Evaluation of a peer network-based sexual risk reduction intervention for men in beer halls in Zimbabwe: Results from a randomized controlled trial

Katherine Fritz, Willi McFarland, Robert Wyrod, Charles Chasakara, Knox Makumbe, Admire Chirowodza, Chamunorwa Mashoko, Timothy Kellogg, Godfrey Woelk

Research output: Contribution to journalArticle

Abstract

While much emphasis has been placed on involving men in AIDS prevention in sub-Saharan Africa, there remain few rigorously evaluated interventions in this area. A particularly appealing point of intervention is the sexual risk behavior associated with men's alcohol consumption. This article reports the outcomes of The Sahwira HIV Prevention Program, a male-focused, peer-based intervention promoting the idea that men can assist their friends in avoiding high-risk sexual encounters associated with alcohol drinking. The intervention was evaluated in a randomized, controlled trial (RCT) implemented in 24 beer halls in Harare, Zimbabwe. A cadre of 413 male beer hall patrons (̃20% of the patronage) was trained to assist their male peers within their friendship networks. Activities included one-on-one interactions, small group discussions, and educational events centering on the theme of men helping their male friends avoid risk. Venues were randomized into 12 control versus 12 intervention beer halls with little cross-contamination between study arms. The penetration and impact of the intervention were assessed by pre- and post-intervention cross-sectional surveys of the beer hall patronage. The intervention was implemented with a high degree of fidelity to the protocol, with exposure to the intervention activities significantly higher among intervention patrons compared to control. While we found generally declining levels of risk behavior in both study arms from baseline to post-intervention, we found no evidence of an impact of the intervention on our primary outcome measure: episodes of unprotected sex with nonwife partners in the preceding 6 months (median 5.4 episodes for men at intervention beer halls vs. 5.1 among controls, P = 0.98). There was also no evidence that the intervention reduced other risks for HIV. It remains an imperative to find ways to productively engage men in AIDS prevention, especially in those venues where male bonding, alcohol consumption, and sexual risk behavior are intertwined.

Original languageEnglish (US)
Pages (from-to)1732-1744
Number of pages13
JournalAIDS and Behavior
Volume15
Issue number8
DOIs
StatePublished - Nov 2011
Externally publishedYes

Fingerprint

Zimbabwe
Risk Reduction Behavior
Randomized Controlled Trials
Risk-Taking
Alcohol Drinking
Sexual Behavior
Acquired Immunodeficiency Syndrome
HIV
Unsafe Sex
Africa South of the Sahara
Cross-Sectional Studies
Outcome Assessment (Health Care)

Keywords

  • Alcohol
  • Beer halls
  • HIV
  • Men
  • Zimbabwe

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Social Psychology

Cite this

Evaluation of a peer network-based sexual risk reduction intervention for men in beer halls in Zimbabwe : Results from a randomized controlled trial. / Fritz, Katherine; McFarland, Willi; Wyrod, Robert; Chasakara, Charles; Makumbe, Knox; Chirowodza, Admire; Mashoko, Chamunorwa; Kellogg, Timothy; Woelk, Godfrey.

In: AIDS and Behavior, Vol. 15, No. 8, 11.2011, p. 1732-1744.

Research output: Contribution to journalArticle

Fritz, K, McFarland, W, Wyrod, R, Chasakara, C, Makumbe, K, Chirowodza, A, Mashoko, C, Kellogg, T & Woelk, G 2011, 'Evaluation of a peer network-based sexual risk reduction intervention for men in beer halls in Zimbabwe: Results from a randomized controlled trial', AIDS and Behavior, vol. 15, no. 8, pp. 1732-1744. https://doi.org/10.1007/s10461-011-9922-1
Fritz, Katherine ; McFarland, Willi ; Wyrod, Robert ; Chasakara, Charles ; Makumbe, Knox ; Chirowodza, Admire ; Mashoko, Chamunorwa ; Kellogg, Timothy ; Woelk, Godfrey. / Evaluation of a peer network-based sexual risk reduction intervention for men in beer halls in Zimbabwe : Results from a randomized controlled trial. In: AIDS and Behavior. 2011 ; Vol. 15, No. 8. pp. 1732-1744.
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