I have been living with HIV for the past seven years. In August this year I did a CD4 count which came back at 97. This alarmed my doctor who said I should commence with ARV Treatment and referred me to the South African Government's ARV Treatment Programme.

The programme is quite lengthy and at some point I was interviewed by a social worker to whom I admitted quite honestly that I occasionally consume a considerable amount of alcohol.

This seems to have doomed my chances of being accepted into the programme as it is assertively argued that ARV's and alcohol do not mix. I am currently unemployed and have no other means of accessing treatment.

Is their assertion true or is is one of our government's many tricks to deny the realities of HIV/AIDS?

Excessive use of alcohol increases the risk of medication non-adherence and also increases the risks of side effects related to HIV medications. From a general health perspective it is destructive and leads (in general) to a lower quality life and a shorter life. That said, I have patients who drink way too much, not occasionally, but every day, and they have responded to treatment and have an undetectable viral load. So this was likely a medical care rationing decision made by a government (or health) official.

From a public health perspective, treatment should be available for both HIV infection and alcohol overuse and addiction. Both of these conditions are entirely treatable.