Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa

Abstract

Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counsellors received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and referrals to the patrons of the bars. A responsible server sub-component that had also been planned was not delivered as it was not feasible to train the staff in the two participating bars. Over the eight-month period the counsellors were approached by and provided advice and counselling for alcohol and sexual risk-related problems to 111 bar patrons. The peer interventionists reported 1323 risk reduction interactions with their fellow bar patrons during the same period. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities in some instances. The buy-in that we received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the community at large) was an important contributor to the feasibility and acceptability of the intervention.

High Levels of Persistent Problem Drinking in Women at High Risk for HIV in Kampala, Uganda: A Prospective Cohort Study

“…A more recent systematic review of adherence-enhancing interventions for ART in sub-Saharan Africa identified MI for alcohol-dependent patients as the only one of 21 identified strategies to find a significant impact on adherence [ 49 ]. A recent study in South Africa also showed that it was feasible to implement a combined alcohol and HIV prevention intervention in bar settings, consisting of peer-led brief interventions based on MI, delivered to bar patrons [ 50 ]. Another recent systematic review of interventions to reduce HIV transmission in the context of sex work also highlighted the need to develop and evaluate effective alcohol-control strategies [ 51 ], and notably, of the 26 intervention studies identified among female sex workers in sub-Saharan Africa only one was aimed at the adoption of safer drinking patterns [ 52 ].…”

Reducing HIV Risks in the Places Where People Drink: Prevention Interventions in Alcohol Venues

“…Morojele and colleagues also conducted a multilevel intervention in alcohol venues in South Africa (88). In this study, the researchers implemented a multilevel intervention in two licensed drinking establishments, one in a city and one in a township in Gauteng province.…”

Alcohol Availability, Marketing, and Sexual Health Risk Amongst Urban and Rural Youth in South Africa

“…Eighteen percent (18%) of youth reported having sex after consuming alcohol (20% males and 13.9% females) [ 7 ]. Numerous research studies have established that bars, including taverns, restaurants and shebeens are places where heavy alcohol consumption takes place along with associated HIV sexual risk behaviors [ 14 – 18 ].…”