Men’s use of alcohol, particularly at harmful levels, is associated with increased perpetration of intimate partner violence (IPV) against women, as well as HIV incidence. Interventions that target boys and men and focus on preventing and treating their problematic drinking, both in and out of the context of violent behavior, are urgently needed. Nonetheless, few singular alcohol interventions or alcohol interventions combined with violence reduction approaches have been tested for their impact on IPV perpetration, particularly in sub-Saharan African countries like Uganda. This two-year, mixed methods study will be conducted in partnership with Rakai Health Sciences Program to assess the prevalence of men’s use of alcohol and its relationship with perpetration of IPV in the rural Rakai District of Uganda; and pilot test an integrated alcohol and IPV perpetration reduction intervention for men in one of Rakai’s HIV “hotspot” fishing areas. Addressing men’s alcohol use as a risk factor for women’s experiences of IPV holds potential for reducing harmful levels of consumption and concomitant violence. It is further possible that offering an integrated approach that screens for and intervenes on men’s problematic alcohol use and IPV perpetration will effectively reduce associated adverse reproductive health outcomes such as HIV infection. Specific aims of this study are to:
- Generate evidence on rates of men’s alcohol use and how it contributes to perpetration of IPV against female partners.
- Identify barriers and facilitators to men’s participation in a brief, integrated alcohol and IPV perpetration reduction intervention.
- Design a framework for a brief, integrated alcohol and IPV perpetration reduction intervention that is tailored for delivery to men seeking HIV services in a fishing community.
- Establish feasibility and cultural appropriateness of implementing the integrated alcohol and IPV perpetration reduction intervention to men in a Rakai fishing community and develop a framework and approach for scaling up the tailored intervention.
We will first analyze quantitative survey data from the Rakai Community Cohort Study (RCCS) data to estimate population-level trends of and associations between alcohol use and IPV perpetration among a sample of men in the general RCCS population and a sample of men in 3 fishing RCCS fishing communities. Findings will be used to determine behaviors that could potentially be modified through targeted strategies incorporated into an alcohol and IPV perpetration reduction intervention involving the Alcohol Use Disorders Identification Test, known as the AUDIT (1), the World Health Organization’s brief alcohol intervention (2) and an integrated violence prevention treatment designed to address IPV perpetration. Next we will conduct qualitative interviews and focus groups with men, community members and health providers to identify barriers to participation in the intervention. Finally, we will pilot test the refined alcohol and IPV perpetration reduction intervention model with approximately 80 men seeking HIV services from RHSP in a fishing community, establish the model’s feasibility and develop a unified framework and specific approach for scaling-up the tailored intervention. Findings from this study, as well as the framework to be developed, will be extremely useful to researchers and programmers throughout Uganda and sub-Saharan Africa by providing a model on which they can expand on their own research and help men significantly reduce harmful alcohol use and perpetration of IPV in their setting.
Funding Source: Anonymous Donor
- Babor TF, de la Fuente JR, Saunders J, Grant M. AUDIT. The Alcohol Use Disorders Identification Test. Guidelines for use in primary health care. Geneva, Switzerland: World Health Organization, 1992.