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Integrated Gender-Based Violence and HIV Risk Reduction Intervention for South African Men: Results of a Quasi-Experimental Field Trial

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Abstract

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.

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References

  • Abrahams, N., Jewkes, R., Hoffman, M., & Laubsher, R. (2004). Sexual violence against intimate partners in Cape Town: Prevalence and risk factors reported by men. Bulletin of the World Health Organization, 82, 330–337.

    PubMed  Google Scholar 

  • Ajuwon, A. J., McFarland, W., Hudes, E. S., Adedapo, S., Okikiolu, T., & Lurie, P. (2002). HIV risk-related behavior, sexual coercion, and implications for prevention strategies among female apprentice tailors, Ibadan, Nigeria. AIDS and Behavior, 6, 229–235. doi:10.1023/A:1019839824312.

    Article  Google Scholar 

  • Ajzen, I., & Madden, T. (1986). Prediction of goal-directed behaviour: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22, 453–474. doi:10.1016/0022-1031(86)90045-4.

    Article  Google Scholar 

  • Andersson, N., Cockcroft, A., & Shea, B. (2008). Gender-based violence and HIV: Relevance for HIV prevention in hyperendemic countries of southern Africa. AIDS (London, England), 22, S73–S86. doi:10.1097/01.aids.0000341778.73038.86.

    Google Scholar 

  • Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.

    Google Scholar 

  • Boonzaier, F. (2005). Women abuse in South Africa: A brief contextual analysis. Feminism & Psychology, 15, 99–103. doi:10.1177/0959353505049711.

    Article  Google Scholar 

  • Carter, M., Kraft, J. M., Koppenhaver, T., Galavotti, C., Roels, T., Kilmax, P., et al. (2007). “A bull is not meant to remain the Kraal”: Concurrent sexual relationships in Botswana. AIDS and Behavior, 11, 822–830. doi:10.1007/s10461-006-9203-6.

    Article  PubMed  Google Scholar 

  • Dunkle, K., Jewkes, R., Brown, H., Gray, G., McIntyre, J., & Harlow, S. (2004). Gender-based violence, relationship power and risk for prevalent HIV infection among women attending antenatal clinics in Soweto, South Africa. Lancet, 363, 1415–1421. doi:10.1016/S0140-6736(04)16098-4.

    Article  PubMed  Google Scholar 

  • Friedman, S., Bolyard, M., Mateau-Gelabert, P., Goltzman, P., Pawlowicz, M., Zunino, S., et al. (2006). Some data-driven reflections on priorities in AIDS network research. AIDS and Behavior, 11, 641–651. doi:10.1007/s10461-006-9166-7.

    Article  Google Scholar 

  • Garcia-Moreno, C., & Watts, C. (2000). Violence against women: Its importance for HIV/AIDS. AIDS (London, England), 14, S253–S265.

    Google Scholar 

  • Glick, P., Fiske, S. T., Mladinic, A., Saiz, J. L., Abrams, D., Masser, B., et al. (2000). Beyond prejudice as simple anitpathy: Hostile and benevolent sexism across cultures. Journal of Personality and Social Psychology, 79, 763–775. doi:10.1037/0022-3514.79.5.763.

    Article  PubMed  CAS  Google Scholar 

  • Jan, S., Pronyk, P., & Kim, J. (2008). Accounting for institutional change in health economics evaluation: A program to tackle HIV/AIDS and gender violence in Southern Africa. Social Science & Medicine, 66, 922–932. doi:10.1016/j.socscimed.2007.11.010.

    Article  Google Scholar 

  • Jewkes, R., Penn-Kekana, L., Levin, J., Ratsaka, M., & Schrieber, M. (2001). Prevalence of emotional, physical, and sexual abuse of women in three South African provinces. South African Medical Journal, 9, 315–317.

    Google Scholar 

  • Jewkes, R., & Abrahams, N. (2002). The epidemiology of rape and sexual coercion in South Africa: An overview. Social Science & Medicine, 55, 1231–1244. doi:10.1016/S0277-9536(01)00242-8.

    Article  Google Scholar 

  • Jewkes, R., Nduna, M., Levin, J., Jama, N., Dunkle, K., Puren, A., et al. (2008). Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: Cluster randomised controlled trial. British Medical Journal, 337, a506. doi:10.1136/bmj.a506. doi:10.1136/bmj.a506.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Cherry, C., & Brown-Sperling, F. (1999). Effectiveness of a video-based motivational skills-building HIV risk reduction intervention for inner-city African-American men. Journal of Consulting and Clinical Psychology, 67, 959–966. doi:10.1037/0022-006X.67.6.959.

    Article  PubMed  CAS  Google Scholar 

  • Kalichman, S. C., Rompa, D., Cage, M., DiFonzo, K., Simpson, D., Austin, J., et al. (2001). Effectiveness of an intervention to reduce HIV transmission risks in HIV positive persons. American Journal of Preventive Medicine, 21, 84–92. doi:10.1016/S0749-3797(01)00324-5.

    Article  PubMed  CAS  Google Scholar 

  • Kalichman, S. C., Kaufman, M., Simbayi, L. C., & Jooste, S. (2005a). Gender attitudes, sexual violence, and HIV/AIDS risks among men and women in Cape Town, South Africa. Journal of Sex Research, 42, 299–305.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L., Jooste, S., Toefy, Y., Cain, D., Cherry, C., et al. (2005b). Development of a brief scale to measure AIDS-related stigmas in South Africa. AIDS and Behavior, 9, 135–143. doi:10.1007/s10461-005-3895-x.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007a). Alcohol and HIV/AIDS risk behaviors in Southern Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151. doi:10.1007/s11121-006-0061-2.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Vermaak, R., Cain, D., Jooste, S., et al. (2007b). HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town South Africa. Journal of Acquired Immune Deficiency Syndromes, 44, 594–600. doi:10.1097/QAI.0b013e3180415e07.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Simbayi, L. C., Vermaak, R., Smith, G., Mthebu, J., Jooste, S., et al. (2008). Community-based HIV and alcohol risk reduction intervention for men and women in Cape Town, South Africa. Annals of Behavioral Medicine, 36, 270–279. doi:10.1007/s12160-008-9067-2.

    Article  PubMed  Google Scholar 

  • Kelly, J. A., McAullife, W., Sikkema, K. J., Murphy, D., Solmai, A., Mulry, G., et al. (1997). Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention. Psychiatric Services (Washington, D.C.), 48, 1283–1288.

    CAS  Google Scholar 

  • Latkin, C., Sherman, S., & Knowlton, A. (2003). HIV prevention among drug users: Outcomes of a network-oriented peer outreach intervention. Health Psychology, 22, 332–339. doi:10.1037/0278-6133.22.4.332.

    Article  PubMed  Google Scholar 

  • Morrell, R. (2002). Changing men in South Africa. Durban, South Africa: University of Natal Press.

    Google Scholar 

  • Peacock, D., & Levack, A. (2004). The Men as Partners program in South Africa: Reaching men to end gender-based violence and promote sexual and reproductive health. International Journal of Men's Health, 3, 173–188. doi:10.3149/jmh.0303.173.

    Article  Google Scholar 

  • Phorano, O. D., Nthomang, K., & Ntseane, D. (2005). Alcohol abuse, gender-based violence and HIV/AIDS in Botswana: Establishing the link based on empirical evidence. Sahara: Journal of Social Aspects of HIV/AIDS, 2, 188–202.

    Google Scholar 

  • Pronyk, P. M., Hargreaves, J. R., Kim, J. C., Morison, L. A., Phetla, G., Watts, C., et al. (2006). Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: A cluster randomised trial. Lancet, 368, 1973–1983. doi:10.1016/S0140-6736(06)69744-4.

    Article  PubMed  Google Scholar 

  • Schroder, K., Carey, M., & Vanable, P. (2003). Methodological challenges in research on sexual risk behaviors: II Accuracy of self-reports. Annals of Behavioral Medicine, 26, 104–123. doi:10.1207/S15324796ABM2602_03.

    Article  PubMed  Google Scholar 

  • Shisana, O., Rehle, T., Simbayi, L., Parker, W., Bhana, A., Zuma, K., et al. (2005). South African national HIV prevalence, incidence, behaviour and communication survey. Cape Town: Human Sciences Research Council Press, 2005.

    Google Scholar 

  • Simbayi, L. C., & Kalichman, S. C. (2005). Risk behaviors and risk fatcors for sexually transmitted infection among youth in an African Township in Cape Town, South Africa. AIDS and Behavior, 9, 53–62. doi:10.1007/s10461-005-1681-4.

    Article  PubMed  Google Scholar 

  • Simbayi, L. C., Kalichman, S. C., Jooste, S., Mathiti, V., Cain, D., & Cherry, C. (2006). HIV/AIDS risks among South African men receiving sexually transmitted infection clinic services who report sexually assaulting women. American Journal of Health Behavior, 30, 158–166.

    PubMed  Google Scholar 

  • Simbayi, L. C., Cloete, A., Strebel, A., Henda, N., Kalichman, S. C., Cherry, C., et al. (2008). HIV/AIDS risk reduction and domestic violence intervention for South African men: Theoretical foundations, development, and test of concept. International Journal of Men’s Health, 7, 254–272.

    Google Scholar 

  • UNAIDS/WHO. (2006). AIDS epidemic update, 2006. Joint United Nations Programme on HIV/AIDS, 2006

  • Van der Straten, A., King, R., & Grinstead, O. (1998). Interpersonal violence and HIV infection in women in steady relationships in Kigali, Rwanda. AIDS and Behavior, 2, 61–73. doi:10.1023/A:1022311424652.

    Article  Google Scholar 

  • Weinhardt, L., & Carey, M. P. (2001). Does alcohol lead to sexual risk behavior? Annual Review of Sex Research, 12, 125–157.

    Google Scholar 

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Correspondence to Seth C. Kalichman.

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National Institute of Mental Health Grant R01-MH MH071160 supported this research.

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Kalichman, S.C., Simbayi, L.C., Cloete, A. et al. Integrated Gender-Based Violence and HIV Risk Reduction Intervention for South African Men: Results of a Quasi-Experimental Field Trial. Prev Sci 10, 260–269 (2009). https://doi.org/10.1007/s11121-009-0129-x

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  • DOI: https://doi.org/10.1007/s11121-009-0129-x

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