Drug and alcohol abuse can cause huge damage to society. This week Siyayinqoba Beat It! examines how they have severe implications for the transmission of HIV. Abusers of drugs and alcohol may find their judgement impaired and may easily slip into risky behaviour such as unprotected sex. Substance abuse also has consequences for those on treatment for HIV as alcohol can damage the liver which processes anti-retroviral drugs. Our CJs meet two HIV positive men, Andile who abused alcohol and Sizwe who is addicted to tik (crystal meth), who talk frankly about how HIV and substance abuse have affected their lives.
Andile Mavikela recalls that he first began drinking in Standard Three. As he got older his drinking grew worse and he slept with a lot of women. When he began hearing about HIV he became curious and decided to check his status. His results came back positive. In 2007 he was also diagnosed with TB and began taking ARVs. Despite this he continued drinking throughout this period. At nearby Cecilia Makiwane Hospital, Dr Biulumko Futshane explains how people living with HIV are encouraged not to drink alcohol because it may impair their ability to adhere to their treatment. Forgetting to take ARVs can lead to the virus building a resistance to the medication. Dr Futshane also explains the role of the liver in metabolising ARVs. Excessive drinking that is harmful to the liver prevents it from doing this and could lead to liver failure or liver toxicity. Fortunately Andile learned about these dangers from pamphlets at his local clinic and has subsequently limited his alcohol intake. He has gained weight and says he looks and feels healthier, his CD4 count has risen and his viral load is undetectable.
In Phola Park in Paarl we meet Sizwe, who is also HIV positive and battling substance abuse. Sizwe began using tik in 1993 as an adolescent. In 1999 his girlfriend fell sick and so Sizwe tested for HIV and found out he was positive. In 2007 his girlfriend passed away. Sizwe says the frustration of living with HIV contributed to his drug-use – he didn’t want to think about what was happening. Sizwe lives at home with his mother, Elizabeth. She constantly worries about her son and his drug use is a source of tension in the household. It also means Sizwe sometimes forgets to take his ARVs. He explains that he is eager to stop using drugs and get a job. Our CJs accompany him to the Toevlug Rehabilitation Centre in Worcester which helps people who have substance abuse problems. There Sizwe speaks candidly to the social worker about his reasons for wanting help: “There is no progress in my life, the drugs are holding me back.”
Tik abuse is widespread in parts of the country such as the Western Cape. It is cheap and highly addictive. As a stimulant it increases users’ sex drive which, as drug and alcohol counsellor Megan Pearson explains, is dangerous amidst the HIV epidemic because disoriented users may engage in risky sexual behaviour. Reckless behaviour whilst under the effects of the drugs could also expose them to violence and rape and some addicts are also driven to prostitution in order to support their habit. Tik can also cause psychosis which, when a user seeks helps, must be treated in tandem with the addiction. For many abusers of drugs and alcohol who live in difficult circumstances it is a struggle to escape their addictions. Sizwe and Andile recognised their problems and took steps to alter their lives. It is to be hoped others will do the same.