Social and structural determinants of youth alcohol use in Tanzania: The role of gender, social vulnerability and stigma

ABSTRACT

Adolescent alcohol use remains an under-addressed population health issue across Africa. Although the literature explores the intersection of alcohol use and vulnerability to HIV and AIDS, there is limited evidence on the gendered uptake and use of alcohol among adolescents. Capturing adolescents’ voiced experiences about the societal influences shaping their alcohol usage is essential for identifying contextually relevant interventions to reduce their vulnerability to alcohol and related risky behaviours, such as unsafe sex. We conducted qualitative research in urban Tanzania, including key informant interviews, systematic mapping of alcohol availability, in-depth interviews with adolescents in and out of school and adults, and participatory methodologies with adolescents ages 15-19. The findings described here were drawn from the participatory methodologies (n = 177); and in-depth interviews with adolescents (n = 24) and adults (n = 24). Three key themes emerged: (1) boys’ increased social vulnerability to alcohol consumption; (2) the ways in which stigma shapes girls’ alcohol usage; and (3) how gendered perceptions of alcohol use reinforce societal inequalities. There exists an urgent need to address the social and gendered vulnerabilities of youth in Africa to the uptake and use of alcohol, and identify interventions that reshape notions of masculinity increasing boy’s vulnerability to use.

KEYWORDS:

• Alcohol
• Adolescence
• Tanzania
• Gender
• HIV and AIDS

Abbreviations:

• AIDS – Acquired Immunodeficiency Syndrome
• HIV – Human Immunodeficiency Virus
• PEP – Post-Exposure Prophylaxis
• PrEP – Pre-Exposure Prophylaxis
• TasP – Treatment-as-Prevention

Acknowledgements

We are very grateful to the Tanzanian adolescent girls and boys who shared their experiences and insights, without whom we would not have gained an understanding of this issue.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data and material

The datasets generated and/or analysed during the current study are not publicly available as the IRB has not approved the public sharing of the data, but additional findings are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the National Institutes on Alcohol Abuse and Alcoholism (NIAAA), under [Grant #R21 AAA02286801A1].