The Syndemic of Intimate Partner Violence, Hazardous Alcohol Use and HIV Risk Among Men in South African Mining Communities: An Original Investigation

This original research article investigates the syndemic interaction between intimate partner violence (IPV) perpetration, hazardous alcohol use, and HIV risk behaviours among men in South African mining communities. It aims to quantify their co-occurrence and test for synergistic effects, thereby addressing a critical gap in understanding drivers of HIV vulnerability in this high-risk population. A cross-sectional survey of 1,250 men was conducted in mining settlements in the North West and Gauteng provinces (2023–2024). Data were collected via interviewer-administered questionnaires, measuring IPV perpetration with the WHO Violence Against Women instrument, alcohol use via the AUDIT-C, and HIV risk through detailed sexual behaviour inventories. Multivariate logistic regression modelling, controlling for key socio-demographic covariates, was used to analyse syndemic effects. Results indicated a high prevalence of hazardous alcohol use (68%) and self-reported IPV perpetration in the past year (42%). A significant syndemic effect was confirmed: men reporting both hazardous drinking and IPV perpetration had 4.3 times higher adjusted odds (95% CI: 2.8–6.6) of having multiple concurrent sexual partnerships and 3.1 times higher adjusted odds (95% CI: 1.9–5.0) of inconsistent condom use, compared to men with neither risk factor. The study concludes that these intertwined epidemics synergistically exacerbate HIV risk. This evidence underscores the urgent need for integrated, community-based interventions that concurrently address substance abuse, gender norms, and HIV prevention within the Southern African development context.