Adding Fuel to the Fire: Alcohol’s Effect on the HIV Epidemic in Sub-Saharan Africa

Abstract

Alcohol consumption adds fuel to the HIV epidemic in sub-Saharan Africa (SSA). SSA has the highest prevalence of HIV infection and heavy episodic drinking in the world. Alcohol consumption is associated with behaviors such as unprotected sex and poor medication adherence, and biological factors such as increased susceptibility to infection, comorbid conditions, and infectiousness, which may synergistically increase HIV acquisition and onward transmission. Few interventions to decrease alcohol consumption and alcohol-related sexual risk behaviors have been developed or implemented in SSA, and few HIV or health policies or services in SSA address alcohol consumption. Structural interventions, such as regulating the availability, price, and advertising of alcohol, are challenging to implement due to the preponderance of homemade alcohol and beverage industry resistance. This article reviews the current knowledge on how alcohol impacts the HIV epidemic in SSA, summarizes current interventions and policies, and identifies areas for increased research and development.

The Challenges and Perceptions of Community Caregivers With Regard to Antiretroviral Treatment Adherence of Patients: A Phenomenological Study

“…A study done by Hahn et al (2011:5) on alcohol's effect on the HIV epidemic in Sub-Saharan Africa indicated that alcohol consumption is associated with risky sexual behaviour and an increased risk of HIV infection. Alcohol consumption reduces a person's ability to make informed choices about safer sex and protection from HIV infection (Inungu & Karl, 2006:4 Sub-theme A3.3: Cultural and traditional practices and beliefs influence the patient's adherence to ART Cultural and traditional practices and beliefs, discrimination and stigma as well as nondisclosure are social factors that influence adherence from the perspective of the community caregivers, as discussed below.…”

Event-based analysis of the association between alcohol use and unsafe sex in seven sub-Saharan African countries

“…Alcohol use contributes to disease and injury, including cancer, cardiovascular disease, liver cirrhosis, motor vehicle accidents, and epilepsy (Hahn, Woolf-King, & Muyindike, 2011;Lim et al, 2013;Rehm et al, 2009;World Health Organization [WHO], 2014). In addition, studies have found associations between alcohol and HIV/AIDS (Baliunas, Rehm, Irving, & Shuper, 2010;Hahn et al, 2011).…”

“…In addition, studies have found associations between alcohol and HIV/AIDS (Baliunas, Rehm, Irving, & Shuper, 2010;Hahn et al, 2011). This link between HIV infection and alcohol use is of particular concern in sub-Saharan Africa, where HIV prevalence is the highest in the world (Hahn et al, 2011).…”

Randomized Study of Assessment Effects on Alcohol Use by Persons With HIV in Rural Uganda

“…SSA continues to be disproportionately affected by the HIV/AIDS epidemic, home to more than 70% of the cases (UNAIDS, 2013), with the majority of infected persons living in rural areas. Alcohol use plays a key role in HIV transmission, adherence to anti-retroviral therapy (ART), and mortality (Braithwaite et al, 2014;Hahn et al, 2011;Schneider et al, 2012). Yet little has been done to intervene on unhealthy drinking in HIV positive persons in rural, resource-limited settings.…”