Prevention of Alcohol-Related HIV Risk Behavior
Across countries and cultures, alcohol is known to reduce both the perception of risk and inhibitions to engage in risky behaviors. In developing countries, a growing body of research strongly suggests that moderate to heavy alcohol consumption is associated with the behaviors that put people at risk for HIV infection. These behaviors include inconsistent condom use with casual or commercial partners, greater number of lifetime and recent sexual partners, concurrency of sexual partners, intergenerational sex, the buying and selling of sex and the experience of violent or coercive sex.
Research also indicates that problem drinking and alcohol dependency are widespread and growing problems in developing nations, where alcohol is the most commonly abused drug. More research is needed in developing countries to understand the socio-cultural and economic context of alcohol use, as well as the specific psychological pathways through which alcohol affects sexual behavior; however, the existing scientific evidence linking alcohol use with HIV sexual risk behavior already provides a compelling call to action. In countries battling severe HIV epidemics, interventions that address problem drinking in conjunction with community-based efforts to reduce HIV risk behavior have the potential to reduce the spread of HIV.
The development of effective programs to address the intersection of risky sexual behavior and alcohol consumption is still in its infancy. In developing countries, programs that specifically address alcohol and HIV are extremely rare. However, a small number of alcohol and HIV prevention interventions have recently been developed and implemented in sub-Saharan Africa and India. Below, we highlight these programs, all of which have been shown to be acceptable and feasible to implement in diverse community settings. Some of these programs also show promise in bringing about behavior change—for example, reducing recent and heavy alcohol consumption, improving attitudes toward and use of condoms, reducing the frequency of consuming alcohol prior to sex and of meeting sex partners at drinking venues. The interventions fall into the following three categories:
- Prevention of Alcohol-Related HIV Risk Behavior among Youth
- Prevention of Alcohol-Related HIV Risk among Women
- Venue-based Prevention of Alcohol-Related HIV Risk
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