A 2007/8 biennial report by Population Services International (PSI) reports that heavy drinkers are more likely to have multiple partners. They are also unlikely to use condoms.

The report says that whilst alcohol and substance abuse do not play a direct role in HIV transmission, they are both associated with high-risk sexual behaviour due to reduced inhibitions and diminished risk perception.

PSI said that they have an HIV and alcohol project which aims to develop responsible drinking habits and promote safer sexual behaviour while drinking to prevent the spread of HIV in Botswana.

"The campaign has focused on intervening at the community level, using the same network of community and faith-based organisations. At the end of 2008, a new concept was introduced into the campaign, "Celebrate Life".

"It focuses on behaviour in and around drinking establishments and uses social marketing techniques to increase the popularity of responsible drinking," reads the report.

Writing in an article titled 'Alcohol speeds HIV' in the United States, George Atkinson says alcohol abuse and HIV infection are believed to compromise the immune system.

Alcohol use, he writes, may accelerate HIV disease progression.

New research, published in 'Alcoholism: Clinical and Experimental Research', has found that HIV-infected patients with a history of alcohol problems, who are receiving highly active antiretroviral therapy (HAART), and are currently drinking, have greater HIV progression than those who do not drink," reads the article in part.

The article also says that in the world before HIV, chronic alcohol use led to problems that are more common in immunodeficiency states such as tuberculosis and pneumonia.

"Of course we also know that HIV attacks the immune system.

So you can pose the question, 'Could these two things - HIV and alcohol - be interacting in some way that makes the immune state worse than just HIV alone?" asks the article.