Heavy alcohol consumption is strongly and consistently associated with sexual risk behaviors in both men and women in Botswana, according to one of the few research studies on the topic in sub-Saharan Africa.
The results argue for the need to deal with alcohol abuse within HIV prevention programs in African countries. Strategies to do this could include education campaigns that target both alcohol use and HIV in schools and in social venues, including beer halls. As the researchers stress, any strategy must consider the cultural and social significance of alcohol use (in Botswana, for example, alcohol use is a symbol of masculinity and high socio-economic status). In addition, any strategy must simultaneously tackle not only the overlap between alcohol use and risky sexual behavior but also the overlap between alcohol and other risk behaviors such as intergenerational sex.