Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa

Kalichman, Seth C.; Simbayi, Leickness C.; Vermaak, Redwaan; Cain, Demetria; Smith, Gino; Mthebu, Jacqueline; Jooste, Sean

doi:10.1007/s12160-008-9067-2

Cited by 142HIV, Drug Use, Sexual RiskHIV/AIDS Research and InterventionsSubstance Abuse Treatment and Outcomes

Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa

Kalichman, Seth C., Simbayi, Leickness C., Vermaak, Redwaan, Cain, Demetria, Smith, Gino, Mthebu, Jacqueline, Jooste, Sean·2008·Annals of Behavioral Medicine

DOI 10.1007/s12160-008-9067-2

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Abstract

BACKGROUND: HIV is devastating southern Africa and alcohol use is closely related to HIV transmission risks. PURPOSE: The current study tested the efficacy of a brief single-session HIV-alcohol risk-reduction intervention for men and women who drink at informal alcohol serving establishments (i.e., shebeens) in South Africa. METHODS: A randomized community field trial recruited men (N = 117) and women (N = 236) through outreach and chain referrals. Participants received either: (a) 3-h theory-based behavioral HIV-alcohol risk-reduction intervention that focused on skills training for sexual negotiation and condom use or (b) 1-h HIV-alcohol information/education control group. Participants were followed up for 3 and 6 months post-intervention with 89% retention. RESULTS: The risk-reduction intervention demonstrated significantly less unprotected intercourse, alcohol use before sex, numbers of sex partners, partners met at drinking establishments and greater condom use relative to the control group. However, intervention effects were moderated by alcohol use; lighter drinkers demonstrated significantly more intervention gains than heavier drinkers in the risk-reduction condition. Intervention effects occurred at 3 months follow-up and dissipated by 6 months. CONCLUSIONS: A brief HIV risk-reduction intervention reduced sexual-risk behaviors among drinkers in South Africa. However, intervention effects were weakest for those who drink heaviest. Our results provide a basis for establishing HIV prevention in alcohol serving establishments in South Africa. Research is needed to identify multi-level intervention models that can reduce risks among heavier drinkers and sustain behavior changes over time.

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Several BIs were successfully delivered by lay-providers.
“Several BIs were successfully delivered by lay-providers [45,53,59,71].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [59]
Some studies reported no intervention effect on alcohol use at month 6.
“Other studies reported no intervention effect on alcohol use at month 3 [44], month 5 [58], month 6 [59,64,68] and month 12 [58,64].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [59]
For the studies that had indicated the duration of the BI, the time taken to deliver the session lasted from 5 minutes to 3 hours.
“For the studies that had indicated the duration of the BI, the time taken to deliver the session lasted from 5 minutes [70] to 3 hours [59].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [59]
The majority of health promotion and education programs addressed alcohol use in the context of HIV/AIDS prevention and risk reduction.
“The majority of programs addressed alcohol use in the context of HIV/AIDS prevention and risk reduction [38–40,43,56,57,95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [56]
About half (8 of 17) of the health promotion and education interventions were found to have positive results.
“About half (8 of 17) of the health promotion and education interventions were found to have positive results [25,26,38,39,54,56,57,65,66,84].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [56]

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ORIGINAL ARTICLE Randomized Trial of a Community-based Alcohol-related HIV Risk-reduction Intervention for Men and Women
Africa, I. C. T. S., Kalichman, S. C., Ph., D., Simbayi, L. C., Phil, D., Vermaak, R., Cain, D., Smith, G., Mthebu, J., & A, S. J. M. (2008)
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HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa
Human Sciences Research Council (2025) · Human Science Research Council SA · doi:10.14749/30266701
The efficacy of a brief intervention to reduce alcohol use in persons with HIV in South Africa, a randomized clinical trial
Huis in ‘t Veld, D., Ensoy-Musoro, C., Pengpid, S., Peltzer, K., & Colebunders, R. (2019) · PLOS ONE · doi:10.1371/journal.pone.0220799 · Cited by 35 · see citing works
A brief HIV risk reduction intervention for male and female patients with a sexually transmitted infection who use alcohol in primary health care clinic in Cape Town, South Africa
Simbayi, L. C., Kalichman, S. C., Jooste, S., Cain, D. N., Magubane, P., Nibe, X. P., Vermaak, R., Kekana, Q., & Bidla, P. (2008)
Self-citation
Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Town, South Africa.
Simbayi, L. C., Kalichman, S. C., Jooste, S., Mathiti, V., Cain, D. N., & Cherry, C. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.434 · Cited by 134 · see citing works
Self-citation

Authors: Kalichman, S. C., Simbayi, L. C., Vermaak, R., Cain, D., Smith, G., Mthebu, J., & Jooste, S.
Affiliations: University of Connecticut (US)
Human Sciences Research Council (ZA)
Corresponding author: Kalichman, Seth C.
ORCID: Kalichman, Seth C.
Simbayi, Leickness C.
Vermaak, Redwaan
Cain, Demetria
Jooste, Sean
Venue: Annals of Behavioral Medicine
Publisher: Oxford University Press (OUP)
Published: 2008-10-04
Volume: 36
Issue: 3
Pages: 270-279
ISSN: 0742-5554 (ISSN-L)
0883-6612
1532-4796
DOI: 10.1007/s12160-008-9067-2
OpenAlex: W2104218863
Cited by: 142
References: 41
Citations by year: 2026: 2 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 3 · 2020: 5 · 2019: 10 · 2018: 7 · 2017: 12 · 2016: 7 · 2015: 13 · 2014: 12 · 2013: 9 · 2012: 11
FWCI: 10.14
Type: journal article
Language: en
Open access: closed
Locations: Annals of Behavioral Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (R21AA014820, R01AA017399)
Topics: Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: HIV risk reduction, alcohol consumption, sexual risk behavior, condom use, sexual negotiation, shebeens, brief intervention, community-based intervention, heavy drinking, intervention moderators, HIV prevention, Cape Town
MeSH terms: Adult, Alcohol Drinking, Community-Institutional Relations, Female, Health Education, Humans, Male, Sexual Behavior, South Africa, HIV Infections, Condoms, Risk Reduction Behavior

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Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa

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