Chapter 22: Review of interventions to reduce alcohol use-related sexual risk behaviour in Africa by Neo K. Morojele & Chitra Ranchod
The harmful use of alcohol has long been recognized as a major contributor to mortality and morbidity in many parts of the globe, and in various parts of Sub-Saharan Africa in particular (WHO, 2004). Levels of alcohol consumption among those who consume alcohol are extremely high (Roerecke, Obot, Patra, & Fiehm,2008; WHO, 2004), and in some regions of Sub-Saharan Africa, those who drink are particularly involved in heavy/binge drinking patterns of consumption (Clausen, Rossow, Naidoo, & Kowal, 2009), which make them prone to acute problems
such as intentionai injuries, unintentional injuries and a range of other social and health problems (Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham et al.,2003; Rehm, Baliunas, Borges, Graham, Irving, Kehoe et al., 2010).
Alcohol consumption is increasingly being recognized to be associated with HIV infection in various parts of Africa (Fritz, Morojele & Kalichman, 2010), and particularly, in those regions of the continent, such as Southern and Eastern Africa, that have the greatest burden of HIV (UNAlDS & WHO, 2009). A recent meta-analysis of studies globally found that alcohol consumption was associated with incident HIV (Baliunas, Rehm, Irving, & Shuper, 2009), and its findings were similar to those of a meta-analysis (Fisher et al., 2007) and a descriptive review (Pithey & Parry, 2009) of studies in Africa which showed strong associations between alcohol consumption and HIV infection. Sexual risk behaviour is understood to be the main mediator between alcohol consumption and HIV infection (Kalichman, Sibayi, Kaufmann, Cain, & Jooste, 2007a). Indeed, Kalichman et al.’s systematic
review of studies conducted in Africa provides substantial evidence of alcohol’s association with sexual risk behaviour. Qualitative and quantitative research has uncovered some of the moderators of the relationship between drinking and sexual risk behaviour.