Practices of pregnant women regarding tobacco and alcohol use during pregnancy at one primary health care clinic in Southern Namibia

Tobacco and alcohol use during pregnancy has negative consequences for the fetus. The study's purpose was to investigate the practices of pregnant women regarding the use of tobacco and alcohol during pregnancy. A quantita tive research approach with a descriptive, cross sectional, analytical design was used. The population was all pregnant women aged 18 years and above attending antenatal care at the Mariental clinic. Written informed consent was obtained from all respondents prior to data collection. Data was collected from 211 respondents selected through a systematic sampling. Data was analyzed using Statistical Package of the Social Sciences version 27. Descriptive statistics were used for frequencies and percentages. Fisher's Exact test at 0.05 alpha level was used to determine the association between variables. The mean age was 28.8, with a standard deviation of 6.9 years. Most participants, 92 (43.6%), were aged between 18 and 24 years. The majority, 186 (88.15%), were in the third trimester of pregnancy, and 154 (73%) were single. Most, 148 (70.14%), respondents have good practices towards alcohol use during pregnancy. Moreover, 190(90 %) of the respondents were classified as having good practices towards tobacco use in pregnancy. Educational levels showed a significant association with practices towards tobacco smoking (P=0.042). The study concluded good practices among pregnant women on alcohol and tobacco smoking during pregnancy. It is recommended that health facilities should introduce awareness campaigns on the dangers of alcohol and tobacco use during pregnancy. Moreover, educational materials should be developed in local languages and distributed to the community.

Development of alcohol control law, Sao Tome and Principe

The World Health Organization (WHO) African Region is struggling with increasing harm associated with alcohol consumption. Legislators of Sao Tome and Principe, concerned about this harm and the high prevalence of alcohol use disorders, designed a comprehensive alcohol control bill to tackle this situation. Input into the design of the bill was obtained through interviews involving many stakeholders. The process had five phases: (i) scoping the problem to understand the social burden of the harm caused by alcohol consumption; (ii) updating the evidence on alcohol policies and identifying areas for legislative interventions; (iii) drafting the bill; (iv) aligning the legislative framework of the bill; and (v) initiating the parliamentary procedure. The new bill scored 92/100 using a standardized alcohol control policy scale. The bill covers all domains of WHO's 2010 global strategy to reduce the harmful use of alcohol, and includes the three most cost-effective interventions for reducing alcohol consumption: increased excise taxes on alcohol; bans or comprehensive restrictions on exposure to alcohol advertising; and restrictions on the availability of retailed alcohol through reduced hours of sale. The National Assembly plenary session upheld the bill, which is now under evaluation of the specialized First Commission on Political, Legal, Constitutional and Ethical Affairs. Approval of the bill requires the final voting once it is back with the National Assembly and its promulgation by the President. Drafting an alcohol control bill which is country-led, inclusive, evidence-based and free of interference by the alcohol industry helps prioritize public health objectives over other interests.

The spatial relationship between tuberculosis and alcohol outlets in the township of Mamelodi, South Africa

Background: The availability of alcohol in society is known to increase the risk of a range of negative health outcomes. Objectives: The aim of this research is to determine if there is a spatial association between tuberculosis and alcohol outlets in Mamelodi, South Africa. We also aim to examine whether the socio-economic characteristics of the neighbourhood in which an alcohol outlet was located was related to the magnitude of tuberculosis in the immediate vicinity of the alcohol outlet. Methods: Location quotient analysis is used to compare the extent of tuberculosis within a series of buffer intervals (100m, 200m, 300m) immediately surrounding alcohol outlets with tuberculosis across the township of Mamelodi as a whole. Results: The density of tuberculosis around alcohol outlets in Mamelodi at all buffer distances was found to be substantially higher than across the township as a whole. These findings indicate that the risk of tuberculosis in Mamelodi is higher around alcohol outlets. Alcohol outlets located in more deprived areas of Mamelodi were significantly associated with higher density of tuberculosis relative to alcohol outlets located in more affluent neighbourhoods. Conclusion: Despite alcohol outlets forming an integral part of the urban landscape in townships in South Africa, they may facilitate the transmission of tuberculosis.

The association between intimate partner violence, psychiatric morbidity amongst pregnant women and partner alcohol use in southern Nigeria

Background: Intimate partner violence (IPV) against women is common, although prevalence and correlates amongst pregnant women in developing countries are poorly researched. Aim: To identify the magnitude of IPV, and its relationship with psychiatric morbidity and partner alcohol use. Setting: This study was conducted among women receiving routine ante-natal care at a secondary level healthcare facility in southern Nigeria. Methods: A cross-sectional descriptive study was conducted by recruiting pregnant women (n = 395) attending the Ante-Natal Clinic of the Central Hospital, Benin-City, Edo State, Nigeria, between August 2015 and February 2016 and undertaking face-to-face interviews utilising a socio-demographic questionnaire, the Composite Abuse Scale and the 20-item Self-reporting Questionnaire. Results: Past 12-month prevalence of IPV was 24.8%, with emotional abuse being the commonest type (89.8%). Forty-six participants (11.6%) screened positive for probable psychiatric morbidity. Predictors of IPV included partner alcohol use in the past 12 months (adjusted odds ratio [aOR]: 2.67; 95% confidence interval [CI]: 1.16­6.16; p < 0.02), having a psychiatric morbidity (aOR: 2.53; 95% CI: 1.27­5.04; p < 0.01), being single (aOR: 2.12; 95% CI: 1.25­3.58; p < 0.01) and multiparous (aOR: 2.5; 95% CI: 1.43­4.38; p < 0.001). Conclusion: Intimate partner violence was common amongst pregnant women in Nigeria. Identified modifiable risk factors can be targets for screening and intervention for women in these settings

Alcohol use among high school learners in rural areas of Limpopo province

Background: Alcohol use is a serious public health concern among youth in South Africa and worldwide.Aim: To determine the factors contributing to alcohol use among high school learners in the rural areas of Limpopo province.Setting: The Greater Marble-Hall municipality, Sekhukhune district in Limpopo province.Method: A quantitative, cross-sectional study design was conducted on 314 learners from three high schools in a rural area in Limpopo. A stratified random sampling technique was used to select learners from 11 to 25 years of age. The drinking behaviour was classified according to predetermined Alcohol Use Disorders Identification Test (AUDIT). Data were analysed using SPSS Software v23.0.Results: More than half of the respondents were consuming alcohol 169 (53.8%). Also, 173 (55.1%) of respondents had parents who consume alcohol and 204 (65%) had friends who drank alcohol. Most respondents were classified as low-risk drinkers (AUDIT score < 8) and a quarter of the respondents were classified as almost dependent on alcohol (AUDIT score > 13). Significant associations were found between learners' alcohol consumption and parents and friends who drank alcohol (p = 0.000; p = 0.000, respectively).Conclusion: Alcohol use was prevalent among high school learners in the area under investigation. Also, learners who had parents and friends who consume alcohol were more likely to consume alcohol. Further, learners who were classified as almost dependent on alcohol needed urgent intervention as their health-related quality of life was likely to be poor

Depression, anxiety and stress symptoms in patients presenting with dyspepsia at a regional hospital in KwaZulu-Natal province

Background: Depression, anxiety and stress (DAS) have been shown to be co-morbid with dyspepsia. Local data on the factors associated with these co-morbidities could inform the role of psychiatric intervention in affected patients.Aim: The aim of this study was to describe the frequency of undiagnosed DAS and their associated protective and risk correlates in a sample of patients undergoing endoscopies for dyspepsia.Setting: The study was conducted at a regional hospital's gastro-intestinal unit in KwaZulu-Natal province.Method: A cross-sectional survey was conducted on 201 in- and outpatients with symptoms of dyspepsia awaiting endoscopy. Information on DAS symptomatology (using the DASS-21 screening questionnaire, as well as socio-demographic and clinical data) were collected.Analyses: Following a descriptive analysis of the participants' socio-demographic and clinical details, linear regression models were fitted to identify potential risk and protective correlates linked to DAS symptomatology.Results: The mean age of participants (N = 201) was 48.89 years, of whom approximately two-thirds (n = 133; 66.17%) were women, 97% (n = 195) were African and 64.68% (n = 130) resided in rural areas. Anxiety was the most prevalent symptom category (n = 149; 74.13%) versus depression (n = 96; 47.76%) and stress (n = 68; 33.83%) in each category of symptom (mild to extremely) severity. In the severe and extremely severe range, anxiety existed without co-morbid depression or stress in 61.19% of anxious patients. Alcohol use was significantly associated with all three symptom categories (p < 0.01).Conclusions: Given high frequencies of depression and anxiety in patients undergoing endoscopies for dyspepsia, screening for common mental disorders is essential

Consommation d'alcool chez les travailleurs à Ouagadougou (Burkina Faso)

Dans le monde du travail, l'alcoolisation de certains travailleurs est une préoccupation aussi bien de l'employeur que des autres salariés. En effet, l'alcool est un facteur démultiplicateur du risque professionnel. Cependant très peu de données sont disponibles dans les pays de la sous-région. L'objectif était d'étudier l'ampleur de la consommation d'alcool chez les travailleurs à Ouagadougou. Nous avons procédé à un échantillonnage stratifié simple. Le questionnaire AUDIT a été administré aux travailleurs ayant donné leur consentement. Les résultats ont été présentés sous formes univariées. L'échantillon était constitué de 350 travailleurs avec un taux de participation de 100 %. La prévalence de la consommation d'alcool était de 65,14 % avec une fréquence de consommation inférieure ou égale à 4 fois par mois chez 50 % des travailleurs. La quantité d'alcool consommée un jour typique de consommation était inférieure ou égale à 4 verres chez 57,02 %. Les travailleurs qui avaient une consommation à faible risque étaient les plus représentés avec 39,43 %. Le sexe masculin, la confession religieuse non musulmane et le niveau d'instruction supérieur étaient les facteurs associés à la consommation d'alcool chez les travailleurs. La consommation d'alcool chez les travailleurs dans la ville de Ouagadougou est importante. Cela interpelle les acteurs de la prévention quant à la nécessité d'en tenir compte dans la politique santé et sécurité au travail en entreprise

Consommation d'alcool en milieu scolaire: Cas des lycéens de la Commune VI du District de Bamako

L'objectif était d'étudier les différents aspects de la rupture prématurée des membranes dans un contexte de pays à ressources limitées. Il s'est agi d'une étude prospective et descriptive à visée analytique, sur une période de 12 mois, dans le département de Gynécologie, d'Obstétrique et de Médecine de la Reproduction du Centre Hospitalier Universitaire Souro Sanou de Bobo-Dioulasso au Burkina Faso. Elle a concerné les gestantes reçues dans notre département chez qui le diagnostic de rupture prématurée des membranes (RPM), sur des grossesses de 28 à 34 semaines d'aménorrhée, a été confirmé à l'issue de l'examen clinique. Nous avons enregistré 38 cas de rupture prématurée des membranes pour 5024 accouchements soit une fréquence de 0,75 %. Ces gestantes étaient surtout jeunes, primipares, femmes au foyer, non alphabétisées, ayant fait peu de consultations prénatales. Les antécédents de ces patientes ont été marqués par des cas de ruptures prématurées des membranes et d'avortement. Ces patientes présentaient en outre soit des infections urogénitales, des présentations irrégulières, des distensions utérines et/ ou un placenta prævia. Cela nous a permis ainsi d'identifier un groupe de femmes que l'on pourrait dans une certaine mesure qualifier de groupe à risque de rupture prématurée des membranes dans notre département. La présence de certains éléments cliniques et paracliniques chez ces patientes, nous a permis d'identifier ce qu'on pourrait appeler des femmes à risque de rupture prématurée des membranes

Daily tobacco use and problem drinking among urban adults in South Africa: a longitudinal study

Introduction: there is a lack of longitudinal studies investigating daily tobacco use and problem drinking in Africa. The aim of this study was to explore the prevalence of daily tobacco use and problem drinking and to determine the factors associated with daily tobacco use and problem drinking among urban dwellers in a longitudinal study in South Africa.Methods: electronic interview data were collected from 2213 adults (mean age 45.7 years, SD=15.1; range 20-97) at time 1 (baseline assessment) and Time 2 (12 months follow-up assessment) from one urban centre in South Africa.Results: daily tobacco use only, was at time 1 24.0% and at time 2 23.4%, a decrease of 0.5%. Problem drinking only was at time 1 19.6% and at time 2 21.1%, an increase of 1.5%. Concurrent daily tobacco use and problem drinking increased from time 1 9.5% to 10.3% at time 2, an increase of 0.8%. In longitudinal regression analyses, being male and being born in current city were significantly associated with all three substance use indicators (daily tobacco use; problem drinking; and concurrent daily tobacco use and problem drinking). In addition, older age, not currently married, lower education, underweight and higher levels of perceived stress were associated with daily tobacco use and younger age was associated with problem drinking.Conclusion: high prevalence of daily tobacco use and problem drinking were found among urban dwellers and several socio-demographic (being male, being born in the city, not married and lower education) and health variables (being underweight and perceived stress) were identified which can guide substance use intervention programmes for this population

Prevalence and correlates of alcohol use disorders among bipolar patients at Amanuel Mental Specialized Hospital, Addis Ababa (Ethiopia): A cross-sectional institution based study

At this time, alcohol use is increasing in African countries. The prevalence of alcohol use disorders (AUDs) remains unknown in patients with psychiatric disorders. This study aimed to assess the prevalence of AUDs among individuals with bipolar disorder in the outpatient department at Amanuel Mental Specialized Hospital. An institution-based cross sectional study was conducted among 412 bipolar patients attending the outpatient department at Amanuel Mental Specialized Hospital from May ­ July 2015.Participants were selected using a systematic random sampling technique. Semi-structured questionnaires were used to collect socio-demographic and clinical data. Alcohol use disorder was measured using the Alcohol Use Disorders Identification Test (AUDIT-10). Binary logistic regression analysis was performed. The prevalence of alcohol use disorder was found to be 24.5%. Those affected were predominantly female (58.5%). Being18-29 years of age(AOR=3.86, 95% CI: 1.34, 11.29), being 30-44 years of age (AOR=4.99, 95%CI: 1.85, 13.46), being unable to read and write (AOR=5.58, 95%CI: 2.026, 13.650), having a secondary education (AOR=3.198, 95%CI: 1.149, 8.906), being a farmer (AOR=4.54, 95%CI: 1.67, 12.32), being employed by the government (AOR=3.53, 95%CI: 1.36, 4.15), being a day labourer (AOR=3.5, 95%CI: 1.14, 10.77), use of other substances during past 12 months (AOR=2.06, 95%CI: 1.06, 3.99), having a family history of alcohol use (AOR=2.18, 95%CI: 1.29, 3.68), having discontinued medication (AOR=2.78, 95%CI: 1.52, 5.07), having suicidal thoughts (AOR=4.56, 95%CI: 2.43, 8.54), and having attempted suicide (AOR=5.67, 95%CI: 3.27, 9.81) were statistically significant to alcohol use disorder using multivariate logistic analysis. The prevalence of co-morbid alcohol use disorder was high. This finding suggests that screening for risky alcohol use should be integrated into routine hospital outpatient care. Further, preventive measures against alcohol use disorder should be established

Medico-legal aspects regarding drunk driving: experience and competency in practice of community service doctors

Background: Drunk driving has been reported to increase the risk of road traffic accidents associated with death and severe injury.In South Africa, an increase in blood alcohol concentration of as little as 0.01 g per 100 ml above the legal limit may warrant criminal prosecution or the denial of an insurance claim for damages. However, multiple court cases have been withdrawn because of the incompetence of officials at various stages of the investigation. The scope of the mistakes range from poor scene handling to the incorrect handling of blood samples at the laboratory to eventual laboratory testing of blood samples. Using a group of community service doctors (CSDs) as a cohort study group, this study investigated the competency of medical graduates in relation to the medico-legal aspects of drunk driving.Methods: A self-administered questionnaire-based study was done with 150 CSDs. The questionnaire was administered in Afrikaans and English and was dispatched electronically via e-mail. All potential participants were contacted telephonically to obtain verbal consent. Results are displayed as percentages.Results: A response rate of 59.3% was achieved. The results obtained in this study confirm that some CSDs lack competency in handling medico-legal aspects relating to drunk driving, and are thus unable to serve the communities they have been assigned to adequately. Their lack of skills and knowledge suggests that the present undergraduate Clinical Forensic Medicine curriculum is inadequate.Conclusion: It would be beneficial to revise the curriculum for Clinical Forensic Medicine in undergraduate medical training to address the gap in knowledge and practice of various demands of forensic medicine required from new medical graduates and CSDs

Factors associated with recidivism at a South African forensic psychiatric hospital

Aims: This study examines common factors associated with recidivism among state patients at a South African forensic psychiatric hospital. More specifically, demographic, clinical and criminological factors of a recidivist group are compared to a non-recidivist group with the intention of understanding to what extent these factors might determine the likelihood of re-offending. Method: A retrospective case file review of 293 inpatients and a random selection of 120 outpatients was conducted. For the purpose of the study, a patient was classified as a recidivist if anadditional charge or act of violence was added to the file while the patient was on leave of absence in the community. Of the inpatients, only those who met the criteria for recidivism were included in the study. All 120 randomly selected outpatients were included. Demographic, clinical and criminological data were captured for all patients. Results: Eighty recidivists were compared with 100 non-recidivists. Using the × 2 and Fischer's exact test, substance-use disorder, antisocial personality disorder, an index offence of assault and in-ward adverse events were found to be associated with recidivism (p < 0.05). Using logistic regression analysis, the odds of recidivism in a patient with an index offence of assault was 8.4 times of those who did not commit assault as an index offence (95.0% CI 1.6­43.1). The odds of recidivism for patients with cannabis use was 2.8 (95.0% CI 1.3­6.0) and for patients with in-ward adverse sexual behaviour was 17.2 (95.0% CI 2.0­150). Conclusion: Substance-use disorder and antisocial personality disorder are associated with higher risk for recidivism. This study also highlights that a less serious offence such as assault had a higher association with recidivism. Patients noted to display adverse sexual behaviour in the ward pose a potentially high risk for re-offence. Important criminal history factors and certain clinical factors could not be interpreted because of large amounts of missing data in patients' files

Self-reported alcohol use and binge drinking in South Africa: Evidence from the National Income Dynamics Study, 2014 - 2015

Background. Although the South African (SA) government has implemented alcohol control measures, alcohol consumption remains high.Objectives. To quantify the prevalence of self-reported current drinking and binge drinking in SA, and to determine important covariates.Methods. We used the 2014 - 2015 National Income Dynamics Study, a nationally representative dataset of just over 20 000 individuals aged ≥15 years. Multiple regression logit analyses were performed separately by gender for self-reported current drinkers (any amount), self-reported bingers as a proportion of drinkers, and self-reported bingers as a proportion of the total population. An individual was defined as a binge drinker if he/she reported consumption of ≥5 standard drinks on an average drinking day.Results.Current alcohol use (any amount) in 2014 - 2015 was reported by 33.1% of the population (47.7% males, 20.2% females).Of drinkers, 43.0% reported binge drinking (48.2% males, 32.4% females). The prevalence of self-reported binge drinking as a percentage of the total population was 14.1% (22.8% males, 6.4% females). Although black African males and females were less likely than white males and females to report drinking any amount, they were more likely to report binge drinking. Coloured (mixed race) females were more likely than black African females to report drinking any amount. Males and females who professed a religious affiliation were less likely than those who did not to report drinking any alcohol. The prevalence of self-reported binge drinking was highest among males and females aged 25 - 34 years. Smoking cigarettes substantially increased the likelihood of drinking any amount and of binge drinking for both genders. Conclusion. In SA, one in three individuals reported drinking alcohol, while one in seven reported binge drinking on an average day on which alcohol was consumed. Strong, evidence-based policies are needed to reduce the detrimental effects of alcohol use

Cancer et Nutrition / Neoplasm and nutrition

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Trends of alcohol abuse using surveillance data from the Health Management Information System (HMIS) of Uganda

Introduction: Uganda has the highest alcohol per capita consumption in Africa. Surveillance data was analysed to describe trends in alcohol abuse by gender, identify districts with most cases and describe trends of annual rates by region.Methods: data was from HMIS 108 (inpatient), HMIS 105 (outpatient) forms. Total number of cases was acquired by summing age-aggregated cases by gender in both reports. Rates of alcohol abuse were acquired by dividing annual total cases by annual regional projected population.Results: 57897 cases were reported between 2010 and 2014. Most were males 72% (1963). There is a steady increase in reported cases. All regions show increases in cases reported, the highest being central, western, northern then eastern. Kampala, Kabale, Arua, Gulu, Wakiso reported most cases. Higher numbers among males might be because of a higher genetic risk for disorders. Men are more likely to exhibit risk factors of disorders such as impulsivity making diagnosis simpler. Additionally, biological and social consequences among women may be deterrents to alcohol use. Increasing numbers of cases might be because of social acceptability of alcohol and aggressive advertising. Current legislation limiting alcohol use covers only manufacture and sale, is weak and poorly enforced. High numbers in central region might be due to higher numbers of health centers and population density. Actual numbers are likely to be higher as people with alcohol abuse rarely seek for help. Findings are subject to epidemiological weaknesses: healthcare access bias, referral filter bias, mis classification bias.Conclusion: there is urgent need to address the increasing problem of alcohol abuse especially in central region. The national alcohol control policy should be completed and passed to address issues such as alcohol advertising, taxation and sale of alcohol to minors to limit access. Interventions to address alcohol abuse should be gender specific

Should Drinking during Pregnancy be Criminalised to Prevent Fetal Alcohol Spectrum Disorder?

The harmful effects of alcohol use during pregnancy have been well documented. Fetal alcohol spectrum disorder (FASD) is the collective term encompassing the various clinical diagnoses that can occur in a child who was exposed to alcohol prenatally. The affected child suffers a range of lifelong primary and secondary disabilities. There is no cure for FASD; but it is preventable if women do not drink during pregnancy. Should women be banned from; and/or punished for drinking during pregnancy for the sake of preventing fetal harm? This article considers the appropriateness of criminalising drinking during pregnancy as a means of preventing fetal harm and consequently FASD in children; and concludes that criminal approaches are unjustified; potentially discriminatory and likely to be ineffective

Correlates of Sexual Activity Versus Non-Activity of Incoming First-Year Students at a South African University

In order to contribute to the design of more effective programmes to curb the spread of HIV at tertiary institutions; this study compares the profile of students who are sexually active versus those who are not yet sexually active when entering university. The study was conducted among three cohorts of first-year university students at the University of the Western Cape from 2007 to 2009. A range of correlates of sexual activity versus non-activity were explored using logistic regression analysis. The predicted probabilities of the logit link function depict marked differences between genders and racial groups. Males were more likely than females to be sexually active when entering university and the Black racial group was more likely than other racial groups to be sexually active. Risk-taking behaviours such as smoking; alcohol and drug use were shown to increase the likelihood of being sexually active when entering university; as did indicators of depression and suicidal ideation. The results indicate that religion plays an important role in influencing sexual behaviour; highlighting the important potential role that religious organisations can play in addressing HIV risk at tertiary institutions

Alcohol Consumption and High Risk Sexual Behaviour among Female Sex Workers in Uganda

Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1 027 women selected from 'hot spots' in the suburbs of Kampala city. We conducted 3 in-depth interviews with 40 female sex workers between 2010 and 2011. Data were analysed thematically; focusing on alcohol use within the context of sex work. Alcohol consumption was very high with only seven women reporting that they did not drink. Alcohol consumption was driven by the emotional and economic needs of the participants; but also promoted by clients who encouraged consumption. Many sex workers only started drinking alcohol when they joined sex work on the advice of more experienced peers; as a way to cope with the job. Alcohol was blamed for unsafe sex; acts of violence and poor decision making which increased sexual and physical violence. Alcohol was reported to affect medication adherence for HIV-positive women who forgot to take medicine. The findings suggest that the drivers of alcohol consumption are multifaceted in this group and require both individual and structural interventions. Alcohol reduction counselling can be supportive at the individual level and should be an integral part of HIV prevention programmes for female sex workers and others such as patrons in bars. The counselling should be addressed in a sensitive manner to bar owners and managers

Black generation Y students' attitudes towards the demarketing of tobacco and alcohol consumption

This article reports on a study undertaken to determine Black Generation Y students' attitudes towards the demarketing of tobacco and consequent attitudes towards the demarketing of alcohol consumption in South Africa. As governments around the world; including South Africa; seek to tackle growing health care costs; so unhealthy consumption behaviours are increasingly coming under the spotlight. Tobacco smoking and; more recently excessive alcohol consumption; are two of such consumption behaviours that have received particular attention in recent years; with different demarketing strategies being implemented in an effort to dissuade the consumption thereof. While the effectiveness of these demarketing strategies may be measured directly by looking at changes in demand levels; little is known concerning consumer attitudes towards these strategies; even though an essential prerequisite for achieving their beneficial effects may depend on consumers having a positive attitude towards these strategies. A self-administered questionnaire was distributed to a sample of 400 Black Generation Y students registered at two South African higher education institutions situated in the Gauteng province. The captured data were analysed using z-tests; Pearson's Product-Moment Correlation and regression analysis. The findings indicate that Black Generation Y students have a statistically significant positive attitude towards both the demarketing of tobacco and alcohol consumption; and their attitudes towards the demarketing of tobacco serve as an important predictor to their attitudes towards the more recently proposed demarketing of alcohol consumption in South Africa

The Impact of Alcohol on HIV Prevention and Treatment for South Africans in Primary Healthcare

Background: Antiretroviral treatment (ART) has substantially reduced morbidity and mortality for HIV patients. In South Africa; with the largest ART programme globally; attention is needed not only on the further expansion of ART coverage; but also on factors which undermine its effectiveness; such as alcohol use. Objective: South African primary health sector; it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV. Method: This study comprised a narrative review of relevant literature. Results: Alcohol acts through both behavioural and physiological pathways to impact on the acquisition; further transmission and then progression of HIV disease. Besides links to risky sex; alcohol undermines the immune system; raising susceptibility to contracting and then countering HIV and other infections. There are important drug interactions between alcohol and ART; or therapies for opportunistic infections and other co-morbidities. Moreover; alcohol undermines adherence to the medication which is essential for effective ART. Conclusion: Primary healthcare clinic attendees need evidence-based information on the detrimental effects of alcohol consumption on HIV infection; which ensue throughout the clinical course of HIV. This spans the role of alcohol consumption as a risk factor for HIV infection; HIV replication in infected individuals; a person's response to HIV infection and HIV treatment. Primary healthcare workers; especially nurses and HIV counsellors; require training in order to screen for and provide appropriate interventions for HIV-positive patients; those on treatment and treatment-naive patients; who will benefit from reduced alcohol consumption or the cessation thereof