Behavioral HIV Intervention in Beerhalls

Project Overview:
This ongoing project is a randomized community-level trial of a behavioral intervention: the "Sahwira HIV Prevention Program" tailored for men who patronize beerhalls in Harare, Zimbabwe. Alcohol use is a significant correlate of HIV transmission in Africa, and sex while intoxicated is a strong predictor of recent HIV seroconversion among adult men. This program draws on the concept of the "Sahwira" (best friend, mentor, and advocate) to reduce risky sexual behavior. Trained Sahwira Peer Educators are randomly assigned to 12 of 24 major beerhalls in Harare. The intervention combines:

• Distribution of accurate HIV information.
• Teaching strategies for reducing risky sex, including commercial sex, unprotected sex, and sex while intoxicated.
• Promoting the importance of friends intervening with friends who are about to engage in HIV risk behavior.

The impact of the program is measured using four waves of cross-sectional surveys with representative samples of beerhall patrons (n=1,200 per wave). Beerhalls are randomized in clusters to minimize spillovers. Two pre-intervention baseline surveys conducted nine months apart establish the comparability of treatment and control groups, and two post-intervention surveys, one conducted at the end of the intervention and another one year later are used to assess immediate and long-term outcomes of the program, enabling a detailed cost-benefit assessment.

Main Results:
Project ongoing

Principal Investigator:
George W. Rutherford