Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

Kisumu, Kenya, showed that only half had used a condom with their most recent
client, and a third had never used a condom. Perhaps not surprisingly, given this low
rate of condom use, fully three-quarters of the sex workers responding to the survey
in this high-prevalence area of East Africa tested positive for HIV.
One of the factors that influences condom use is alcohol consumption. In many continents, commercial sex and other risky encounters take place after drinking sessions. People who are drunk are less likely to use condoms than people who are
sober. The consequences can be dire, as Figure 24 shows. In this South African
study, the prevalence of HIV infection was far higher among men and women who
consumed alcohol than among men and women who said they never drank. This
was true even among women in red-light districts.

Figure 24.

HIV prevalence rates among people consuming alcohol and
among non-drinkers, Carletonville, South Africa, 1998

70
60
50
S40
~ 30
20
10
0

Sdrinkers
U non-drinkers

women in commercial sex areas

men

women

Source: Campbell et al. (unpublished data)
In Zambia, close to a quarter of women and a fifth of men with casual partners said
they had been drinking the last time they had sex with their casual partners. In western Kenya, most sex workers questioned said that alcohol was involved the first time
they ever sold sex, and the overwhelming majority of sex workers in the town of
Kisumu said that alcohol was an integral part of sexual transactions, with men buying women a drink to signal their interest in buying sex. They also said condom use
tended to evaporate when either the client or the sex worker was drunk. Studies
among men in Europe, Mexico, Zimbabwe and Uganda have also shown a strong
correlation between frequent use of alcohol and other drugs and unprotected sex.

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