STRIVE Tackling the structural drivers of HIV

Alcohol is an important risk factor for HIV worldwide. In 2016, 73% of new HIV infections among adolescents occurred in Africa - despite a decline in other populations - the prevalence among youth is increasing. Studies show that alcohol use influences behaviours such as multiple partnerships, unsafe sex and transactional sex that in turn increase the risk of contracting HIV. Efforts to address alcohol consumption in this region have mainly taken the form of interventions to reduce individual alcohol consumption, but these have not, in general proved effective. The challenge is to reach a better understanding of alcohol as a structural driver of HIV risk among youth.

This brief synthesises research from the field and STRIVE findings and gives evidence on three main issues:

1. Alcohol use is a significant problem among young people, particularly young men, and increases HIV risk and other health harms
2. Alcohol is widely available, affordable, aggressively promoted and convieniently packaged for purchase from formal and informal sellers in residential neighbourhoods
3. Alcohol promotion, availability, packaging and promotion influence alcohol consumption among young people

STRIVE recommends research efforts to:

• Continue building the evidence base on alcohol use and youth and alcohol initiation in East Africa
• Continue building the evidence base on the availability, affordability and promotion of alcohol.
• Ensure that evidence on youth drinking and health harms reaches the general public, policy makers and other intermediary partners.
• Engage with government institutions responsible for alcohol legislation to contribute evidence to inform policymaking.