Integrated gender-based violence and HIV Risk reduction intervention for South African men: results of a quasi-experimental field trial.

South Africa is in the midst of one of the world's most devastating HIV/AIDS epidemics and there is a well-documented association between violence against women and HIV transmission. Interventions that target men and integrate HIV prevention with gender-based violence prevention may demonstrate synergistic effects. A quasi-experimental field intervention trial was conducted with two communities randomly assigned to receive either: (a) a five session integrated intervention designed to simultaneously reduce gender-based violence (GBV) and HIV risk behaviors (N = 242) or (b) a single 3-hour alcohol and HIV risk reduction session (N = 233). Men were followed for 1-, 3-, and 6-months post intervention with 90% retention. Results indicated that the GBV/HIV intervention reduced negative attitudes toward women in the short term and reduced violence against women in the longer term. Men in the GBV/HIV intervention also increased their talking with sex partners about condoms and were more likely to have been tested for HIV at the follow-ups. There were few differences between conditions on any HIV transmission risk reduction behavioral outcomes. Further research is needed to examine the potential synergistic effects of alcohol use, gender violence, and HIV prevention interventions.

Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa.

BACKGROUND: HIV is devastating southern Africa and alcohol use is closely related to HIV transmission risks. PURPOSE: The current study tested the efficacy of a brief single-session HIV-alcohol risk-reduction intervention for men and women who drink at informal alcohol serving establishments (i.e., shebeens) in South Africa. METHODS: A randomized community field trial recruited men (N = 117) and women (N = 236) through outreach and chain referrals. Participants received either: (a) 3-h theory-based behavioral HIV-alcohol risk-reduction intervention that focused on skills training for sexual negotiation and condom use or (b) 1-h HIV-alcohol information/education control group. Participants were followed up for 3 and 6 months post-intervention with 89% retention. RESULTS: The risk-reduction intervention demonstrated significantly less unprotected intercourse, alcohol use before sex, numbers of sex partners, partners met at drinking establishments and greater condom use relative to the control group. However, intervention effects were moderated by alcohol use; lighter drinkers demonstrated significantly more intervention gains than heavier drinkers in the risk-reduction condition. Intervention effects occurred at 3 months follow-up and dissipated by 6 months. CONCLUSIONS: A brief HIV risk-reduction intervention reduced sexual-risk behaviors among drinkers in South Africa. However, intervention effects were weakest for those who drink heaviest. Our results provide a basis for establishing HIV prevention in alcohol serving establishments in South Africa. Research is needed to identify multi-level intervention models that can reduce risks among heavier drinkers and sustain behavior changes over time.