The association between alcohol use, sexual risk behavior, and HIV infection among men attending beerhalls in Harare, Zimbabwe

HIV testing and a behavioral survey were conducted with a cross-sectional sample of 324 men recruited at beerhalls in Harare, Zimbabwe, to examine the relationship among alcohol use, high-risk sexual behavior, and HIV infection among male beerhall patrons and to evaluate the feasibility of using beerhalls as venues for male-centered HIV prevention activities. Recent HIV seroconversions were identified using the less-sensitive enzyme immunoassay. HIV education activities were provided inside beerhalls and qualitative methods were used to assess the acceptability of conducting HIV prevention activities and research at beerhalls. The prevalence of HIV infection was 30%; the prevalence of recent seroconversion was 3.4%. Having sex while intoxicated in the previous 6 months was reported by 31% of men and was strongly associated with recent HIV seroconversion as well as unprotected sex with casual partners and paying for sex. Acceptability of prevention and research activities was high among beerhall patrons, managers, and owners. Beerhalls present an environment associated with high-risk sexual behavior and concomitantly high rates of HIV seroconversion. Beerhalls are appropriate and feasible venues for delivering HIV prevention programs targeted at men in many regions of sub-Saharan Africa and the world.