Abstract #137  -  Taking care of businesss: Alcohol as currency in transactional sexual relationships among players in Cape Town, South Africa.
Authors:   Presenting Author:   Mrs Loraine Townsend - Medical Research Council
Additional Authors:  Mr Anders Ragnarsson, Dr Cathy Mathews, Dr  Lisa Johnston, Dr Anna Mia Ekstrom, Dr Anna Thorson, Dr Mickey Chopra,
Aim: HIV continues to be a major health challenge in South Africa, where HIV prevalence is one of the highest in the world (18.8%). Another significant public health concern in this country is the high rate of alcohol consumption - approximately 20 litres of pure alcohol per drinker per annum one of the highest rates in the world. Sub-Saharan African studies have shown that high levels of alcohol consumption are associated with HIV seropositivity and seroconversion, as well as a number of HIV risk behaviours. Currently there is little research examining the underlying factors that promote alcohol use and the pathways by which alcohol use is thought to promote risky sexual behaviour/s. This paper examines the dynamics of social relationships in which alcohol use and risky sexual behaviours co-occur among a sample of players - heterosexual men who have multiple female sexual partners.
Method / Issue: This study was conducted in one of the poorest and urban, informal settlements on the outskirts of Cape Town, South Africa. During a bio-behavioural survey assessing HIV prevalence and associated risk factors, 20 recruits were approached to participate in in-depth interviews. Interviews lasted between one and two hours for which informants provided written informed consent. The interview transcripts were analyzed according to a latent content analysis. Manifest content in the form of categories that represent explicit areas of content were extracted first. These were then examined for underlying meaning and situated in sub-themes. Sub-themes were then grouped into overarching themes that expressed the latent content of the interviews.
Results / Comments: During a typical weekend, men in this study socialised in close-knit groups of friends at local drinking venues where they consumed alcohol at risky levels. Their way of life strongly supported a masculine ideal that condoned and promoted heavy drinking and the formation of casual sexual partnerships. The overt display of large quantities of superior quality alcohol was seen to symbolise wealth and generosity and perceived to be central in attracting women to them. Implicit in the findings was the role that alcohol played as a currency in transactional sex. Men in this study believed that most women deliberately targeted them for alcohol and/or money, and were complicit in the understanding that this would lead to sexual relations. Men saw this exchange as taking care of business with no strings attached.
Discussion: This studys findings have provided an in-depth examination of the normative role that alcohol plays in the formation of casual sexual partnerships characterised by exchange. However, in providing alcohol and/or money in exchange for sex, the �paying� partner gains sexual leverage and the right to dictate the terms on which sex takes place, including high-risk (non)condom use. Multi-level HIV risk reduction interventions among men are needed to reduce excessive alcohol use, risky sexual behaviours and underlying perceptions of ideal masculinity. Interventions will need to be implemented at the peer group rather than individual level and venue-based interventions that target patrons within local drinking venues may be more effective than non-venue, community based interventions.
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