Original Paper

AIDS and Behavior

, Volume 15, Issue 8, pp 1732-1744

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Evaluation of a Peer Network-Based Sexual Risk Reduction Intervention for Men in Beer Halls in Zimbabwe: Results from a Randomized Controlled Trial

  • Katherine FritzAffiliated withInternational Center for Research on Women
  • , Willi McFarlandAffiliated withSan Francisco Department of Public HealthDepartment of Epidemiology and Biostatistics, University of California, San Francisco Email author 
  • , Robert WyrodAffiliated withWomen’s Studies Department, University of Michigan
  • , Charles ChasakaraAffiliated withThe Harare Beer Hall Intervention
  • , Knox MakumbeAffiliated withThe Harare Beer Hall Intervention
  • , Admire ChirowodzaAffiliated withThe Harare Beer Hall Intervention
  • , Chamunorwa MashokoAffiliated withThe Harare Beer Hall Intervention
  • , Timothy KelloggAffiliated withSan Francisco Department of Public Health
  • , Godfrey WoelkAffiliated withDepartment of Community Medicine, University of ZimbabweRTI International


While much emphasis has been placed on involving men in AIDS prevention in sub-Saharan Africa, there remain few rigorously evaluated interventions in this area. A particularly appealing point of intervention is the sexual risk behavior associated with men’s alcohol consumption. This article reports the outcomes of The Sahwira HIV Prevention Program, a male-focused, peer-based intervention promoting the idea that men can assist their friends in avoiding high-risk sexual encounters associated with alcohol drinking. The intervention was evaluated in a randomized, controlled trial (RCT) implemented in 24 beer halls in Harare, Zimbabwe. A cadre of 413 male beer hall patrons (~20% of the patronage) was trained to assist their male peers within their friendship networks. Activities included one-on-one interactions, small group discussions, and educational events centering on the theme of men helping their male friends avoid risk. Venues were randomized into 12 control versus 12 intervention beer halls with little cross-contamination between study arms. The penetration and impact of the intervention were assessed by pre- and post-intervention cross-sectional surveys of the beer hall patronage. The intervention was implemented with a high degree of fidelity to the protocol, with exposure to the intervention activities significantly higher among intervention patrons compared to control. While we found generally declining levels of risk behavior in both study arms from baseline to post-intervention, we found no evidence of an impact of the intervention on our primary outcome measure: episodes of unprotected sex with non-wife partners in the preceding 6 months (median 5.4 episodes for men at intervention beer halls vs. 5.1 among controls, P = 0.98). There was also no evidence that the intervention reduced other risks for HIV. It remains an imperative to find ways to productively engage men in AIDS prevention, especially in those venues where male bonding, alcohol consumption, and sexual risk behavior are intertwined.


Beer halls Zimbabwe Men Alcohol HIV