So many people here take alcohol and AIDS is a big problem: Examining the factors influencing the HIV epidemic in iringa, Tanzania

Background: The study explored contextual factors fueling HIV transmission in Iringa urban and Mufindi districts in Tanzania. Method: The data collection methods included two focus group discussions, ten in-depth interviews with community members and six systems key informant interviews. Results: Study participants voiced concerns on alcohol consumption as a risk factor in HIV transmission. Findings indicate that many people in the study districts are alcohol drinkers – with lots of outlets (vilabu) for homemade alcoholic beverages that are affordable to low income individuals. Alcohol consumption was conceptualized in three main categories, namely: 1) A promoter of multiple sexual partners – a man attempts to get a new sexual partner at every drinking place he goes to; 2) An inhibitor - when a person is drunk, he/she is less likely to remember to put on a condom during sexual encounters and, 3) An intergenerational risk - drunkenness promotes intergenerational sex because alcohol consumption is practiced by both younger and adult populations. More importantly, in such circumstances poor young women who use sex as a means of earning income – knowing very well the risk involved – charge more money if the male partner demands to have unprotected sex. Although alcohol drinking was reported to be fueling HIV transmission, alcohol brewing and selling constitute an important source of income for many poor people particularly women in the two districts. Conclusion: HIV control programs in Tanzania, particularly in Iringa, should seriously consider addressing the questions of alcohol brewing and consumption from different perspectives.