Exploring the relationship between HIV and alcohol use in a remote Namibian mining community

In southern Africa, the use of alcohol is increasingly seen as creating a context of risk for HIV transmission. This qualitative study investigates the links between alcohol use and higher-risk sexual behaviours in a remote southern Namibian mining-town community. Using data from six focus groups and 16 in-depth interviews conducted in 2008, the researchers investigated knowledge of the link between alcohol consumption and HIV risk, focusing on the specific mechanisms related to drinking and higher-risk sexual behaviours. Although knowledge regarding HIV and alcohol was high among the mineworkers and other community members, the social structure of a remote mining town appears to lead to high levels of alcohol use and higher-risk sexual behaviours. The heavy use of alcohol acts as an accelerant to these behaviours, including as a source of fortitude for those with an intention to engage in casual sexual partnerships or multiple concurrent partnerships, and as a cause for those behaviours for people who may otherwise intend to avoid them. The findings suggest a need for HIV-prevention programmes that focus more holistically on HIV and AIDS and alcohol use, as well as the need for structural changes to mining-town communities in order to reduce the likelihood of both heavy alcohol use as well as a high prevalence of higher-risk sexual behaviours.