Perceptions of the Combination of Hiv/aids and Alcohol as a Risk Factor among Sti Clinic Attenders in South Africa: Implications for HIV Prevention

By Simbayi, Leickness C.; Mwaba, Kelvin et al. | Social Behavior and Personality: an international journal, May 30, 2006 | Go to article overview

Perceptions of the Combination of Hiv/aids and Alcohol as a Risk Factor among Sti Clinic Attenders in South Africa: Implications for HIV Prevention


Simbayi, Leickness C., Mwaba, Kelvin, Kalichman, Seth C., Social Behavior and Personality: an international journal


With the emergence of HIV/AIDS as a global health threat, there has been increasing interest among researchers in understanding sexual risk-taking behavior. The finding of a strong link between sexually transmitted infections (STIs) and HIV suggests that individuals with STIs may be at greatest nsk for HIV infection. This study sought to gain insight regarding STI clinic attenders' perceptions of HIV/AIDS and alcohol as a risk factor with regard to HIV infection. Twenty-one men and women who were self-referrals at an STI dedicated clinic in Cape Town, South Africa, participated in the study. The findings showed that HIV/AIDS was cognitively represented as an STI. transmitted through risky sexual behavior such as casual sex, multiple sexual partners, and inconsistent condom use. Alcohol was implicated as a major risk factor to HIV infection because it was perceived as the main tool for transactional sex, lowering of sexual inhibitions and inconsistent use of condoms. The implications of these findings for the development of effective HIV/AIDS prevention programs are discussed.

Alcohol use is the most prevalent form of substance abuse in South Africa with an estimated 5 billion liters of alcoholic beverages consumed each year (Parry, 1998). In the only national study of its kind that used a national household survey methodology, Shisana, Zungu-Dirwayi, Toefy, and Simbayi (2004) found that 32.8% of South Africans consumed alcohol; 11.2% consumed alcohol monthly, 12% weekly, 7% 2-3 times per week and 2% daily. A township survey found that 89% of men and 61% of women reported lifetime alcohol use (Kalichman & Simbayi, 2003) while a survey of youth between 15 and 19 years in one province found that 39% were regularly using alcohol (Madu & Matla, 2003). Other surveys have found that 39% of males and 23% of females in grades 8 and 11 used alcohol (Parry), while 31 % of students in one city admitted to having used alcohol during the previous month (Flisher, Parry, Evans, Muller, & Lombard, 2003).

Although it has long been established that excessive alcohol consumption can cause substantial health risk to an individual, it is only recently that researchers in South Africa have been trying to examine systematically the association between alcohol use and sexual risk-taking behavior. A recent study by Shisana et al. (2004) showed a strong link between sexual risk-taking behavior and alcohol use. Respondents with multiple partners (16.2%) were significantly more likely to report consuming alcohol (2-3 times per week) than were monopartners (8.3%), abstainers from sex in the last 12 months (5.0%) and virgins (0.5%). Condom use during the last sex act was negatively and significantly related to frequency of alcohol use. Another study conducted in Gugulethu, a township in Cape Town, reported that 94% of all places where people meet new sexual partners were formal and informal alcohol-serving establishments (Weir et al., 2003). A study, also conducted in a Cape Town township, found that 42% of the patrons socializing at alcohol-serving establishments reported meeting a new sexual partner there (Simbayi, 2004). In addition, only 60% of the patrons reported using a condom with the most recent new partner. Another study by Kalichman and Simbayi (2003) reported that having a history of engaging in an activity with higher risk for HIV infection was significantly associated with alcohol use. These researchers found that 54% of individuals who had been diagnosed with a sexually transmitted infection (STI) reported using alcohol, compared with 40% of persons who did not have an STI.

The aim of this study was to increase understanding of the perception of HIV combined with alcohol as an HIV risk factor in South Africa in a sample that may be considered to be vulnerable to HIV infection. Unlike previous studies that have obtained quantitative data on alcohol and risk behavior, the present qualitative study sought to gain in-depth understanding of a sample of STI clinic attenders' perceptions of HIV/AIDS and related risk factors. …

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