Men's perceptions and experiences of alcohol use and alcohol use disorder treatment engagement: A qualitative study in areas across four provinces in South Africa

Abstract

Introduction: Alcohol use disorders (AUDs) and related treatment needs are more prevalent among men than women. However, research in South Africa has rarely focused on men's experiences and perceptions of alcohol use and AUD treatment. We explored men's perceptions and experiences of alcohol use and AUD treatment in areas located in four provinces in South Africa. Methods: We recruited men who met criteria for moderate to severe alcohol involvement from treatment and drinking settings. We interviewed 21 men on their experiences and perceptions of alcohol and other drug use as well as AUD treatment seeking, access, and engagement. The data were analyzed thematically. Findings: Four themes were generated from the data. Young, Curious, and Pressured to Drink showed that alcohol use often began in adolescence due to peer pressure and normalization in social settings. Progression to Frequent and Problematic Drinking revealed that drinking evolved from a social activity to a coping mechanism in adulthood. Indicators of Having a Drinking Problem indicated that men recognized excessive drinking and loss of control as signs of an AUD. AUD Treatment Seeking and Engagement highlighted that men often ignored treatment needs due to the normalization of alcohol use within their communities and perceived inaccessibility of treatment centers. Conclusion: Community norms and masculinity ideals contribute to heavy drinking and hinder men's engagement in AUD treatment. Community-based interventions incorporating gender-transformative elements are needed to address the factors driving heavy alcohol use among South African men.