Alcohol, violence and HIV risk among adolescent girls and young women in South Africa
Alcohol, violence and HIV risk among adolescent girls and young women in South Africa
Summary
- Adolescent girls and young women (AGYW) in South Africa remain at disproportionate risk of HIV acquisition, despite overall declines in national prevalence, while harmful alcohol use is widespread and increasingly normalised in the same age group.
- We examined how alcohol use, sexual violence, condomless sex and HIV risk intersect in high HIV-burden communities
- The study used a mixed-methods design: a household survey of AGYW aged 15–24 years across 24 sub-districts in eight provinces with dried blood spot (DBS) HIV testing, combined with qualitative interviews with 68 AGYW
- Hazardous drinking was common, but it did not show a direct statistical association with being DBS-confirmed HIV positive in this study. However, alcohol use was clearly associated with sexual violence, condomless sex and the broader social contexts that increase HIV vulnerability.
- Policy responses should go beyond individual behaviour change to consider the policy environments that shape risk, including alcohol availability and marketing, enforcement of age restrictions, safety in drinking venues and surrounding transport spaces, and coordination between alcohol-harm reduction, gender-based violence and HIV-prevention services