Numerous studies have been undertaken to see if it’s feasible to integrate alcohol content in HTC services after it was realized that alcohol abuse increased risky sexual behaviors and HIV related disease progression.  Besides alcohol has been linked to sexual and gender based violence which increases HIV transmission vulnerability.

Despite all these, there has been little or no reference to alcohol in the Kenya National Strategic Plan nor has alcohol been integrated in HIV and AIDS programming and service delivery guidelines. Alcohol consumption can contribute to HIV & AIDS by increasing the rates of high risk sexual behaviors and disclose progression among those living with the virus.  Alcohol has been known to affect a person’s mental capacity and makes a person slow at processing information which affects decision making. With this in mind one is not likely to consider condom use especially when there is no condom at hand.  It is a known fact that the higher number of
unprotected sex and sexual partners’ one has increases the chances of a person sero-converting.  Similarly, some people have been known to take alcohol as an excuse for pre-meditated deviant behavior
such as rape.

Alcohol intake has been identified as a barrier to optimal adherence to antiretroviral therapy.  Adherence to ART is a major predictor of viral suppression and success of HIV treatment that can prolong life and
improve health status of the HIV infected individual such that they can remain economically productive. The ARVs regimen is effective only if the patient adheres strictly to the regimen. Alcohol abuse is associated with poor adherent to medication in general and as previously noted it impairs judgment making it difficult for an individual to comply with the recommended ARV treatment regimens. Alcohol consumption may influence a person’s capacity to follow a strict regimen besides leading to intoxication which may lead to reduced self control and difficulties to follow up routines and duties Heavy drinking is often associated with a less regular life-style and problems to follow up one’s daily care resulting in bad nutrition.  The HIV virus can replicate itself and infect other healthy body cells. The drugs used in antiretroviral treatment slow down the replication of HIV in the body.  Nutrition is an essential part of HIV care.  An adequate quality food contributes to strengthening the immune system which besides keeping one healthy it also helps in prolonging the period of time between HIV infection and the onset of opportunistic infections and the development of AIDS.

Excessive drinkers most often than not neglect their dietary needs and have bad eating habits Chronic alcohol intake could also compromise a person’s compliance because the amount of drug in the blood stream
will be reduced to a lower level than is needed which could result in treatment failure and resistance. Besides, alcohol has been proven to interfere with the liver function, affecting its ability to metabolize certain antiretrovirals
such as protease inhibitors thus reducing their therapeutic efficacy and increasing the likelihood of resistance.

It is recommended that, programs aimed at lowering alcohol abuse be implemented in context to HIV programming besides reviewing existing HIV service delivery guidelines to include alcohol as a standard part of care with appropriate tools and training of service providers. Similarly resources should be mobilized to address the integration of alcohol in HIV programming especially in comprehensive care clinics and HTC.
There should also be a national HIV & AIDS policy calling for alcohol screening and intervention in HIV care and support programs.  Lastly there should be exploration of viable alcohol addiction treatment options that also give priority to people living with HIV.