Intervening to reduce gender-based violence does not enhance HIV risk reduction outcomes for South African men: results of a quasi-experimental field trial

Abstract

Background: There is a well documented association between violence against women and HIV transmission. Interventions that integrate HIV prevention with gender-based violence prevention may demonstrate synergistic effects. Aim of study: The current study tested the effects of a community-based HIV/gender-based violence prevention intervention targeted to South African men. Methods: A quasi-experimental intervention trial was conducted with two communities randomly assigned to receive either (a) an intensive 5-session integrated intervention designed to simultaneously reduce HIV risk behaviors and gender-based violence or (b) a single session workshop focused on alcohol abuse and HIV risk reduction. Participants were followed for 1, 3, and 6-months post intervention, with 90% retention. Results: The results indicated few differences between conditions on any behavioral outcomes. In fact, the few differences that were observed favored the HIV/alcohol risk reduction comparison intervention over the HIV/gender-based violence intervention. Conclusion: The association between gender-based violence and HIV risk behaviors does not lead to a path of enhanced HIV risk reduction through integrated interventions. Unlike alcohol's connection to sexual risks, gender-based violence poses risks for increased women's HIV risks and not men's risks. Interventions are needed to reduce gender-based violence and HIV prevention interventions should focus on correlates proximal to risk behavior, such as alcohol use in sexual contexts.