Background and aims
The link between alcohol use and sexually transmitted infections (STIs), including HIV, is well
documented. Several studies have demonstrated an association between drinking alcohol and engaging
in sexual risk behaviors that may indirectly contribute to the transmission of STIs and HIV infection,
including behaviors such as low rates of condom use, multiple sexual partners, and exchanging sex for
money or goods (Ghebremicheal et al., 2009; Fisher et al., 2008; Kalichman et al., 2007). In Botswana,
studies have shown that alcohol consumption is associated with increased HIV prevalence and HIVassociated
risk behaviors (Central Statistics Office, 2009; Weiser et al., 2006b; Campbell, 2003; Talbot et
al., 2002). The link between alcohol consumption and positive HIV status has also been noted in other
regional countries, including Tanzania (Fisher et al., 2008), Uganda (Mbulaiteye et al., 2000), and
Zimbabwe (Fritz et al., 2002). Substantial attention has been directed towards the venues where alcohol
use and abuse is common, and where people might meet new sexual partners. In South Africa, study
participants who reported meeting their sex partners at shebeens (illegal and informal drinking venues
usually operating without a license) reported more alcohol consumption, sex partners, and inconsistent
condom use than participants who did not meet their partners at shebeens (Kalichman et al., 2008).
Botswana has historically high levels of drinking among its population (WHO, 2011). In response to
national polices enacted by the government and strict regulations related to the sale and consumption
of commercial and non-commercial alcohol, the number of venues registered and licensed to sell
alcohol in the country decreased in the last decade; however, alcohol consumption remains very
prevalent in the country (Pitso & Obot, 2011; Mirkovic, 2012). A recent study by the National AIDS
Coordinating Agency in Botswana showed that almost two-thirds of males (64.4%) and more than a third
of females (35.5%) voluntarily drank alcohol (Mirkovic, 2012). Data from the Botswana Ministry of Trade
and Industry suggested that 54% of current drinkers were binge drinkers who consumed more than five
drinks on one day in the last week (Mirkovic, 2012).
Despite the persistent high prevalence of drinking among Batswana1 and the evidence linking alcohol
consumption with sexual risk behaviors and HIV infection, few studies have explored the relationship
between alcohol use and behaviors that contribute to HIV risk in Botswana. There is little information on
the types of individuals who access alcohol-based venues (e.g., bars, nightclubs, and recreational clubs),
their HIV-associated risk behaviors, or the level of interest among these patrons to be tested for HIV
infection at alcohol consumption venues. As a result, little is known about rates of HIV infection and
behaviors among alcohol consumers in Botswana and whether environmental factors in alcohol venues
modify such behaviors.
This venue-based study aimed to describe HIV risk behaviors among patrons of alcohol venues in
Botswana and increase understanding of the relationships between alcohol use, risk behaviors, and HIV status. The goal of the study was to estimate prevalence of HIV infection and HIV risk behaviors among
patrons of alcohol consumption venues in Gaborone, Botswana. Specifically, the study aimed to
1. Estimate HIV prevalence among patrons of alcohol consumption venues (such as bars,
nightclubs, and recreational clubs)
2. Estimate risk behaviors associated with HIV transmission among patrons of alcohol consumption
venues.
Results of the study might be used to inform the development of HIV prevention interventions for
patrons of the licensed alcohol venues in the sampling frame.