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February 17, 2019

Alco-blow and HIV

For the typical middle class beer drinker the conversation is all about alco-blow and how the police have managed to invade yet another space that hard working Kenyans deserve to have as their own. It is not enough that having bought the newest and latest eight-year-old car, that you can no longer drive as fast as you please. Now the scenario is worse. You are being told; that you cannot drive your new car in the evening, meet the boys and sometimes girls, your car parked in clear sight being ‘car-washed’.

How will the boys know that you are doing well? Keys on the table can be faked. What is the point of having all kinds of safety features in the car if you are never allowed to try them out? Features like front, side, rear, and roof airbags? Emergency brake immobiliser assist? Post and pre collision safety systems? Adaptive blind spot warning systems? Head down displays? Traction control with LED lights? The list as anyone who has sat in a bar with a new car owner is endless. Now the law says that you should do all this talk while sober, which seems to contradict beer company sales advertisements which promote the idea that beer helps the conversation move and without it the world is fairly silent. But there is more to alcohol drinking and efforts to curb excessive drinking than just trying to spoil peoples’ fun.

In the days leading up to Easter many Christians take it upon themselves to deny themselves something they usually enjoy as part of the process of reflection on their faith. Not taking alcohol along with meat is one of the favourite penances. Many who do this report a sense of satisfaction and indeed feel ‘healthier’ for the effort. Yet at the same time cannot wait to get back to their vices. Why is this so? Why do we want to do ‘bad’ things? Some justify their actions by reporting that what they are avoiding are not bad things at all, only bad when there is excessive consumption. They typical beer recipe after all lists just four ingredients water, barley, hops and yeast. Some go a little further and list carbon dioxide, which is a critical part of normal air anyway. A curious question arises from the list of ingredients and that is whether beer is suitable for vegetarians? On the surface of it, yes, but often in the process of making beer, animal products are used. 

A major difference between traditional beer brew and industrial beer brew is that the traditional stuff comes looking thick, like porridge while the industrial bottled type is clear. This is because industrial beer undergoes a process of filtration. Beer makers use a variety of agents to clear the beer of the yeast. Agents can be chemicals such as silicon dioxide, basically sandstone, gelatine or even isinglass a substance made from the dried fish bladder of fish.

Some beer are made with the addition of a sweetener derived from an animal. Honey, from bees, an animal remember, is one such ingredient, so is lactose from cow milk. These ingredients and others will only be listed if required by law. Finally some brewers add glycerol monostearate to provide the foamy head that beer has when initially poured into a glass. Glycerol monostearate is a by-product of the breakdown of fats, and is used as an emulsifying agent. It is also used in the pharmaceutical industry in hair products and ice cream to give it a smooth texture. The bottom line is that those people who think that by drinking beer and eating meat they are eating two distinctly different things are often mistaken.

The current emphasis on excessive drinking is around drink driving, which is indeed a major problem. But we have to remember that alcohol use is associated with other major health conditions. One that is not often talked about is the association of alcohol with HIV acquisition. Research shows that users of alcohol and especially problem drinkers are more likely to be HIV positive than non-users with frequency and quantity of alcohol use positively associated with HIV prevalence. In the years after independence there was a steady rise in per capita alcohol consumption in many African countries related to the initial post independence economic boom.

The 1980s so a decline as economies began to do badly with structural adjustment. Now as we discover oil various minerals, with better education the economy is beginning to wake up. With it is an increase in alcohol consumption. So alco-blow and other strategies to manage alcohol consumption is very necessary. Unchecked excessive alcohol consumption is a major health problem and the point is prevention not punishment or profiting from the situation.

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