Prevention of Alcohol-Related HIV Risk Behavior


  1. Definition of the Prevention Area

    Alcohol use in virtually all cultures reduces both the perception of risk and inhibitions to engage in risky behaviors. The association between alcohol use and high-risk behaviors, including inconsistent condom use with casual 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, is in turn associated with an increased risk of HIV infection.

  2. Epidemiological Justification for the Prevention Area

    Sub-Saharan Africa is home to two-thirds of all people living with HIV. South Africa has one of the highest volumes per capita of alcohol consumption in the world. There is evidence that alcohol consumption has been increasing over time in sub-Saharan Africa, where alcohol is the most commonly abused drug. Existing scientific evidence linking alcohol use with HIV sexual risk behavior already provides a compelling call to action, but more research is needed in developing countries to understand the sociocultural, psychological, and economic context of alcohol use, as well as the ways in which alcohol affects sexual behavior. 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.

  3. Core Programmatic Components

    Programs to change behaviors related to alcohol use and HIV risk may include population-based or venue-based interventions. School-based programs are an example of a population-based intervention. Venue-based projects target establishments, both legal and informal, where alcohol is served. Program developers and managers are challenged to go beyond mere knowledge-based programs, since knowledge about HIV risk behaviors is already high in some areas. To address the difficult situations that can arise when one or both partners have been drinking prior to sex, such as refusing sex with a partner who declines to wear a condom, many programs are providing supports and scripts that individuals can use to anticipate and handle high-risk situations, along with encouragement and support to avoid sex while intoxicated.

  4. Current Status of Implementation Experience

    Effective programs to address the intersection of risky sexual behavior and alcohol consumption are still in their infancy. Programs that specifically address alcohol and HIV in developing countries 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 show promise in bringing about behavior change, such as reducing recent and heavy alcohol consumption, improving both attitudes toward and the use of condoms, and reducing the frequency of consuming alcohol prior to sex. 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

UPDATED 6/2016

What We Know

HIV-Alcohol Risk Reduction Interventions in Sub-Saharan Africa: A Systematic Review of the Literature and Recommendations for a Way Forward

Carrasco, M.A., Esser, M.B., Sparks, A., and Kaufman, M.R. AIDS and Behavior (March 2016), 20(3), 484–503.

This review synthesized findings from 19 HIV-alcohol risk reduction interventions in the African region. All studies promoted individual behavior change using strategies such as peer education, health trainings and workshops, and health education videos; 15 promoted HIV-alcohol risk reduction; and 4 focused on integrating HIV-alcohol risk reduction into multifaceted HIV prevention programs. Seventeen studies showed efficacy in at least one of the three main types of outcomes analyzed (HIV-alcohol risk behaviors, sexual risk behaviors, and alcohol consumption). The authors reported that studies targeting youth in schools had limited efficacy; studies targeting women who use drugs, sex workers, and clients of services for voluntary testing and counseling or sexually transmitted infections were more successful. Studies targeting drinking venue patrons were efficacious when delivered as a short intervention in a community setting, but not when delivered by peers at the drinking venues. However, the authors also emphasized that though many studies show an association between alcohol consumption and risky sexual behavior, there is a scarcity of HIV-alcohol risk reduction interventions in sub-Saharan Africa. They urged integrating alcohol risk reduction components into current HIV prevention programming, and expanding the use of structural interventions to increase the sustainability of less risky alcohol consumption patterns and sexual behaviors.

Gender-Specific HIV Prevention Interventions for Women Who Use Alcohol and Other Drugs: The Evolution of the Science and Future Directions

Wechsberg, W.M., Deren, S., Myers B., et al. Journal of Acquired Immune Deficiency Syndromes (June 2015),69(Suppl 2): S128–139.

This article presented the history and evolution of HIV prevention intervention research with women who use alcohol and other drugs. This behavior is associated with other, intersecting risk behaviors that drive gender disparities in HIV risk and health outcomes. The analysis focused on projects that address 1) women's risk behavior, roles in sexual relationships, and gender power dynamics and 2) issues commonly faced by women who use alcohol and other drugs, such as gender-based violence and victimization. The literature search covered 25 years and identified fewer than 25 gender-specific interventions for this group. Initial projects emphasized knowledge and increasing condom use. Second-generation research addressed structural factors including gender-based violence, economic dependency, power dynamics, and couple relationships. Recent programs, implemented in more real­-world settings, incorporated biobehavioral interventions like pre-exposure prophylaxis. Programs examined in the study focused primarily on reducing sexual risks, and none addressed sociostructural barriers like stigma, discrimination, and marginalization from health services. These issues, as well as harm reduction activities such as condom distribution, opiate substitution, and syringe exchanges, need to be incorporated into programs implemented and evaluated in real world settings. Globally, women who use alcohol and other drugs remain a key population at risk for HIV, and programs using evidence-informed, gender-specific interventions must address their unique needs. 

Summary of the Proceedings of Meeting on Alcohol, HIV Risk Behaviors and Transmission in Africa: Developing Programmes for the United States President’s Emergency Plan for AIDS Relief (PEPFAR)

Ashley, J.W., Levine, B., and Needle, R. African Journal of Drug and Alcohol Studies (June 2006),5(2).

Evidence about the link between alcohol-related risk behavior and HIV transmission was presented at an Africa-wide meeting, with participants concluding that intervention programs should target populations that drink heavily and include multilevel interventions at drinking venues. Participants emphasized the need to take into account social and cultural norms that may increase alcohol-related risk behaviors. Speakers also highlighted the importance of addressing the particular risks of specific populations. For example, women may be subject to gender-based violence and may be at increased risk of HIV infection, while individuals in the military and uniformed services are at increased risk of alcohol abuse due to circumstances of service, and may be more likely to frequent sex workers given their distance from home and peer pressure. The authors recommend incorporating intervention services into existing programs, such as HIV testing and counseling programs. Because government is the “largest financial stakeholder in the alcohol industry” in many countries, program developers may find resistance to implementing interventions.

Reducing HIV Risks in the Places Where People Drink: Prevention Interventions in Alcohol Venues

Pitpitan, E.V., and Kalichman, S.C. AIDS and Behavior (January 2016), 20(Suppl 1): 119–133. 

This study reviewed research on the role that venues where alcohol is served or sold for consumption may play in HIV risk. The authors examined social and structural factors associated with HIV risk, HIV prevention interventions, and methodological considerations for research in these venues. Many characteristics of venues influence behavior and HIV risk: proximity, physical characteristics, staff, social norms that promote consumption of alcohol and drugs, a confluence of violence and disinhibition, and the intersection of sex and alcohol. Nevertheless, relatively few prevention programs have been implemented in alcohol venues; the review identified only 11 eligible studies. The studies tended to focus on individual behaviors and specific populations (college students, female sex workers and clients, and so on). Specific venue types included (depending on the setting) bars, nightclubs, stores, and informal settings like shebeens; the authors also included homes in this review. They outlined interventions at individual, social, and structural levels, and found that multilevel programs that combine approaches at these three levels are the most successful in leading to lasting behavior change. The authors argued that research and interventions, which tend to focus on individual patrons, should also consider alcohol venues and their characteristics as independent entities for research, and study the characteristics most closely associated with HIV risk to inform future interventions. 

A Population-Based Study on Alcohol and High-Risk Sexual Behaviors in Botswana

Weiser, S.D., Leiter, K., Heisler, M., et al. PLOS Medicine (October 2006), 3(10) e392.

Previous research examining alcohol use and sexual risk behavior has been limited by its dependence on samples drawn from clinics or drinking venues. This study of 1,268 adults in the five districts of Botswana where HIV prevalence is highest found that both men and women with the highest rates of problem drinking were more than three times as likely to have a history of unprotected sex with a non-primary partner as those who were not heavy drinkers. Male heavy drinkers were more likely to pay for sex, and female heavy drinkers were more likely to sell sex. This study supports the findings of previous research showing associations between alcohol use and sexual risk behavior and illustrates that the trends hold within a large population-based sample.

The Role of Alcohol Policies in Preventing Intimate Partner Violence: A Review of The Literature

Vall L.A.. Kearns, M.C., Reidy, D.E., Valle, L.A. Journal of Studies on Alcohol and Drugs (January 2015), 76(1): 21–30. 

This article summarized research on the impact of alcohol policies on intimate partner violence (IPV). Eligible studies included those that specifically assessed the impact of alcohol policies on IPV outcomes, and also those that examined the impact of alcohol policies on other types of violence. Studies on policies and IPV focused on three main areas: density of alcohol outlets; time and day of alcohol sales; and pricing and taxation. Some studies on density suggested that higher density is associated with higher rates of violence, including IPV; but the association was inconsistent, and no studies directly assessed the impact of policies to regulate density on violence. Policies restricting the time and day of sales, and those addressing pricing/taxation, showed promise in reducing problem drinking. However, the few studies examining the impact of these policies on IPV had inconsistent findings; most indicated no impact on IPV. Gaps in research and methodology also hampered measurement of the impact of alcohol policies on IPV. For example, policies may only have impact if they are enforced, which can be difficult to assess. Many studies relied on police reports to assess IPV; and such reports may not reflect the true extent of IPV. Determining the impact of alcohol policy on IPV requires additional research, the authors concluded. 

Alcohol Use and Sexual Risk Behaviour: A Cross-Cultural Study in Eight Countries

Bianchi, G. World Health Organization (2005).

This report reviews published and unpublished documents on alcohol and sexual risk behavior, ranging from scientific publications to police and law enforcement records in Kenya, South Africa, Zambia, Belarus, Romania, the Russian Federation, India, and Mexico. Cultural issues, poverty, gender, the history of colonialism, and disruption of life following the fall of communist regimes and the rise of the free market have led to a range of connections between alcohol use and HIV. Proving one’s masculinity by drinking and having multiple sex partners, for example, was universal. Although alcohol consumption was concentrated among men, it was increasingly a becoming a female phenomenon, especially in Belarus and South Africa. The association between alcohol and sexual risk behavior was “far from linear”; in some cases, alcohol consumption occurs before risky sex, while in other cases drinking follows risky sexual activity. Obstacles to HIV prevention are also reviewed.

Effectiveness of Brief School-Based Interventions for Adolescents: a Meta-analysis of Alcohol Use Prevention Programs

Hennessy E.A., and Tanner-Smith, E.E. (April 2015) Prevention Science 16(3): 463–474. 

This article reported on a meta-analysis of the effectiveness of school-based brief alcohol interventions (BAIs) among adolescents, including group- and individually-based interventions. BAIs have been shown to be effective in reducing alcohol use among adults, but reviews had not previously assessed their effectiveness in adolescents. Seventeen studies met the criteria for inclusion in the analysis: eight individual and nine group-based interventions. School-based BAIs were associated with significant reduction in alcohol consumption among adolescents who participated in the programs compared with those in controls. Subgroup analyses indicated that BAIs delivered to individuals were effective, and were associated with significant reductions in alcohol use; but no such association was seen among BAIs delivered in groups. However, this analysis was confounded with the program approach. Motivational enhancement therapy (MET) was the most effective approach; MET was used in all of the individually-delivered interventions, but in only one group intervention. Also, several of the group-delivered programs enrolled participants who reported excessive alcohol use at the beginning of the study. The study concluded that some school-based BAIs are effective in reducing adolescents' alcohol consumption, but may not be effective if delivered in groups. The authors suggested additional research to determine if group-delivered BAIs that use MET are beneficial.

The Association between Alcohol Use, Sexual Risk Behavior, and HIV Infection among Men Attending Beerhalls in Harare, Zimbabwe

Fritz, K.E., Woelk, G.B., Bassett, M.T., et al. AIDS and Behavior (September 2002),6(3): 221–228.

The authors interviewed 324 beer hall patrons in Harare, Zimbabwe. Each of the patrons underwent HIV testing to determine the link between drinking and HIV. The authors found that HIV prevalence increased with more frequent drinking and with each of the following: meeting a sex partner at the beer hall, having sex while intoxicated, and paying for sex in the past six months. Men who had sex while intoxicated reported 20 times more episodes of unprotected sex and 27 times more episodes of paying for sex, compared to men who had not had sex while intoxicated. Having sex while intoxicated in the last six months was the single greatest determinant of recent HIV seroconversion. This study demonstrated the strong link between alcohol use and HIV risk behavior, as well as the feasibility of conducting HIV prevention interventions and research in beer halls.

Putting it Into Practice

Randomized Community-level HIV Prevention Intervention Trial for Men Who Drink in South African Alcohol-serving Venues

Kalichman, S.C., Simbayi, L.C., Cain, D. et al. European Journal of Public Health (November 2013), 24(5): 833–839. 

This cluster-randomized trial evaluated the effect of a multilevel (individual and social-structural) HIV prevention intervention for men who drink in shebeens (informal alcohol-serving venues). The program aimed to reduce men’s sexual risks and sustain changes by changing the social context within which they drink. Twelve matched pairs of neighborhoods in South Africa were randomized to 1) an HIV prevention intervention to reduce sexual risk and increase communication around risk reduction in social networks; or 2) a control intervention on preventing violence in relationships. The individual-level intervention comprised skills building workshops on alcohol use and reducing sexual risk. The social-structural intervention promoted conversations about safer sex, distributed information, and conducted community educational events. Overall, modest effects on increasing condom use and shifting social norms around risk reduction were seen. Men who participated in the HIV prevention workshops reported greater condom use, perceptions of safer sex norms, and HIV prevention-oriented conversations than men in the comparison workshops through one year. Community changes in conversations and social norms were observed. Increases in condom use were modest and less consistent over time.  The authors suggested that shebeens can serve as venues for HIV prevention, and that shifting perceptions of shebeens from risk environments toward venues that support protective behaviors could help sustain individual behavior change. 

Evaluation of a Peer Network-Based Sexual Risk Reduction Intervention for Men in Beer Halls in Zimbabwe: Results from a Randomized Controlled Trial

Fritz, K., McFarland, W., Wyrod, R., et al. AIDS and Behavior (November 2011), 15: 1732–1744.

This article reported on a randomized, controlled trial (2002–2007), the Sahwira HIV Prevention Program, a male-focused, peer-based intervention to engage men in HIV prevention. The program was based on the concept that men could help their friends avoid alcohol-related risky sex. Twenty-four beer halls in Harare, Zimbabwe were randomized into intervention and control sites; in the intervention halls, more than 400 male patrons were trained to help and educate men within their networks of friends. This training involved one-on-one interactions, small group discussions, and educational events providing skills and information to help male friends avoid risk. Overall, risk behavior declined in both intervention and control communities. A modest, statistically significant increase in peer-to-peer interactions to reduce risk was seen. However, there was no evidence that the intervention affected the primary outcome measure (levels of unprotected sex outside of marriage) in the intervention group compared to the control group. Nor was there significant impact on other outcome measures (numbers or types of partners, HIV knowledge, and HIV testing). The authors said that finding effective ways to engage men in HIV prevention is urgent, and suggested that settings like beer halls may present good opportunities for such programs. 

The Impact of an Alcohol Harm Reduction Intervention on Interpersonal Violence and Engagement in Sex Work Among Female Sex Workers in Mombasa, Kenya: Results from a Randomized Controlled Trial

Parcesepe, A.M, Engle, K.L., Martin, S.L., et al. Drug and Alcohol Dependency (April 2016), 21: 21–28. 

The authors described the results of a randomized controlled trial examining the effect of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya. The 818 participants (patrons of HIV prevention drop-in centers who were moderate-risk drinkers, and had engaged in transactional sex in the past six months) were evenly randomized to receive either six monthly individual counseling sessions on harm reduction from a trained nurse counselor (intervention) or six sessions on non-alcohol-related nutrition (control). Neither intervention included information on interpersonal violence or HIV risk. Participants were interviewed at enrollment, just after the intervention, and at six months post-intervention. At baseline, virtually all participants (99%) reported engaging in sex work in the previous 30 days, and high levels of physical (26.5%) and verbal (50.0%) violence from a paying sex partner. Almost one-third reported physical violence from a non-paying sex partner. The alcohol intervention was associated with several statistically significant outcomes: decreases in physical violence and verbal abuse from paying partners; and reduced odds of engaging in sex work. The authors suggested other research approaches to further understand the complex pathways among alcohol, violence, and sex work, and develop potential interventions. 

Gender and HIV Infection in the Context of Alcoholism in Kenya

Muturi, N. African Journal of AIDS Research (April 2015), 14(1): 57–65. 

This study examined rural communities’ perspectives on HIV risk factors among women, especially how alcohol contributes to women's risks in relationships where the man drinks excessively and the woman does not. Women (30) and men (30) in rural central Kenya were recruited from community-based organizations to participate in focus group discussions divided by sex. Men and women confirmed very high alcohol use in these communities, particularly widely-available fermented alcoholic beverages made from grains or fruit. Drinking by women was socially unacceptable and women generally did not drink alcohol in this setting. Men and women cited serious health effects from drinking, and linked men's drinking to women’s risk of HIV, largely because women married to drinkers often engaged in extramarital, sometimes risky, partnerships. Women were driven to these relationships by a lack of sexual satisfaction and above all by significant social pressure to bear and rear children. Women whose husbands drank excessively also engaged in risky sex for economic reasons, because some husbands could not provide economic support. Participants also associated escalating sexual violence, including sexual abuse of children and incest, with excessive alcohol consumption. They noted that neither women nor men used condoms effectively in this context, despite awareness of HIV risk. The authors strongly suggested interventions and support programs that combine alcohol and HIV prevention and focus on the needs of married older women.

Condom Availability in High Risk Places and Condom Use: a Study at District Level in Kenya, Tanzania and Zambia

Sandøy, I.F., Blystad, A., Shayo, E.H. et al. BMC Public Health (November 2012), 12: 1030

The authors described a study on condom availability and use in one district each in Kenya (Malindi), Tanzania (Mbarali) and Zambia (Kapiri Mposhi). In each study district, researchers collected data in "high-risk" venues where people meet new sex partners; through population-based surveys; and during focus group discussions. The study, nested within a broader intervention to improve priority-setting at the district level, assessed whether condom programs are appropriately prioritized in health systems. Researchers visited high-risk venues to ask whether people met sex partners there, condoms were available, and HIV prevention activities took place there. Most of the venues named in Kenya and Tanzania were informal drinking places, bars, or restaurants. Though national strategies mention bars and lodgings as important distribution points for condoms, condoms were available in only one-third of high-risk settings in Malindi, fewer than half in Mbarali, and 60 percent in Kapiri Mposhi. Rural respondents perceived condoms to be less available, and reported lower use, than urban respondents. Most focus group participants reported that condoms were available, but free condoms were not always widely accessible. Easy availability of condoms in high-risk venues could increase their use, and is a stated HIV prevention strategy in all three countries. The authors urged prioritizing making condoms available consistently in formal and informal drinking venues. 

Tools and Curricula

Researchers Adapt HIV Risk Prevention Program for African-American Women

Williams, J.S. NIDA Notes (April 2004),19(1).

Developed in the early 1990s, the United States National Institute on Drug Abuse (NIDA) standard intervention is an HIV/AIDS education program that adds HIV prevention for drug users and their sex partners to CDC’s standard HIV testing and counseling intervention. This article describes the elements of the NIDA standard intervention and how it has been effectively tailored to meet the needs of populations at risk.

Brief Intervention for Hazardous and Harmful Drinking: A Manual for Use in Primary Care

Babor, T., and Higgins-Biddle, J. World Health Organization Department of Mental Health and Substance Dependence (2001).

Brief interventions—practices that identify a real or potential alcohol problem and motivate an individual to do something about it—have a positive impact on alcohol abuse. This manual provides the rationale for using alcohol abuse screening tools and brief interventions in the primary care setting. It also provides clinicians guidance on how they can quickly and effectively screen patients for alcohol problems and provide information, support, encouragement, and joint problem-solving. Sample scripts are provided, as are patient education materials. When used together with AUDIT: Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, providers have access to a comprehensive approach to alcohol screening and brief intervention in the primary health care setting.

AUDIT: Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care

Babor, T., Higgins-Biddle, J., Saunders, J., et al. World Health Organization Department of Mental Health and Substance Dependence (2001).

This manual introduces AUDIT, the Alcohol Use Disorders Identification Test, a simple screening tool that primary care providers can use to identify patients who may benefit from reducing their alcohol consumption. This updated edition of AUDIT incorporates advances in research, clinical experience, and evaluation over a twenty-year period. It includes both interview and self-screening instruments. This manual is designed to be used in conjunction with Brief Intervention for Hazardous and Harmful Drinking: A Manual for Use in Primary Care.

The HIV and Alcohol Prevention in Schools Project

The HIV and Alcohol Prevention in Schools (HAPS) Project demonstrates the effective adaptation to South Africa of two successful HIV and alcohol prevention curricula from the United States. The project combines participatory classroom and media interventions targeting at-risk adolescents in eight schools. Preliminary results indicated significant differences between students in the intervention and control conditions on sexual and alcohol refusal self-efficacy, attitudes about sex and about alcohol, and intention to use alcohol with sex. Results also suggest that when appropriately adapted for cultural differences, behavioral interventions developed in western countries may be effective in other contexts.

Motivational Interviewing

Motivational Interviewing (MI), a counseling technique for eliciting behavior change, has been used alcohol and substance abuse and health promotion interventions. This webpage from National Registry of Evidence-based Programs and Practices from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration contains summaries on MI outcomes, quality of research, study populations, readiness for dissemination, costs, and replication. A link is provided to access relevant manuals.

Popular Opinion Leader (POL)

Popular Opinion Leader (POL) interventions identify and enlist the help of key opinion leaders to change risky sexual norms and behaviors. The program is based on the principle that trends and innovations are often instigated by a small but influential group of leaders, which then diffuse throughout the population. The United States Centers for Disease Control and Prevention successfully used POL interventions in gay bars to encourage safer sexual norms and behaviors through informal social interaction. This webpage provides links to resources and tools that can be used when implementing a POL intervention, an evaluation field guide and instruments, and contact information for requesting implementation materials.

Project Northland

Project Northland was a large randomized community trial for the prevention of adolescent alcohol use, sponsored by the National Institute on Alcohol Abuse and Alcoholism of the U.S. National Institutes of Health. The project ran from 1991 to 1998 targeting youth in 24 schools and 28 communities in northeastern Minnesota during their 6th, 7th, and 8th grade years. The three-year intervention involved classroom curricula, parental involvement programs, extracurricular peer leadership, and community-wide task force activities. The results of Project Northland supports the effectiveness of primary prevention programs that comprehensively engage youth, parents, and the community.

South Africa HealthWise Project

HealthWise is a comprehensive risk-reduction and life skills curriculum targeting eighth and ninth grade students in Western Cape province of South Africa. An international research collaboration between Penn State University and University of the Western Cape, HealthWise was designed to reduce the transmission of HIV/AIDS and other STIs, reduce drug and alcohol abuse, and increase positive use of leisure time. HealthWise was adapted from similar curricula from the United States, TimeWise. The HealthWise project website hosts a project description as well as slides describing the theoretical underpinnings and logic model for the curriculum.


TimeWise is a published curriculum that teaches youth how to use their free time in healthy ways. The TimeWise Learning Lifelong Leisure Skills project ran from 2001 to 2003 and targeted middle-school youth in the rural Eastern United States to increase positive free time use and mitigate or prevent the initiation of substance use. Based on interrelated theoretical foundations such as Intrinsic Motivation Theory, Self-determination Theory, and Constraints Theory, TimeWise was designed to teach students to determine personally satisfying and meaningful leisure activities; understand the benefits of participating in healthy leisure; alleviate boredom and increase optimal experience in leisure time; and identify and overcome constraints to participating in desired activities. The project website includes a detailed description of the curriculum and a link to ETR Associates, from whom the published curriculum may be purchased.

Additional Resources

United States National Institute on Alcoholism and Alcohol Abuse (NIAAA)

NIAAA is a United States (U.S.) National Institutes of Health website providing extensive information and resources on prevention initiatives for populations that are at risk for alcohol abuse. The site includes a database of alcohol-related biomedical research, educational materials on alcohol abuse prevention and the association of alcohol use and other diseases, including HIV. The focus of NIAAA and the website is on U.S.-based activities, although some information on alcohol programs and consumption in other countries is available in the database. 

United States Substance Use & Mental Health Services Administration (SAMHSA)

This website is a repository for the United States (U.S.) Office of Applied Statistics searchable database on substance abuse and mental illness. SAMHSA collects national statistics on the incidence and prevalence of mental illness, alcohol, tobacco and illicit drug use. The site includes reports, publications and references on a wide range of substance use and mental health topics in U.S. populations. It also contains a database of evidence-based practices for the prevention and treatment of mental and substance use disorders

The World Health Organization (WHO) Management of Substance Abuse

Management of Substance Abuse is a section of the WHO website that offers a large databank on substance use and mental health around the world. The Global Information System on Alcohol and Health includes comprehensive regional and country-level information and standard indicators on substance use trends and related mortality in all United Nations member countries. These data are updated on a regular basis. The site also houses a database of publications and resources on alcohol abuse as a risk factor for HIV, as well as programmatic approaches for HIV prevention related to alcohol use.