Spread of HIV and Alcoholism
Name
Walden University
2022
Spread of HIV and Alcoholism
O'Farrell, (2006), suggests that, people who drink to excess, either on single occasions or
regularly, are more likely than others to engage in behavior that place them at risk for contracting
HIV. They will more often be present at locations where the risk is higher and more often engage
in sexual risk-taking, like having multiple partners, casual partners or unprotected sex. Under the
influence of alcohol people loose their inhibitions and have their judgment impaired and can
easily find themselves involved in behavior that would put them at risk for contracting HIV.
Such behavior can not alone be attributed to the physical effects of alcohol on the brain and the
body, maybe not at all.
Kozlovskiy (2000) argues that, the explanation is more likely to be of a cultural, social and
psychological kind. In many societies and cultures, in all corners of the world, irresponsible or
rude behavior under alcohol intoxication is tolerated and even pardoned. With this cultural
acceptance in mind, people use alcohol as an excuse to perform actions that are normally not
tolerated or as an explanation of failure, like poor sexual performance. In other words, drinking
gives you privileges and these privileges are accepted by others. Another thing is that the
assumption or expectation that alcohol gives a certain effect, may in itself lead to feelings of joy
and happiness or violent behaviors.
Mwenesi (1995) states that, people who abuse alcohol are more likely to engage in behaviors that
place them at risk for contracting HIV. For example, rates of injection drug use are high among
alcoholics in treatment, and increasing levels of alcohol ingestion are associated with greater
injection drug–related risk behaviors, including needle sharing. A history of heavy alcohol use
has been correlated with a lifetime tendency toward high-risk sexual behaviors, including
multiple sex partners, unprotected intercourse, sex with high-risk partners (e.g., injection drug
users, prostitutes), and the exchange of sex for money or drugs. There may be many reasons for
this association. For example, alcohol can act directly on the brain to reduce inhibitions and
diminish risk perception.
However, expectations about alcohol’s effects may exert a more powerful influence on alcohol-
involved sexual behavior. Studies consistently demonstrate that people who strongly believe that
alcohol enhances sexual arousal and performance are more likely to practice risky sex after
drinking. Some people report deliberately using alcohol during sexual encounters to provide an
excuse for socially unacceptable behavior or to reduce their conscious awareness of risk.
According to McKirnan(2001) and colleagues, this practice may be especially common among
men who have sex with men. This finding is consistent with the observation that men who drink
prior to or during homosexual contact are more likely than heterosexuals to engage in high-risk
sexual practices.
Finally, the association between drinking levels and high-risk sexual behavior does not imply
that alcohol necessarily plays a direct role in such behavior or that it causes high-risk behavior on
every occasion. For example, bars and drinking parties serve as convenient social settings for
meeting potential sexual partners. In addition, alcohol abuse occurs frequently among people
whose lifestyle or personality predisposes them to high-risk behaviors in general, (Kresina 2002)
Alcohol use causes disinhibition and diminished perception of risk, which increase the likelihood
that a person would put him or herself (or his/her partner) at risk for HIV infection by engaging
in unsafe sexual practices, such as having multiple sex partners, unprotected intercourse, sex
with high-risk partners (e.g., injection drug users, prostitutes), and exchanging sex for money or
drugs (Windle 1997). However, this issue still is being debated (Raj et al. 2009; Seth et al. 2008;
Theall et al. 2007). Sexual promiscuity triggered by alcohol abuse also increases the risk of
acquiring other sexually transmitted diseases (STDs) (Windle 1997), and people with STDs are
at risk for both transmitting and acquiring HIV (Wasserheit 1992).
STDs appear to increase susceptibility to HIV infection by two mechanisms. Ulcerative STDs
such as syphilis, herpes, or cancroids cause breaks in the genital tract lining or skin, creating a
portal of entry for HIV. Genital ulcers or non ulcerative STDs such as chlamydiosis, gonorrhea,
and trichonomiasis induce inflammation in the genital tract, thus increasing the concentration of
cells in genital secretions that can serve as targets for HIV (e.g., CD4+ T-cells, a type of white
blood cell involved in cell-mediated immunity which also serves as host cells that aid HIV in
replication). STDs also appear to increase the risk of an HIV infected person transmitting the
virus, as people with HIV who present with other STDs are shedding more HIV in their genital
secretions than are those who are infected with HIV only (Kiviat et al. 1990; Moss et al. 1995).
Moreover, the concentration of HIV in semen is significantly higher in patients co infected with
the bacteria responsible for gonorrhea, (Plummer et al. 1991).
Jernigan, (2001) asserts that, sexual risk behavior accounts for a large number of opportunities
for acquiring HIV infection, and alcohol use has been shown to increase high-risk sexual
behavior. Moreover, the social dynamics that surround alcohol use, sexual risk behavior and HIV
infection and interactions between these issues warrant a search for alternative ways of dealing
with the problem in diverse socio cultural settings, if intervention is to be effective. Only by
unraveling the social dynamics of alcohol use-related sexual risk behavior within particular
cultural settings can this be achieved. It can be anticipated that the body of knowledge acquired
through proven scientifically sound instruments will not only highlight the relevant preventive
measures to be adopted but will bring out relevant clinical and experimental research questions
to be considered by all disciplines interested in curbing the problem of alcohol use-related sexual
risk behavior with regard to HIV infection.
There is generally an increase in alcohol use by teenagers and women. Men, however, generally
have more social liberties than women, with respect to alcohol use as well as sexual activities.
Furthermore, the literature shows that the age for initiating alcohol use and experimenting with
sex is on the decline, but the age for marriage is on the rise (e.g. the Russian Federation, India).
Teenage pregnancies are also on the rise. Sexual experimentation outside marriage is increasing.
Risky sexual behaviors continue despite a confirmed STI/HIV status, as reported in Belarus,
Zambia and India. Denial of the problem and social stigma prevent people with STIs to seek
treatment. Severity of symptoms is another factor that influences the decision of persons with
STIs to seek treatment. Despite knowledge about preventive measures, condom use is limited,
Zorko (2001)
The spread of the HIV epidemic from high-risk groups to the general population is a concern in a
populous country like India. Male dominance also limits the ability of women to adopt
preventive measures such as the use of condoms. Alcohol use is associated with certain types of
sexual activity. Crime often plays a role in unprotected casual sex, group sex and anal sex when
participants in these activities are under the influence of alcohol. Alcohol use has also been
linked to early sexual experiences (e.g. Belarus, the Russian Federation, Kenya and South
Africa). Alcohol use and sexual risk behaviors are particularly prevalent in settings such as
nightclubs, bars, dark houses, highway eating joints and motels, and brothels.
Nikulina (2001) furthermore states that, alcohol is commonly used as a dis inhibitor, a sex
facilitator, a symbol of masculinity, and a means of relaxation, recreation, socializing and
improving communication skills (e.g. in Mexico and Romania). Alcoholic beverages are also
used as a facilitator in approaching the opposite sex. “Masculinity” is often linked to the ability
to have multiple partners, imbibe alcohol and engage in promiscuous behavior. Among women,
alcohol use increases involvement in risky sexual encounters and sexual victimization, exposing
them to the risk of unwanted pregnancies and STIs (e.g. in the Russian Federation and South
Africa).
It has also been shown that alcohol use and sexual risk behaviors increase during certain
festivities and celebrations across countries (e.g. in South Africa, Kenya and Romania). Alcohol
use and promiscuity are customary during funerals among certain population groups in Kenya. In
contrast, certain religions and religious sects prohibit the use of alcohol and indulgence in risky
sexual practices. Dry sex (a preference among certain rural tribes in Zambia and South Africa),
sexual cleansing and levirate marriage (Zambia) increase the risk of STIs in Africa. The media
(electronic and print) play an important role in shaping and influencing sexual behavior and
alcohol use patterns. Certain advertisements, pornographic movies, thrillers and romantic
programs glamorize and promote engagement in these activities, Sabo (1998)
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