HIV-Alcohol Risk Reduction Interventions in Sub-Saharan Africa: A Systematic Review of the Literature and Recommendations for a Way Forward
Carrasco, M.A., Esser, M.B., Sparks, A., and Kaufman, M.R. AIDS and Behavior (March 2016), 20(3), 484–503.
This review synthesized findings from 19 HIV-alcohol risk reduction interventions in the African region. All studies promoted individual behavior change using strategies such as peer education, health trainings and workshops, and health education videos; 15 promoted HIV-alcohol risk reduction; and 4 focused on integrating HIV-alcohol risk reduction into multifaceted HIV prevention programs. Seventeen studies showed efficacy in at least one of the three main types of outcomes analyzed (HIV-alcohol risk behaviors, sexual risk behaviors, and alcohol consumption). The authors reported that studies targeting youth in schools had limited efficacy; studies targeting women who use drugs, sex workers, and clients of services for voluntary testing and counseling or sexually transmitted infections were more successful. Studies targeting drinking venue patrons were efficacious when delivered as a short intervention in a community setting, but not when delivered by peers at the drinking venues. However, the authors also emphasized that though many studies show an association between alcohol consumption and risky sexual behavior, there is a scarcity of HIV-alcohol risk reduction interventions in sub-Saharan Africa. They urged integrating alcohol risk reduction components into current HIV prevention programming, and expanding the use of structural interventions to increase the sustainability of less risky alcohol consumption patterns and sexual behaviors.