Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa
Open accessAbstract
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.
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Sample sizes ranged from nine to 54,187.
“The sample sizes ranged from nine, in a study exploring the effectiveness of training lay providers to deliver a BI [42], to 54,187 in a cross-sectional study exploring the feasibility of implementing BI in a health facility and community setting [43].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [42]
The Methods section (Counsellor intervention; page unavailable) says nine counsellors were recruited and trained in brief intervention. But nine is the number of counsellors, not the overall study sample, and the Introduction says intervention outcomes were not assessed. The paper therefore does not support describing this as a study of the effectiveness of training lay providers. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSample sizes ranged from 9 to 946.
“Sample sizes ranged from 9 [42] to 946 [111] (for all studies and not by study design).”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [42]
The Results (‘Sisonke Mentor’ intervention; page not available) report nine trained mentors at the township bar, but 39 recruited across both bars. Thus, nine is a site-specific subgroup, not this study’s overall sample size. The citation [42] is attached to nine; the figure 946 is attributed to a different source and is not assessed here. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn all studies, participants reported that the training was useful and improved their capacity to offer SBI.
“In all studies, the participants reported that the training was useful and improved their capacity to offer SBI [41,42,110].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [42]
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Self-citation
- Authors
- Morojele, N. K., Kitleli, N., Ngako, K., Kekwaletswe, C. T., Nkosi, S., Fritz, K., & Parry, C. D. H.
- Affiliations
- University of the Witwatersrand (ZA)
- International Center for Research on Women (US)
- South African Medical Research Council (ZA)
- Corresponding author
- Morojele, Neo K.
- Venue
- SAHARA-J: Journal of Social Aspects of HIV/AIDS
- Publisher
- Informa UK Limited
- Published
- 2014-01-02
- Volume
- 11
- Issue
- 1
- Pages
- 1-9
- ISSN
- 1729-0376 (ISSN-L)
- 1813-4424
- PMC
- PMC4272098
- OpenAlex
- W2109829919
- Cited by
- 24
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2022: 5 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 1 · 2016: 1 · 2015: 3 · 2014: 2
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- SAHARA-J Journal of Social Aspects of HIV/AIDS (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- Centers for Disease Control and Prevention (U2GPS001137)
- 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 prevention, sexual risk reduction, bar patrons, alcohol consumption, peer-led intervention, intervention feasibility, acceptability, HIV stigma, Tshwane
- MeSH terms
- Alcohol Drinking, Counseling, Female, Humans, Male, Peer Group, Risk Factors, South Africa, HIV Infections, Risk Reduction Behavior, Unsafe Sex, Young Adult, Motivational Interviewing
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