Sachets containing hard alcohol found roadside in a peri-urban neighborhood of Tanzania.

GATE

Alcohol & Sexual Health

Adolescence is recognized globally as a period of increased vulnerability to risky behaviors.  However there remains a significant gap in the existing research on adolescent alcohol uptake and use and related sexual behaviors in low-income contexts, particularly in sub-Saharan Africa. Our alcohol and adolescence research agenda, initiated in 2015, emerged from our prior National Institute of Child Health and Human Development (NICHD) funded research conducted with adolescent boys in Tanzania. The latter study highlighted the many peer pressures boys experience to uptake and use alcohol, along with the linkages between alcohol use and violence and unsafe sexual behaviors.  Much of the alcohol and violence observed by boys was described as happening between intimate partners in their homes or villages.

Given that heavy use of alcohol use by adults is often the result of adolescence uptake, there seemed a clear need to better understand the alcohol use patterns of adolescent boys and girls in Tanzania, including the ways in which their social and physical environments influence uptake and use.  This exploratory research study focused on structural and environment factors related to youth alcohol use (availability, affordability, accessibility) and related risky sexual behaviors.  The study was funded by the National Institute for Alcohol Abuse and Alcoholism (NIAAA), and sought to describe young peoples’ experiences and perspectives on alcohol use and related unsafe sex in urban Tanzania, and capture their recommendations for structural interventions to reduce alcohol use and unsafe sex among Tanzanian youth.

Tanzanian youth supporting participatory research to inform the development of a new health education book targeting older adolescents boys in Tanzania.

This research utilized a range of qualitative and participatory methodologies including key informant interviews, ethnographic observations, mapping, and participatory activities, including Photovoice, with groups of adolescents. Research publications sharing the learning from this study are currently under review. The learning was also used to develop an educational book, in collaboration with Grow and Know, for older adolescents that focuses on the risks associated with alcohol, drugs and unsafe sexual activity. This book represents the third in the series, following on the puberty books, and is aimed at 15-19 year olds, with 15,000 copies distributed to date.  A team of Mailman masters-level and doctoral students support this research agenda, including through assisting with data collection and data analysis.

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