BACKGROUND: Harmful drinking among students in tertiary institutions has become a major public health issue worldwide. Botswana is among the countries that are experiencing this problem. Abuse of alcohol amongst students is linked to road crushes, intentional and unintentional injuries, raping and an array of communicable diseases notably HIV/AIDS. Drinking among students could be a function of personal and environmental factors. PURPOSE: The purpose of the study was to identify factors that are consistent with abuse of alcohol among students in tertiary institutions in Gaborone. METHOD: This is a quantitative, non-experimental, cross sectional descriptive study. Data were collected from a sample of students in tertiary institutions. SPSS was used for the analysis of data. RESULTS: The study has revealed hazardous drinking among students. The use of alcohol was predicted on demographic, psychological and environmental factors of respondents. Influence from a close friend, year level of study and area of residence were correlates of drinking among students. Institution based educational interventions that focus on building leadership skills of students are critical in addressing issues of alcohol in tertiary institutions. Statutory measures are necessary to limit students’ access to alcohol. CONCLUSION: The study has identified factors that are related to abuse of alcohol among students. The findings could be used to strengthen evidence based planning and implementation of interventions for tackling issues of alcohol in tertiary institutions. There is a need for future research on this area using qualitative approach. / Health Studies / M.A. (Public Health)

Cette thèse de doctorat a pour objectif de développer une typologie socioculturelle de la consommation d’alcool à partir des mesures d’usages, de contextes et de motivations à boire pour approfondir notre connaissance sur les pratiques collectives de boire au Canada et d’explorer la variabilité des pratiques selon les caractérisations sociodémographiques et socioéconomiques des buveurs . Partant du constat des limites conceptuelles des modèles typologiques développés en alcoologie qui ne permettent pas d’observer toute la complexité des pratiques du boire dans une société puisqu’ils sont construits principalement à partir de l’usage, cette thèse propose de conceptualiser les pratiques de boire comme l’interface de l’usage, des contextes de consommation et des motivations à consommer. Les données utilisées proviennent de l’enquête GENder, Alcohol, and Culture: an international study – Canada. Uniquement les buveurs réguliers (consommant au moins une fois par mois) ont été retenus dans le cadre de cette thèse. Des analyses de correspondances et des analyses de classes latentes ont permis de dériver des typologies tridimensionnelles des pratiques de boire et de les associer à des caractéristiques sociales. Les résultats de recherche sont présentés en trois articles scientifiques qui répondent chacun à un objectif spécifique de la thèse. Le premier article présente une classification des buveurs réguliers canadiens en six grands types et établit le lien entre ces types et le genre ainsi que le groupe d’âge. Le deuxième article teste l’invariance de la typologie selon le genre et propose des classifications distinctes pour les femmes et pour les hommes en lien avec le groupe d’âge et le niveau d’éducation. Le troisième article se concentre sur les buveurs réguliers en emploi et examine l’association entre la position socioprofessionnelle dans la hiérarchie sociale et les pratiques de boire. / This doctoral thesis aims to develop a socio-cultural typology of alcohol consumption through measures of use, contexts and motivations to drink in order to explore and deepen our knowledge about collective practice of drinking in Canada, and to explore the variability of practices along demographic and socioeconomic characteristics of drinkers . The general hypothesis of the thesis stipulates that existing typologies in alcohol research do not allow for the exploration of all the complexities of drinking practices within a society because they are based primarily on alcohol consumption. We believe that adding contextual and motivational dimensions to the dimension of use allows for improving the observation and description of collective practices of drinking, which are associated with it. Quantitative data from the GENACIS, GENder, Alcohol, and Culture: an international study – Canada project helped to validate the main research hypothesis. Only regular drinkers (consuming at least once a month) were selected as part of this thesis. Multiple correspondence analysis and latent class analysis permitted to derive three typologies of drinking practices, associated to social features. The results of the research are presented in three scientific articles, each of which responds to a specific objective of the thesis. The first article presents a classification of Canadian drinkers in six major types and establishes the link between these types, age and gender. The second article tests the invariance of the typology according to gender and proposes separate classifications for women and men in relation to age group and level of education. The third section focuses on regular drinkers’ employment and examines the association between professional position in the social hierarchy and practice of drinking.

BACKGROUND: Harmful drinking among students in tertiary institutions has become a major public health issue worldwide. Botswana is among the countries that are experiencing this problem. Abuse of alcohol amongst students is linked to road crushes, intentional and unintentional injuries, raping and an array of communicable diseases notably HIV/AIDS. Drinking among students could be a function of personal and environmental factors. PURPOSE: The purpose of the study was to identify factors that are consistent with abuse of alcohol among students in tertiary institutions in Gaborone. METHOD: This is a quantitative, non-experimental, cross sectional descriptive study. Data were collected from a sample of students in tertiary institutions. SPSS was used for the analysis of data. RESULTS: The study has revealed hazardous drinking among students. The use of alcohol was predicted on demographic, psychological and environmental factors of respondents. Influence from a close friend, year level of study and area of residence were correlates of drinking among students. Institution based educational interventions that focus on building leadership skills of students are critical in addressing issues of alcohol in tertiary institutions. Statutory measures are necessary to limit students’ access to alcohol. CONCLUSION: The study has identified factors that are related to abuse of alcohol among students. The findings could be used to strengthen evidence based planning and implementation of interventions for tackling issues of alcohol in tertiary institutions. There is a need for future research on this area using qualitative approach. / Health Studies / M.A. (Public Health)

Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.