Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research

There is now conclusive evidence of a causal linkage between heavy drinking patterns and/or alcohol use disorders and the worsening of the disease course for HIV. However, while alcohol usage is consistently associated with the prevalence and incidence of HIV, further research is needed to substantiate causality in terms of the acquisition of this disease. The burden attributable to alcohol use in South Africa in 2004 has been estimated to be 1.3 million years in terms of years lost though premature death caused by alcohol and years lived with an alcohol-related disability (or just over 6% of all years lost from all causes). Of all years lost through death and disability that can be attributed to alcohol, 10% for men and 28% for women can be directly attributed to alcohol's impact on the progression of HIV in infected individuals. The implications of the above will be discussed in terms of research gaps that need to be addressed and broader policy responses that are needed in the health and social services sectors. In addition, emphasis will be given to specific practices that should be considered for rollout by agencies involved in substance abuse and HIV/AIDS treatment and prevention.