Wednesday, September 23, 2020

Bottoms up!

A number of Botswana lecturers, medical doctors and researchers have joined forces to try and force Botswana to cut down on beer drinking. But given the strong business and political interests that back the multi-million-pula industry, is this a battle they can win? ÔÇô Asks OLIVER MODISE

Dr Joseph Pitso’s cluttered table is snowed under a mountain of research papers with titles like: “Alcohol and Sexual behaviour”, “Association between alcohol and HIV”, “A note on alcohol consumption and sexual behaviour of youths in Botswana”, “Alcohol alert” and “Draft National Alcohol Policy for Botswana.”

The University of Botswana lecturer has curved himself a well-deserved reputation as a champion of the view that alcohol is partly to blame for Botswana’s HIV/AIDS problem. And he has a few black eyes to show for it.

The ink had hardly dried on his qualitative research paper on alcohol abuse and condom use in Botswana when Kgalagadi Breweries Public Relations Director, Percy Raditladi came swinging back in defence of lager.

Raditladi appears to have won a free pass when it comes to denying or minimizing the link between alcohol and HIV/AIDS. He argues that there is no causal link between drinking alcohol and AIDS. Such a viewpoint is not exceptional.

Batswana who have been following the debate on the proposed liquor trading regulations have occasionally watched irate bar owners stand up in kgotla meetings to rubbish government for coming up with regulations that seek to limit the sale of beer. Some write in calling government cruel and insensitive.

A few have even been reeling out statistics that Batswana are not among the highest of the world’s alcoholic consumers. In 1996, Botswana ranked eighty-third among 153 developed and developing countries. Per capita consumption of alcohol in South Africa, Gabon, Liberia, and Zimbabwe e.t.c exceeds that of Botswana.

They point out that Botswana’s level of alcohol consumption is by far lower than in the United Kingdom, United States of America, Germany, France, Ireland and Switzerland, among others, all of which have far lower HIV prevalence rates compared to Botswana.

The situation is further complicated by the sweetheart deals, done under the radar screen, between some politicians and beer traders.
As the debate over the proposed liquor trading regulations gained pace, Dr Pitso looked like a goner, then a survivor, and then a goner again and then, well who knows.

This afternoon, the bespectacled lecturer with a signature bebop cut is on song as he talks about his next project: a quantitative research on alcohol abuse and condom use. His upbeat mood is hardly surprising.

The research papers weighing down his desk suggest that he is in respectable company.
A growing number of researchers are coming up with papers supporting the view that alcohol use is partly to blame for Botswana’s HIV/AIDS problems.

A PowerPoint presentation by Peter Kilmarx, a medical doctor with BOTUSA, based on a research about the “Association between Alcohol and HIV” says, “HIV-positive patients were more likely than HIV-negative patients to: be female; be 26-35 years old; be unmarried; have higher income; report separation from spouse/partner for work; have two sex partners other than their regular partner and state that they or their partner drank alcohol before sex.”

The conclusion of Dr Kilmarx’s research is that “taking account of other factors such as marital status and income, those who used alcohol (or whose partner used alcohol) before sex were 6.8 times more likely to have HIV infection.

He quotes five other studies that came to the same conclusion that there is an association between a history of alcohol consumption and being HIV sero positive.

Another research paper titled “HIV risk factors among patients with tuberculosis ÔÇô Botswana 1999”, published in the international journal of STD & AIDS, also comes to the same conclusion.

The paper by doctors Elizabeth Talbot, Thomas Kenyon, Nancy Binkin, Themba Moeti, Gary Hsin, Laura Dooley and Shanaaz El-Halabi states, “Alcohol use was prevalent in our study population, particularly among men, and was associated with HIV infection. Intoxicants such as alcohol can disinhibit the user, and may lead to a high-risk sexual behaviour, such as casual sexual liaisons, irregular or incorrect use of condoms and even rape.

Alcohol may also increase cellular susceptibility to HIV infection, and may increase the rape of progression from HIV infection to symptomatic AIDS.

Another research paper by University of Botswana Demography lecturer Eugene Campbell, published in the African Sociological Review last year concluded that “alcohol induced intoxication influences nonÔÇôuse of condoms, and inconsistent condom use by alcohol users partly explains why the incidence of sexually transmitted infections is significantly higher among alcohol users than non alcohol users.

Implicitly, attention is called to the contribution of alcohol to HIV/AIDS infection among youths in Botswana…. Apparently, alcohol consumption by youths influences sexual behaviour just as much as their sexual behaviour influences consumption of alcohol.”

A Department of GenitoUrinary Medicine researcher at a UK hospital, A R Markos, argues in his research paper that “sexual behaviour is affected by alcohol, and the effects differ with gender, personality, background, culture, amount and years of consumption.

The perceived sexual arousal associated with alcohol is a combination of pharmacological and expectancy factors and is related to dosage in a curvilinear fashion. Sexuality is increased as the dosage of alcohol is increased to a point when further intoxication will lead to impaired sexual responsiveness.”


Read this week's paper

The Telegraph September 23

Digital edition of The Telegraph, September 23, 2020.