‘We shall drink until Lake Victoria dries up’: Drivers of heavy drinking and illicit drug use among young Ugandans in fishing communities

ABSTRACT

We investigated patterns and drivers of alcohol misuse and illicit drug use among young fisherfolk. We undertook this study in fishing communities on Koome Island, Lake Victoria, Uganda, from December 2017–July 2018. We conducted six group discussions with men (3) and women (3) and 33 in-depth interviews with: young people [users (n = 10); non-users (n = 2)], local leaders (n = 3), health workers (n = 2), parents (n = 5), alcohol/illicit drugs sellers/distributors (n = 5), law enforcement officers (n = 5). We sampled participants using purposive and snowball strategies. Interview themes included: knowledge, experiences and perceptions of alcohol use/illicit drug use, HIV risk behaviour and harm reduction. We mapped alcohol/illicit drug use outlets using a Geographic Information System to capture density, distribution and proximity to young people’s homes. We coded and analysed qualitative data using thematic content analysis. Motivations for heavy drinking and illicit drug use were multifaceted and largely beyond individual control. Key contextual determinants included social norms around consumption (acceptability), price (affordability), and ease of purchase (availability). Prevention and harm reduction interventions to tackle alcohol misuse and illicit drug use should be aimed at the structural rather than individual level and must be conducted in tandem with strategies to control poverty and HIV.

KEYWORDS:

• Heavy drinking
• drug use
• substance use
• HIV

Acknowledgements

We recognise the contribution of our study participants the research team, and Andrew Packwood for assisting with GIS data analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, the MRC Tropical Epidemiology Group (TEG) [MR/K012126/1] and International AIDS Vaccine Initiative (made possible by the support of many donors, including: the Bill & Melinda Gates Foundation, the Ministry of Foreign Affairs of Denmark, Irish Aid, the Ministry of Finance of Japan in partnership with The World Bank, the Ministry of Foreign Affairs of the Netherlands, the Norwegian Agency for Development Cooperation (NORAD), the United Kingdom Department for International Development (DFID), and the United States Agency for International Development (USAID)). The full list of IAVI donors is available at http://www.iavi.org.