Addressing the Impact of Alcohol on the Prevention, Care, and Treatment of HIV in Southern and Eastern Africa: Research, Programming, and Next Steps

Report on a PEPFAR Technical Consultation Held in Windhoek, Namibia, April 12–14, 2011

Alcohol use in virtually all cultures reduces both the perception of risk and inhibitions about engaging in risky behavior. Research conducted throughout the world has documented the association between alcohol use and high-risk behaviors, including inconsistent condom use with casual partners, a 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—and all of these, in turn, are associated with an increased risk of HIV infection.1 Alcohol consumption continues to increase in sub-Saharan Africa, with South Africa displaying one of the world’s highest volumes per capita of alcohol consumption; also, sub-Saharan Africa is still home to two-thirds of all people living with HIV. Innovative programmatic approaches to respond to hazardous alcohol use and risk of HIV infection are being implemented in several countries and are beginning to yield positive results. However, they remain underfunded and lack political support.

In response to these challenges, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) sponsored a three-day technical consultation from April 12 to 14, 2011, in Windhoek, Namibia. Eighty-seven participants attended the meeting, including researchers, PEPFAR implementing partners, and U.S. Government Mission staff from 17 African countries, all of whom expressed an interest in gathering additional information and tools for addressing alcohol and HIV (see Appendix A for the meeting agenda and Appendix B for a list of participants).