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Siyayinqoba Beat It! 2006 Episode 2 –

Alcohol and HIV

In this the second episode of Siyayinqoba Beat It! in 2006 the support group watched inserts on HIV positive people who used to drink alcohol and how they now live their lives with little or no alcohol at all. To help discuss this matter, the group was joined by Dr Ullah Mothibi from the Western Cape Department of Health who explained why alcohol has bearing on the HIV infection rate and why alcohol should be avoided when on ARVs.

Shalom Ncala: {Sesotho} [Hello and welcome to Siyayinqoba Beat It! Support Group. My name is Shalom Ncala. In the Siyayinqoba Support Group we are all living positively with HIV] Welcome everybody. Hello Victor, what have you been up to?

Victor Lakay: Hello Shalom, taking it easy, living.

Shalom Ncala: Hello Busi.

Busisiwe Maqungo: Molweni, ndizibulisele nakubabukeli emakhaya. {Xhosa} [Hello everyone. Hello to the viewers at home.]

Lihle Dlamini: Sanibonani babukeli emakhaya. {IsiZulu} [Hello and hello viewers at home.]

Shalom Ncala: {Sesotho} [Every week we get together to discuss issues that affect our lives with HIV, from stress reduction to prevention-of-mother-to-child-transmission. Siyayinqoba is your guide to living better with HIV. In today’s show, we’re looking at some of the dangers of alcohol abuse. Drinking too much is dangerous for anybody, whether you are HIV positive or not. Alcohol makes us careless so that we forget or just don’t bother to use condoms during sex. Women who drink heavily may be exposed to danger from aggressive men who may try to rape them when they are drunk and defenceless. If you are living with HIV, alcohol use puts you at risk because you can forget to take your medication properly. To help discuss this issue, we are joined by Dr Ullah Mothibi from Cape Town. Welcome Dr Ullah. The Beat It! Team visited Mike Matyeni from Nyanga. Let’s take a look.]

I would sleep with three girls a day

Nyanga, Western Cape

Mike Matyeni: Igama lam ndinguMike Matyeni, ndisuka e-Eastern Cape e-Cathcart but ixesh’elininzi ndilichithe apha e-Cape Town. Ndiphila nentsholongwana kagawulayo, nda-diagnoswa ngo 1999 ukuthi ndi-HIV positive. Ugqirha wathi masitsale i-CD4 count yakho. Ok sayitsala i-CD4 count, xa zabuya ii-result ndiyazithatha, Kwathiwa i-CD 4 count yam ngu 123. ndayiyeka i-alcohol but ndigqibelise nge 1st ka December. Sibethile, sibethile, sihamba, sihamba, ndihlae two years ndayeka usela because ndandothukile about i-status sam. Ngokuya ndandisasela into eyayisenzeka … Mna andixhwithwa mna. Yayisothi i-cherry ngos’ke ithathe i-glass yam, ndihambe ndiyomlala. Ndithethe naye ndihambe ndiyoheva i-sex naye without a condom. Emveni koko kengoku I think inoba ndandilala nama-cherry ayi-3 ngemini pha kwaTshawe because ama-cherry ayendithanda. Utywala bunayo indima obuyidlalayo kwi-HIV because abantu abaninzi basuleleka because of utywala, azikho nee-chances zo-condomise xa kunxiliwe. Abanye abakayi-understand into ye-condom kufumaniseke uba niheve i-sex without a condom xa ninxilile. Akhona amaxesha amaninzi kufumaniseke uba andiyuzi condom xa ndinxilile but lonto leyo andi-affect abanye abantu because ndihlala nomntu endithandana naye ndibe ndisazi i-status sakhe uba naye u-positive. But ekupheleni kosuku ndizisole uba bendiyenzela ntoni because xa ulele nomntu without a condom, noba u-HIV positive naye, uthatha le-HIV positive yakho uyayiphindaphinda kule yakhe. Ndiyayenza i-education kwii-taverns nabantu endihlala nabo, ndibaxelele uba utywala abukho grand. Bunayo into ebuyenzayo apha kuthi. Abantu abaninzi baseliswa kuba i-status sabo, umntu azixelele uba u-HIV positive Mandisele ndisifa because sendifile. Abantu bayaziyuza because ngabantu abakwi-denial, usela utywala usithi uselela i-stress. Ndabamamela oogqirha because banyanisile because utywala abukho right. Into mna endiyekisileyo njeng’ba ndizoqala ii-ARVs, ii-ARVs zine-side effects and then kengoku funeke ndiyazi uba zii-side effects okanye yibhabhalaza, ndingathi yibhabhalaza kanti zii-side effects. But ngoku ndiphila nje grand without alcohol, andina-problem yotywala but sometimes ndiye ndiyithathe noba yi-beer eyi-1. {isiXhosa} [My name is Mike Matyeni and I’m from Cathcart in the Eastern Cape, but I spent most of my life in Cape Town. I was diagnosed HIV positive in 1999. My doctor suggested I test my CD4 cell count. I went for the CD4 cell count test, and the result was 123. That is when I decided to quit alcohol, on the 1^st of December. Time went by and I stayed off alcohol for about two years because of my status. When I was still drinking, I was a ‘big boy’. No girl could play with me. When a girl drank from my glass, I would sleep with her. I would talk to her for a while, then we would have sex. I would have sex with about three girls a day because girls loved me. The way in which alcohol affects HIV is that there is no time to look for condoms when you are drunk. Some people still don’t know about condoms and they have unprotected sex while under the influence of alcohol. Sometimes when I’m drunk, I don’t use condoms, but I don’t infect others because I do it with a partner I am loyal to, who I know is also HIV positive. In the long run, I do regret my actions because even if you sleep with your HIV positive girlfriend, you can be re-infected and also re-infect your partner. That’s why I educate people in taverns and such places, and tell them alcohol is not good. Many people resort to alcohol because of their HIV status. They say they are HIV positive so they might as well finish themselves off because they are dying anyway. I think those who drink to ease stress are in denial. I took my doctor’s advice about alcohol being bad for me. ARV side effects made me quit alcohol. As I’m about to start on ARVs, I should be able to tell the difference between the side effects and the hangover. I shouldn’t confuse a hangover with side effects. Now I’m living positively without alcohol but sometimes I do take just one beer.

Support Group

Shalom Ncala: {Sesotho} [Is alcohol going to be one of the factors contributing to the rise in the HIV infection rate?] Meaning that is it going to be a factor that actually leads to people acquiring HIV, is it becoming a trend?

Busisiwe Maqungo: I think ikhona i-connection phakathi kotywala ne-HIV. Amantombazana aselayo afike ezi-tavern efuna usela ngegama elithi uyaxhwitha ne? Abanye abantu abenziwa njalo ke nyani, usela utywala bake uyabubhatala. Inye ke indlela yobhatala utywala bakhe, kuhamba uyolala naye. So uyayicacisa ke uba wayelala nabantu abathathu ngemini and into ye-HIV ayikhanyanga ngelaxesha. Sometimes behamba beyolala nje eyobhatala utywala bukaMike, sekunxilwe nonxilwa akho mntu ozabe ecinga ngento ye-condom. {isiXhosa} [there is a connection. There is a connection between alcohol and HIV. If a girl wants a drink, she uses a man to get the drink. You can never do that to all men because they will want something in return. The only way to return the favour is to sleep with him. Like Mike said, he would sleep with three women a day and HIV was not an issue. Sometimes when they sleep together, they are both too drunk to think about using a condom.]

Lihle Dlamini: Like wise, even if you are on ARVs, I have a close cousin who takes ARVs and he drinks a lot. And sometimes he just remembers at 12 o’clock midnight and then he just takes them. Ndiyabona ukuthi lonto leyo izohindarisha i-adherence yakhe, uzogcina e-resistant kwama-ARVs because uthatha ama-ARVs nges’khathi esi-wrong every time. {isiXhosa} [It might affect his adherence to ARVs and put him at risk of resistance because he’s always taking them at the wrong time.]

Vuyani Jacobs: I can accept the issue of adherence, what I don’t accept is the issue of condoms, there’s a very big difference. I’ll tell you two things. I don’t agree. I do drink alcohol, most of the time I’m lucky to have relationships with HIV negative women. And for me to engage in safe sex becomes a big priority and I engage in social drinking and I always use a condom. Adherence becomes another thing and I will agree only on alcohol because sometimes you get so comfortable in dancing and partying that you forget your medication. Should I then be in a situation of treating any opportunistic infections be it TB, be it thrush, be it ulcers or whatever, then I’ll stop alcohol, completely stop alcohol to make sure that my body recovers. That’s my own way of coping with it because alcohol is such a social thing amongst our people. It’s not just about girls drinking and going out with boys or paying back by using alcohol, it’s actually just compromising situations.

Lihle Dlamini: Abantu abafani Vuyani. Wena uyaphuza, awuphuzeli kudakwa. [But Vuyani, people are different. You don’t drink to get drunk.]

Vuyani Jacobs: Utywala buyadakiswa, hawu! [Alcohol makes you drunk!]

Lihle Dlamini: Lalela Vuyani, enye into ufundisekile wena [Vuyani, you are well informed] about i-HIV, what about umuntu elokishini [the person from a township] who’s not treatment literate, osekwi-stage se-denial ophuza because ufuna ukhipha i-stress se-HIIV. And then masele ephuzile akacabangi ufaka i-condom ngoba uthi angiyitholanga enjeni usho ukuthi nam ngizoyifakela komunye umuntu. Wena ungacabanga because uyazi nge-HIV and AIDS. Omunye umuntu akaze acabange kunjalo. [or someone who is in denial about being HIV positive and drinks to ease the stress of having HIV. When he’s drunk, he doesn’t use condoms because he deliberately wants to infect other people. As for you, you can make informed decisions because you’re HIV literate, whereas someone else is not as informed as you.] {isiXhosa}

Dr Ullah Mothibi: Vuyani, I think she’s bringing up important points. {Sesotho} [People who consume a lot of alcohol tend to forget about using condoms. We’re not saying that alcohol is the only thing that makes people have sex.] There are other factors that cause people to have sex without condoms. If you observe, alcohol is one of the most important factors because what alcohol does in your brain, it decreases your inhibitions, it goes to that part of your brain which can distinguish between right and wrong. So your chances of giving in to the wrong are much higher under excessive alcohol intake.

Shalom Ncala: {Sesotho} [We’ll talk more about alcohol and HIV after this break. Stay with us]

Shalom Ncala: {Sesotho} [Welcome to the Siyayinqoba Support Group – the programme for everyone infected and affected by HIV. We are talking about alcohol and HIV. The Beat It! Team met Thembelani and Lungiswa, an HIV positive couple from Khayelitsha.]

Alcohol made us not care about being HIV positive

Khayelitsha, Western Cape

Lungiswa Mashiya: Igama lam ndingu-Lungiswa, ndihlal’eTown two koo-SST. Ndi-HIV positive, ndazazi ngo-2002. Ok, emveni koba ndizivile uba ndi-HIV positive ndaye ndaziva ndine-stress then emveni koko ndazixelela uba andinabo obunye ubomi ngaphandle koba mandisele. Nyani naqhubekeka ngosela ngoba ndandizixelele uba kuzoba-better ndisela. Ekunxileni kwam bendinawo amaxesha ndibone i-O endiyithandayo so ndihambe nayo, ndingabinalo ixesha losebenzisa i-condom. Ndizixelele uba ndilibele nge-condom kuba ndinxilile, siheve i-sex without i-condom. {isiXhosa} [My name is Lungiswa. I live in SST, TownTwo. I’m HIV positive. I was diagnosed in 2002. After I found out that I’m HIV positive, I was stressed and I told myself that I had no life without alcohol. I started drinking heavily because I thought alcohol would make it better. I would get drunk, meet a guy that I like and go to sleep with him without using a condom. I would just forget about condoms because I’m drunk at the time and we would have unprotected sex.]

Thembelani Booi: Igama lam ndingu-Thembelani, uBooi ifani, ndaqala uziva uba ndi-HIV ngo 2002. Kukho i-cherry endandithandana nayo so ndandisiva uba ine-HIV so ndingayihoyi lonto yoba une-HIV. Ndiqond’ba mhlaw’mbi bayandimonela. Ndisela ndaqond’ba andinaxesha labantu, into emandiyenze qha mandisele. Kungekho nto ndiyikhathaleleyo, ukutya ndingakuhoyanga, ndingahlabi ndivuka ndihambe ndiye es’mokolweni noba andinamali ndinxile ndibeyilento ndifuna ubayiyo. Bendisithi ndonxila, ndithathe intombazana ndiyolala nayo without a condom. So ndadibana nalomntwana, ndathandana naye. Kwathi ngoku sendithandana naye, sendibawela ukumxelela uba ndi-positive ndiphinde ndoyike umxelela because sendilele naye. Inditye lento yongamxeleli uba ndi-positive. Wathi yena masihambe siyotesta, sahamba sayotesta eZibonele, safumaniseka si-positive sobayi-2. Utywala budlale indima e-wrong apha kuthi sobabini because if besingakhange sisele ngesingekazityi ii-ARVs. Besingacingi nto nge-HIV, silibale ngayo sisele qha. So utywala burongo kumntu o-positive. {isiXhosa} [My name is Thembelani Booi. I was diagnosed in 2002. I heard rumours that a girl I was with had HIV, but I ignored them. I thought people were just jealous of me. I started drinking and I didn’t care what people said. I drank a lot and I didn’t care about anything. I was not eating well, I was not washing myself. I would wake up and go to the shebeen. When I had no money I would drink from friends. I would get drunk, take a girl home and sleep with her without a condom. Then I met Lungiswa. We got together and at times I would feel like telling her. Sometimes I’d tell her I’m HIV positive but then I’d pretend that it’s a joke because I had already slept with her. Not telling her about my positive status was bothering me. She suggested that we get tested and we did, at Zibonele Clinic. Both our results came back positive. Alcohol has played a destructive role in both our lives. If we were not so much into alcohol, we wouldn’t be taking ARVs. But because we were drinking, we didn’t care that we have HIV. Alcohol is bad for people living with HIV.

Lungiswa Mashiya: Ugqirha wam undixelele into yoba mandingaseli tywala ndizotya ii-ARVs because ii-ARVs azidibani ne-alcohol. Ngoku kunzima kakhulu ndingaseli and akho nomntu ondikhotshayo uba mandiyeke ekuseleni. Ndihleli nje ne-boyfriend yam, akho mntu utshoyo ndim ozilwelayo ngokwam uba mandingaseli but kunzima akukho lula. {isiXhosa} [My doctor said I shouldn’t mix alcohol with ARVs because the two just don’t go together. Now that I don’t drink, it’s very difficult. There’s no one supporting me to stay off alcohol, it’s just me and my boyfriend. There’s no one else, I’m alone in this fight against alcohol. And it’s not easy, it’s very difficult.]

Support Group

Shalom Ncala: What services are there to help people stop alcohol abuse?

Dr Ullah Mothibi: If you’re looking in the townships, people are poor, people don’t have any other social outlets except to go and drink. People cannot say: “Look I’m going to take my golf stick, I’m going to play golf” or for the next four or five hours I will be occupied. I think the community needs to look into itself as well. To say this is a social ill, this is a problem, how are we going to get ourselves out of this problem? So I think there are social problems but I think above all, the individuals as well need to somehow have the strength to say: “Look, I’ve got HIV, I am on ARVs and the doctors have told me what alcohol can do, what problems alcohol can cause me. So it’s up to myself to try and stay away from alcohol. If I can’t, what about looking for support groups that can support me to stay away from alcohol.” And they are there, they are around, you’ve got AA. No, not in the township. There are groups that can help you to get out of alcohol. If you are a person taking ARVs you go to your community centre and they will let you know that this is where you can go. There is an AA in Athlone, in Khayelitsha there is an AA group, I know. So there are, you just need to open your eyes, look and ask and find them. It’s not easy and the starting point for that lady, Lungiswa, is to find out from her treatment site, there is usually a counsellor there, there is usually a social worker there who will be able to give you these networks.

Shalom Ncala: {Sesotho} [We’ll talk more about alcohol and HIV after this break. Stay with us.]

Shalom Ncala: {Sesotho} [Welcome back to the Siyayinqoba Support Group – the programme for everyone infected and affected by HIV. We are talking about alcohol and HIV.]

Busisiwe Maqungo: There is stigma to i-HIV. Now I’ve been drinking all these years and all of a sudden I stop like this, I mean abantu sebesazi into yoba [people will start suspecting once you just stop like this] ukusela ithetha ukuthi lonto leyo sekunjalo. [that means they were right all along.] So people start suspecting awufuni abantu mabayazi lonto leyo so uqonde uba [and you don’t want them to know what is wrong with you] so let me stick to lento irongo endiyaziyo uba irongo ayilunganga [drinking, even though I know it’s wrong] because I’m trying to hide behind it. {isiXhosa}

Lihle Dlamini: If you don’t realise that une-problem, you won’t go out and seek for help. Abantu abaninzi abaphuzayo [Most people] don’t realise ukuthi baphuza [that drinking] too much, babona bona ku-normal. [isn’t normal.] We are the ones that see that this is abnormal, you should seek help. And when you approach that person lomuntu uzokutshela ukuthi mina angisos’dakwa [they will tell you they are not alcoholics] I don’t need help. {IsiZulu}

Dr Ullah Mothibi: When you are going to the clinics, specifically around HIV/AIDS, because i-alcohol sithetha ngayo, siyakhuluma ukuhti abantu mabayeke ukusela. So if wena ungumuntu oselayo and uyaya kule-clinic ye-HIV, kuyathethwa kuth’wa ungaseli utywala but wena awuzazi uba usela kancinci noba usela kakhulu. Ufanele ubuza kaloku, ufanele uthi kugqirha ‘mna ndiyasela, ngisela two beer quarts, injani leyo? Kunintsi noma ku-right? And then uzoxelelwa ukuthi no, no two quarts is too much. {IsiZulu} [We do speak about alcohol, and encourage people to stop. So if you are a person who is drinking and you attend an HIV clinic, they ask you to stop drinking, but you don’t know how much is too little or too much. You should tell your doctor or counsellor that you are consuming two beers, quarts a day. How is that? Is it too much or is that normal? Then they will tell you that two quarts a day is two much.]

Lihle Dlamini: I-problem isekuthinini abantu bes’lisa [The problem is that] men especially who do not go for HIV testing. Abantu abaningi [Most people] that go for HIV testing is women and most of them baya [go] because they are pregnant. And umuntu wes’lisa, most of them, if eya for i-HIV test, uya for i-test then athole ukuthi u-HIV positive and then akaphinde futhi alibeke inyawo lakhe ekliniki. Uzohamba aye elokishini and then aphuze ngoba ukwi-denial, ayitshele ukuthi ukhipha iintsizi zakhe and yet ngalesos’khathi yena uphinde ubulala is’bindi sakhe and also ne-alcohol, I think it plays a role nakhona kwi-immune system yakhe. Like ngezinto ezinje nge-peripheral neuropathy, uzoba-worse usho ukuthi i-HIV probation yakhe izoba-worse. Up until aye nakhona seyedontswa sekuthiwa masambe siye esibhedlele, hake nimthatheni igazi, kanti ebevele ezazi ukuthi u-HIV positive. {IsiZulu} [If a man goes for a HIV test and he tests positive, he never sets his foot in a clinic again. He goes back to the township and drinks because he’s in denial, telling himself he’s de-stressing. In that process he damages his liver. I think alcohol plays a role in reducing his immune system. He develops peripheral neuropathy, which makes his condition worse. Until he is forcefully taken to the hospital where he has to do a HIV test and he already knows his status.]

Dr Ullah Mothibi: Very, very true Lihle. {Sesotho} [What we tend to see, looking very broadly at people visiting hospitals, men don’t like to go to clinics because they are scared of testing. So if they test positive, they won’t disclose this to their wives. Instead, they keep quiet about it and drink even more. In that case, alcohol is playing a role in immune suppression. So now you have two factors that decrease your immunity, HIV and alcohol abuse. You are destroying yourself. So we need to be aware of those points.]

Thami Mthembu: ’Cause I was about to ask you doctor, because I was under the impression yokuthi i-alcohol [that alcohol doesn’t] affect immunity directly. Bengicabanga uba ilwa ngezinto njenge-liver yakho. [I thought that it only affects the liver] and all the other ailments that you mentioned. And I must say because I’m not on treatment yet and I’m HIV positive and I drink. To tell you the truth I actually drink quite excessively of late and I’ve always thought that my drinking would only affect my liver but now I realise it also suppresses my immunity, that’s actually quite a big concern. {IsiZulu}

Dr Ullah Mothibi: I think it should be a concern for everyone, not just HIV positive people but people drinking excessively. We know that alcohol does suppress your immunity on top of damaging your liver and once your liver is also damaged, that will further suppress you immunity in a different way because the liver has also got a role to play in your immunity. There are many things that play a role in your immunity but the liver as well.

Thami Mthembu: But does it affect your immunity directly or does it affect it when you have ailments, will your immunity be compromised?

Dr Ullah Mothibi: Alcohol suppresses your immunity directly, that’s a direct immune suppressant effect, ok?

Shalom Ncala: {Sesotho} [Today we have learnt that alcohol abuse can have serious consequences. It causes us to do things we wouldn’t do when sober, including having unsafe sex when we know we could be infected with HIV or other sexually transmitted infections. It can cause people on ARVs to skip their medication and that can lead to the virus becoming resistant and the ARVs won’t work anymore. Each week we receive many letters from you, our viewers. Today we’d like to share this letter from a young man in Bodibe:

[Dear Siyayinqoba, Last February, I met a girl and we started dating. This year in August, she told me that her mother is HIV positive and that I’m the only person who knows this besides her and her mother. She told me that her mother is afraid of telling her family because she is afraid of being rejected. On the other side, my girlfriend is afraid of losing her mother. I’ve advised her on all I can, but for me, it doesn’t feel good enough.]

One thing your girlfriend and her mother should do is to watch Siyayinqoba together and start talking about HIV. Seeking counselling is also a good idea. Your girlfriend should also encourage her mother to go for a CD4 or a viral load test so they can know what stage she is with HIV. If needed, the mother should start on ARVs. This should help her live for many years. Please keep the letters rolling in. We hope you have enjoyed the show and you are feeling the Siyayinqoba spirit, that together we can beat it. We value your comments and questions. Please contact us on the following address www.beatit.co.za or you can email us at info@beatit.co.za. Join us again next week in the Siyayinqoba Beat It support group. Until then, stay healthy and stay positive. Goodbye.]

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