV risk profile of alcohol users, there is a need to strengthen VCT providers’ capacity to assess alcohol use and, when appropriate, to address alcohol abuse in VCT counseling.