Online Program

Reducing alcohol-related HIV risk in katutura, Namibia: Results from a multilevel intervention with bar owners, servers, patrons, and community members

Monday, November 4, 2013 : 4:50 p.m. - 5:10 p.m.

Sophie Namy, MPA, MA, Gender, Violence and Rights, International Center for Research on Women (ICRW), Washington, DC
Hannah Lantos, MPAID, School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Johannes Haufiku, Society for Family Health, Windhoek, Namibia
Helvi Shilongo, Society for Family Health, Windhoek, Namibia
Katherine Fritz, PhD, MPH, Global Health, International Center for Research on Women (ICRW), Washington, DC
In sub-Saharan Africa, evidence-based approaches are urgently needed to address the community- and bar-level dynamics that enable heavy drinking and sexual risk behavior. We contributed to this evidence-base by designing, implementing, and evaluating a 3-year demonstration project in a low-income community near Windhoek, Namibia—a country with high HIV prevalence and heavy alcohol use. The main project components included bar-based prevention activities, changes to the bar environments, and widespread community outreach.

Results from two waves of cross sectional survey data (conducted before and after the intervention) indicate that more intense program exposure was significantly associated with positive behaviors such as discussing condom use, obtaining condoms, and refusing to have sex without a condom, however we found little evidence linking program exposure to safer sexual practices. In addition, female patrons with the highest exposure to the intervention reported lower rates of heavy episodic drinking as compared to their peers with less exposure, even after controlling for any unobserved bar-level effects. No statistical associations were found between program exposure and rates of alcohol consumption among male patrons; however overall trends suggest that rates of binge drinking have decreased among men and women over the study period. Findings from this small-scale and short-term program demonstrate that a multi-level intervention with bar owners and community members is feasible to implement. Moreover, we find promising indications that community mobilization and delivery of prevention advice within the bar setting may motivate some patrons to alter their attitudes and behaviors related to using condoms and alcohol consumption.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe program outcomes on bar patrons expressed attitudes and behaviors Discuss implications of evaluation findings for other alcohol and HIV programming

Keyword(s): Alcohol Use, HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Katherine Fritz is Director of Global Health at ICRW. She is a social-behavioral scientist with expertise in developing and testing community-based HIV prevention programs in sub-Saharan Africa. She holds a PhD in cultural anthropology and a Master’s in Public Health. Since 2009, she has served as the Lead Technical Specialist on the prevention of alcohol-related HIV risk for AIDSTAR-One and was the Principal Investigator for the Demonstration Project on Alcohol and HIV in Katutura, Namibia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.