Elizabeth is a 57 year-old woman living in Soweto, Johannesburg. From her puffy face and pale lips one can easily tell that she drinks heavily. She is not only battling alcoholism. In 2000, she was diagnosed with HIV. But, already before that she had not been feeling well, getting in and out of hospital.  

‘€œI started getting sick in 1984 but did not know the cause. I heard radio announcements urging people who are sick to get tested. I went to Florida clinic where I was tested and then, I was told that I have HIV’€, says Elizabeth sadly.

Elizabeth has been on anti-retroviral therapy (ART) for the past three years. Her CD 4 count was a weak 179 when she started taking treatment and it strengthened soon thereafter, reaching a healthy 533. But now, it’€™s slowly taking a nose-dive.  

‘€œBecause of my excessive drinking my CD 4 count is now at 233. I don’€™t even eat before drinking. Moreover, I skip my medication since I’€™m not supposed to take alcohol when on ARVs’€, she tells me with regret all over her face.

‘€œDoctors and nurses say I have to go to SANCA (South African National Council on Alcohol and Drug Dependence). They say I will not survive if I continue like this. I will die’€, she adds.

Rehabilitation is nothing new to Elizabeth. When she was still employed in the 1990’€™s her employer realised her problem and sought help for her from SANCA. She stayed sober for only six months.

But this time, Elizabeth says she is desperate for help.

‘€œIt’€™s because I always get depressed from seeing all the filth in the house as if there’€™s no woman around. When I’€™m drunk I can’€™t work. The alcohol gets into my body and paralyses me’€, she says.

But why does she continue drinking so much?

‘€œI have problems’€, she says. ‘€œI look after my two elderly sisters who are sickly. That adds to my misery. I also have a problem with my sisters. They also drink and when they are drunk, they often say to me: ‘€˜We don’€™t want your food, you have AIDS’€™,’€ she tells me.  

Elizabeth is fully aware of the dangers of excessive drinking for someone on AIDS medication. Dr Gail Ashford, Lecturer at Wits Donald Gordon Medical Centre in Johannesburg, cautions against mixing alcohol with ARVs.

‘€œThere seems to be very complicated interactions ‘€“ not just at the level of drugs and at the level of physiology with the liver ‘€“ but also, it affects the immune system, causing deterioration. So, somebody who is HIV-positive, who abuses alcohol, is more likely to have a low CD4 count and is more likely to progress to full-blown AIDS quicker than the counterpart who has the same CD4 count but doesn’€™t abuse alcohol’€, explains Dr Ashford.

Elizabeth says she wants to end her relationship with alcohol. In the first step to recovery, she visited the local branch of SANCA in Soweto, where I accompanied her. After the session with a social worker, she reported that she is ‘€œoptimistic with the kind of help’€ she will get from SANCA.

‘€œThey explained to me that if I don’€™t help myself first, then they won’€™t be able to help me. They also said if I continue abusing alcohol while taking anti-retrovirals (ARV) that could weaken the strength of the drugs. I’€™m happy now’€, she said with tears running down her cheeks.