College of Nursing, University of Wisconsin-Milwaukee , Milwaukee , WI , USA.
School of Nursing, Lee University , Cleveland , TN , USA.
Glob Public Health. 2019 Dec;14(12):1733-1743. doi: 10.1080/17441692.2019.1638958. Epub 2019 Jul 10.
Sub-Saharan Africa is at the intersection of the HIV epidemic and the highest burden of alcohol-related disease and injury. Alcohol consumption is associated with an increased likelihood of HIV infection, high rates of intimate partner violence and is considered both a cause and a contributor of economic stress and poverty. Our study integrates the syndemic and socio-ecological system theoretical frameworks to qualitatively explore the effect of second-generation alcohol consumption on sexual risk behaviours, alcohol misuse, violence and economic stress (SAVE) factors and HIV infection risk. We recruited 80 people from rural Kenya to participate in 12 focus groups. Consistent with the literature, we found evidence of syndemic associations of second-generation alcohol consumption with SAVE factors, including HIV infection risk. Structural-level factors including availability of cheap second-generation alcohol and widespread unemployment are the biggest risk factors for alcohol misuse. Because of the psychological effect of women's increasing economic independence on men, gendered syndemic programming - that includes both men and women - and addresses the complex web of risk factors for second-generation alcohol misuse can interrupt the vicious cycle of poverty, violence, sexual risk behaviours and mitigate HIV infection risk in rural Kenya.
撒哈拉以南非洲处于艾滋病毒流行和酒精相关疾病与伤害负担最高的交汇点。饮酒会增加感染艾滋病毒的可能性，导致亲密伴侣暴力的发生率很高，并且被认为是经济压力和贫困的原因之一，也是其促成因素。我们的研究整合了综合征和社会生态系统理论框架，定性探讨了第二代酒精消费对性风险行为、酒精滥用、暴力和经济压力（SAVE）因素以及艾滋病毒感染风险的影响。我们从肯尼亚农村招募了 80 人参加 12 个焦点小组。与文献一致，我们发现了第二代酒精消费与 SAVE 因素之间存在综合征关联的证据，包括艾滋病毒感染风险。结构层面的因素，包括廉价的第二代酒精的供应和广泛的失业，是酒精滥用的最大风险因素。由于女性经济独立对男性的心理影响，包括男性和女性在内的有性别针对性的综合征规划，并针对第二代酒精滥用的复杂风险因素，可以打破贫困、暴力、性风险行为和减轻艾滋病毒感染风险的恶性循环。
