Morojele NK, Kachieng'a MA, Mokoko E, et al. Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa

Department of Psychology, Stellenbosch University, Johannesburg, Gauteng, South Africa
Social Science & Medicine (Impact Factor: 2.89). 02/2006; 62(1):217-27. DOI: 10.1016/j.socscimed.2005.05.031
Source: PubMed


This paper describes the South Africa component of a World Health Organization multi-site rapid assessment and response project seeking to develop a methodology for studying factors associated with alcohol use-related sexual risk behaviour in diverse cultural settings. This report focuses on the qualitative assessments that were conducted in order to profile alcohol use and sexual behaviour in the communities concerned, ascertain the relationships between alcohol use and sexual behaviour, and develop a conceptual model of the relationships between alcohol use and sexual risk behaviour. The participants consisted of adults aged between 25 and 44 years in a township and city site in Gauteng province. The assessments involved conducting 18 key informant interviews, observations in seven drinking venues, six focus groups and 16 in-depth interviews of 'risky drinkers' and their partners. Most participants felt that there were high levels of alcohol consumption and unprotected sex among some members of their communities, with the latter occurring mainly among casual sexual partners. The findings also pointed to strong links between alcohol consumption and sexual risk behaviour. A conceptual model of the association between alcohol use and risky sexual behaviour is proposed. This study suggests a need for multi-faceted HIV intervention strategies for reducing levels of alcohol abuse in general, and enhancing protective sexual behaviours among alcohol-using populations.

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    • "Although previous research has been valuable in identifying some aspects of how alcohol increases the risk of sexual risk behavior in drinking settings (Carey et al., 2011; Kalichman et al., 2008; Morojele et al., 2006; Townsend et al., 2010; Watt, Aunon, Skinner, Sikkema, MacFarlane, et al., 2012), further research is needed to give a more in-depth understanding of men's involvement in such behaviors from a gender perspective . We extend previous research by examining the role of alcohol and sexual risk behavior from the perspectives of two prominent theories of gender: the theory of gender and power (Connell, 1987; Connell, 2000) and ambivalent sexism theory (Glick & Fiske, 1996, 2001, 2011; Glick et al., 2000). "
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    ABSTRACT: Alcohol consumption is strongly associated with sexual risk behavior and HIV infection in sub-Saharan Africa. This article seeks to explore the role of constructions of masculinity in men's drinking and sexual risk behavior in drinking venues (bars and taverns) in 2 rural villages of North West Province, South Africa. Ten focus groups were conducted with 58 bar patrons and servers. Four focus groups consisted of female bar patrons, 4 consisted of male bar patrons, and 2 consisted of male bar managers and servers. The participants' ages ranged from 18 to 43 years, and they were interviewed using focus group discussion guides with open-ended questions. Key themes identified through thematic analysis were (a) men's high levels of alcohol consumption, (b) men's tendency to blame women for men's proneness to risky sex when drinking, (c) men's sexual objectification of women, and (d) the far-reaching consequences of sexism and violence perpetrated by men. Policies to promote gender equality are needed to ensure that men are more gender-sensitive, engage in more balanced gender relationships, and do not uphold any destructive gender stereotypes.
    Psychology of Men & Masculinity 10/2015; 16(4). DOI:10.1037/a0038871 · 2.08 Impact Factor
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    • "In addition, other unmeasured factors, such as personality characteristics or new traumatic experiences, could be driving the joint and bi-directional changes in distress and alcohol use. Finally, the sample was non-random, so caution is warranted about generalizing findings to all South African women who drink, especially women who do not attend venues, such as older women who tend to be less likely to attend venues than younger women [49]. "
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    ABSTRACT: Background In South Africa, alcohol use poses a public health burden. Hazardous alcohol use often co-occurs with psychological distress (e.g., depression and post-traumatic stress). However, the majority of the research establishing the relationship between alcohol use and psychological distress has been cross-sectional, so the nature of co-occurring changes in psychological distress and alcohol use over time is not well characterized. The objective of this study is to examine the longitudinal relationship between psychological distress and alcohol use among South African women who attend alcohol serving venues.Methods Four waves of data were collected over the course of a year from 560 women in a Cape Town township who attended drinking venues. At each assessment wave, participants reported depressive symptoms, post-traumatic stress symptoms, and alcohol use. Multilevel growth models were used to: 1) assess the patterns of alcohol use; 2) examine how depressive symptoms uniquely, post-traumatic stress symptoms uniquely, and depressive and post-traumatic stress symptoms together were associated with alcohol use; and 3) characterize the within person and between person associations of depressive symptoms and post-traumatic stress symptoms with alcohol use.ResultsWomen reported high levels of alcohol use throughout the study period, which declined slightly over time. Post-traumatic stress symptoms were highly correlated with depressive symptoms. Modeled separately, both within person and between person depressive and post-traumatic stress symptoms were uniquely associated with alcohol use. When modeled together, significant between person effects indicated that women who typically have more post-traumatic stress symptoms, when controlling for depressive symptoms, are at risk for increased alcohol use; however, women with more depressive symptoms, controlling for post-traumatic stress symptoms, do not have differential risk for alcohol use. Significant within person effects indicated an interaction between depressive and post-traumatic stress symptoms; women reported more alcohol use than usual at times when they had higher post-traumatic stress symptoms, and this increase in alcohol use was further exacerbated for women who also had higher depressive symptoms than usual.Conclusions These findings suggest that interventions targeting post-traumatic stress, especially when post-traumatic stress is comorbid with depression, may reduce alcohol use among South African women who drink.
    BMC Psychiatry 08/2014; 14(1):224. DOI:10.1186/s12888-014-0224-9 · 2.21 Impact Factor
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    • "For example, 93% of adults living in Cape Town townships report meeting new sex partners in shebeens and other drinking venues (e.g., bars, taverns). Sex between new or casual partners often occurs at or around drinking venues (Kalichman et al., 2008; Morojele et al., 2006; Myer et al., 2002) but less than 30% of shebeen patrons reported using a condom at last sexual occasion (Weir et al., 2003). Shebeens may facilitate the sexual transmission of HIV, in part, through sexual networks (Kalichman, 2010). "
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    ABSTRACT: Background Shebeens in South Africa are settings in which alcohol use and sexual behavior often co-occur. The prevalence of alcohol use disorder (AUD), and the association between AUD, situations and settings, and sexual risk behavior, in shebeens remains unknown. Methods Men (n = 763; mean age = 30; 98% Black African) were recruited from townships in Cape Town, South Africa and completed a self-administered survey that assessed alcohol use, sexual risk behaviors, and situations and settings of alcohol use. The Alcohol Use Disorder and Associated Disabilities Interview Schedule DSV-IV Version (AUDADIS-IV) was used to identify the likelihood of AUD. Bivariate regression analyses assessed whether screening for AUD predicted sexual risk behaviors. Multivariate regression analyses examined whether AUD and/or situations/settings predicted risk behaviors. Results Nearly two-thirds of men (62%) endorsed sufficient criteria for AUD; 25%, 17%, and 20% were classified as having a mild, moderate, or severe AUD, respectively. AUD was associated with HIV risk such that men with AUD reported more unprotected sex than men without AUD. Analyses indicated that (a) individual (i.e., AUD) and (b) settings (i.e., frequency of having sex with a partner in a shebeen, tavern, or bottle store) interacted to predict unprotected sex. Conclusions The prevalence of AUD among shebeen patrons was high and was associated with unprotected sex. Findings suggest the need to integrate both individual and situational/setting factors to prevent HIV among patrons of shebeens
    Drug and Alcohol Dependence 07/2014; 140. DOI:10.1016/j.drugalcdep.2014.04.022 · 3.42 Impact Factor
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