HIV-Prevention Intervention Targets in High-risk Alcohol Venues in Argentina

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DESCRIPTION (provided by applicant): The HIV prevalence rate in Argentina is 0.6 percent in the general population, with much higher rates in high risk segments of the population. While the cost of treatment for HIV is covered by the government, programs in HIV prevention are limited. Venue based interventions have the potential to reach segments of the population at high risk for HIV infection. Given the associations between alcohol use and sexual risk behavior, venues where alcohol is sold and sexual behavior occurs could be particularly effective settings for HIV prevention efforts. However, although there has been much research on venues, alcohol use, and sexual risk behavior, no studies have sought to understand the interaction between these three factors, an essential step in developing interventions that target HIV risk behavior in these settings. Targeting public venues in Buenos Aires where men meet, alcohol is consumed, and sexual behavior occurs, the goal of this 2-year exploratory study is to understand the various factors that contribute to the creation of a high risk sexual space. To that end, the study seeks to describe the relative contribution of physical characteristics of the place, patron characteristics, type and level of alcohol consumption, and social dynamics that are at play and potentiate each other to result in sexual risk behavior. The specific aims of this study are to 1) describe 6 public venues in terms of their physical characteristics, alcohol availability, patron characteristics, and sexual behavior that occurs in the venue; 2) identify factors that contribute to alcohol use and high-risk sexual behavior in the venues; 3) identify HIV risk reduction possibilities in the venues and how they can be targeted by interventions; 4) assess willingness of venue owners/personnel to partner with HIV prevention organizations in reducing HIV risk in these settings and the types of prevention programs they find acceptable or unacceptable; and 5) assess ways to measure the efficacy of future interventions in these settings. This qualitative study consists of site observations of 6 venues frequented by men where alcohol is consumed and sexual behavior occurs, as well as in-depth interviews with 48 patrons of those venues, 18 owners/personnel from the venues, and 10 HIV prevention and alcoholism specialists. Venue patrons will also undergo a brief quantitative assessment to gather descriptive data on sexual behavior and substance use among this sample. Grounded theory will guide the qualitative data analysis, with the venue patron data undergoing a second level of analysis to develop cross-case causal models of HIV risk behavior in the context of alcohol use in these venues. We expect findings from this study to provide a blueprint for developing a venue-based HIV prevention intervention for these settings, which could be more fully developed and tested in a subsequent study. PUBLIC HEALTH RELEVANCE: Venue-based HIV-prevention interventions target places versus individuals, thereby tapping into high risk sexual networks and disrupting channels of sexual transmission (Weir, Pailman, Mahlalela, Coetzee, Meidany, & Boerma, 2003; Wohlfeiler & Potterat, 2005). Given the limited HIV-prevention programs in Argentina and high rates of HIV infection among high risk populations, intervening in these settings can be particularly useful in reaching large segments of the population, especially those at high risk of infection. Although this study will be conducted through the lens of Argentine culture (which affects norms of alcohol use and sexual behavior), we expect findings to be useful in informing venue-based interventions for these types of venues in other countries.