Program on Alcohol Use and HIV Shows Promising Results

Results from program in Namibia may be applicable in other settings
Mon, 02/11/2013

A program in Namibia that aimed to reduce people’s risky sexual behavior by curbing their alcohol use showed promising results that may be applicable in other settings in sub-Saharan Africa. ICRW helped design and evaluate the program.

A three-year program in Namibia that aimed to reduce people’s risky sexual behavior by curbing their alcohol use showed promising results that may be applicable in other settings in sub-Saharan Africa, a new report by AIDSTAR-One finds.

The report was part of an AIDSTAR-One initiative, in collaboration with the Gen Pop and Youth Technical Working Group of USAID’s Office of HIV/AIDS. AIDSTAR-One provides rapid technical assistance to USAID and U.S. government country teams and is funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). On behalf of AIDSTAR-One, the International Center for Research (ICRW) led the effort in partnership with the Society for Family Health (SFH) in Namibia.

Namibia is experiencing a severe, generalized HIV epidemic and has very high rates of alcohol consumption. The program was based Kabila, an informal settlement on the outskirts of Namibia’s capital city, Windhoek., The Kabila neighborhood, which encompasses about 2 sq miles, has a significant concentration of informal, home-based bars – 256 in total – that provide one of the few steady sources of income for community members. Drinking helps residents cope with stress associated with poverty, and going to a bar is among the few forms of entertainment for them.

ICRW and SFH worked with bar owners, patrons and community leaders to design, implement and evaluate a program to encourage the community to address hazardous alcohol use and make bars less risky environments for HIV transmission.

Among the findings from the evaluation:

  • Binge drinking decreased from 54 percent to 25 percent
  • Bar patrons who had the most exposure to program activities consumed less alcohol during bar visits
  • Heavy drinkers were more likely to be exposed to the program’s activities and were significantly more likely to discuss condoms with a partner, buy condoms and refuse to have sex without a condom
  • Bar owners found it feasible to change their bar’s environment by having shorter hours and displaying educational materials about alcohol. Sixty-four percent of patrons noticed the former, and 33 percent noted the shift in hours.


The effort in Namibia was one of a few taking place globally that seeks to develop community-level solutions to hazardous alcohol use. Most existing evidence around alcohol and HIV prevention programming is from sub-Saharan Africa, and focuses on individual drinking and risky behavior – not whole communities or the dynamics of bars that enable heavy drinking.

“The findings from this project in Namibia provide a significant contribution to the small, but growing body of evidence on how to tackle alcohol consumption as a contributor to HIV risk,” said Katherine Fritz, director of ICRW’s global health research and programs and a leading expert on the link between alcohol use and HIV. “The experience demonstrated that with community support, bar owners are willing to alter their establishment’s environment and intervene when they witness alcohol-induced risky behaviors.”

Fritz said the experience from the Kabila study can be built upon there and in other similar settings. To do so, the report offers several recommendations, including targeting binge drinking, which has been shown to contribute significantly to harmful behaviors; and encouraging bar staff to talk to patrons about safe sex practices, among other recommendations.

ICRW continues to gather evidence and identify innovative solutions to tackle social forces – like heavy alcohol consumption – that increase people’s vulnerability to HIV infection. ICRW is a member of STRIVE, a global research consortium that is investigating the social norms and inequities that drive HIV. Among efforts in this partnership, ICRW is addressing the correlation between alcohol, drug abuse and HIV among youth participating in an expanded version of Parivartan, a sports-based program in India.

Read more about this project:

Namibian Community Unites to Curb Alcohol Use and HIV Risk

ICRW Tackles Links Between Alcohol Use and HIV Risk

Environmental Influences  


ICRW Releases Blueprint for Reducing HIV-related Stigma in India

Indian government officials and others gather to discuss strategy to address HIV-related stigma
Fri, 01/18/2013

ICRW helped develop a strategy for the Indian government to reduce HIV-related stigma and discrimination nationwide. On Jan. 18, researchers share their findings with government officials, UN organizations and others during an event in New Delhi. 

The International Center for Research on Women (ICRW) on Jan. 18 debuts a much-anticipated blueprint for how to effectively address HIV-related stigma and discrimination in numerous settings – from hospitals to college campuses – in India.

The country’s National AIDS Control Organization (NACO) tapped ICRW and other select organizations three years ago to devise a strategy for reducing HIV-related stigma and discrimination nationwide.

To that end, ICRW researchers used a global blueprint for reducing stigma that they had previously developed and adapted it to be culturally relevant for India. ICRW then tested the framework in five settings throughout India and assessed whether it would be feasible to integrate the framework into NACO’s – and other organizations’ – HIV programs.

India is the first country to pilot ICRW’s universal framework and evaluate whether it could appropriately guide national efforts to reduce stigma.

ICRW will host an event Jan. 18 in New Delhi to present the results of its study and discuss how the Indian government can move forward with the findings. Officials from NACO, the United Nations Development Programme (UNDP), World Health Organization (WHO), UNAIDS and other organizations will participate in the gathering. ICRW President Sarah Degnan Kambou and Ravi Verma, director of ICRW’s Asia Regional Office, as well as Madhumita Das, a senior technical specialist in that office and Anne Stangl, a senior behavioral scientist and HIV stigma expert in ICRW’s Washington office, will lead presentations.

“Our study, with evidence from multiple sectors, is timely and strategic,” Verma said. “With the right kind of advocacy and support from other international agencies like UNDP, UNAIDS and WHO, the framework we have developed can be at the forefront of the Indian government’s efforts to curb HIV.”

Despite a nearly 60 percent drop in HIV prevalence over the past decade, the epidemic persists among India’s most vulnerable populations, such as sex workers and intravenous drug users. ICRW experts say this suggests that more is needed to reduce barriers – like stigma and discrimination – that certain groups face in accessing HIV treatment, care and prevention.

Indeed, tackling stigma is a key component in NACO’s latest phase of programming in response to the epidemic.

For ICRW’s study, researchers worked in partnership with five organizations in three states to carry out a variety of activities aimed at decreasing stigma and discrimination. Specifically, the project took place among university faculty, female sex workers living with HIV, local government members, hospital workers and leadership teams in workplaces. 

ICRW ultimately determined that the global framework for reducing HIV-related stigma could indeed be adapted for India. ICRW found that to do so would require:

  • Addressing a fear of HIV infection and social judgment that is prevalent among many different populations
  • Working with several key groups in the same setting to influence the different factors that drive stigma, such a fear of infection through casual contact
  • Focusing on how HIV-related stigma may also intersect with other types of stigma and discrimination – such as that related to one’s caste or occupation
  • Working with family and peers of populations affected by HIV
  • Using a range of activities to engage a variety of groups – from families to institutions – to help foster an environment that can support lasting change
  • Creating opportunities to meet members of groups who experience stigma – such as transgender people – to help break down discriminatory attitudes

“Our findings will set the stage for a right move forward by the national government as it carries out efforts to address the HIV epidemic,” Verma said. “Our experience in India also demonstrates that the global framework ICRW designed can be adapted by other countries eager to address the underlying factors, like stigma and discrimination, that fuel HIV transmission and impede people’s access to services.”

Watch a video of participant attitudes toward HIV-related stigma here

Read the full summary report, “A Global HIV Stigma Reduction Framework Adapted and Implemented in Five Settings in India."

Commentary: The End of AIDS - Almost

Thu, 11/29/2012

In this commentary to mark World AIDS Day, ICRW's Katherine Fritz praises the significant progress made in the more than 30-year fight against the epidemic. But she also suggests that the world must be realistic about what it takes to reach the "end of AIDS." 

In this TrustLaw "Word on Women" commentary for World AIDS Day, ICRW's Katherine Fritz praises the significant progress made in the more than 30-year fight against AIDS, particularly medical innovations to HIV prevention and treatment. But Fritz also encourages caution. "Today we can truly envision ending the AIDS epidemic. But we're not quite there yet," she writes.

Fritz argues that close the curtain on the epidemic, the world must be aggressive in requiring that medical strategies - such as antiretroviral treatment - are rolled out in tandem with approaches that reduce gender inequality, poverty, stigma and discrimination.

Read more of "The End of AIDS - Almost."

TrustLaw is a service of the Thomson Reuters Foundation that provides news and information on women's rights worldwide.

ICRW at AIDS Conference: Katherine Fritz to Address Social Inequities and HIV

Thu, 07/26/2012

Katherine Fritz, who directs ICRW’s global health research and programs, will participate today on a panel about structural interventions for HIV prevention. The event is part of the International AIDS Conference in Washington, D.C. this week.

International Center for Research on Women (ICRW) Director of Global Health Katherine Fritz will participate today in a panel discussion about approaches to preventing HIV that consider the social, political and economic inequities – or “structural drivers” – that influence the AIDS epidemic.

The event is part of the International AIDS Conference this week in Washington, D.C., and will take place from 6:30 p.m. to 8:30 p.m. in Mini Room 3 at the Walter E. Washington Convention Center downtown. 

Titled “Pushing Forward with Structural Interventions for HIV Prevention – Where We Are Now and How Do We Move Forward,” the panel is sponsored by AIDSTAR-One, the United States Agency for International Development and STRIVE, a new research consortium in which ICRW is a partner. 

During the panel, Fritz is expected to draw on a growing body of ICRW research that analyzes the link between alcohol consumption and increased HIV risk.

ICRW’s Anne Stangl to Discuss HIV-related Stigma at AIDS Conference

Mon, 07/23/2012

ICRW’s Anne Stangl will speak on the challenges posed by HIV-related stigma and efforts underway globally to address the issue during the International AIDS Conference in Washington, D.C.  

ICRW Senior Behavioral Scientist Anne Stangl on July 24 will be a panelist for a discussion on the challenges posed by HIV-related stigma and discrimination and the innovative solutions underway globally to address the issue. 

The event is being hosted by the Stigma Action Network and is part of the International AIDS Conference this week at the Walter E. Washington Convention Center in Washington, D.C. The discussion will take place from 4 p.m. to 5 p.m. in booth 810 at the Positive Action Networking Zone in the conference’s Global Village

Stangl and panelists will provide attendees with an understanding of the varied forms of HIV-related stigma and discrimination, how they fuel the epidemic, the unique challenges faced by key populations, and what to do to reduce stigma. Panelists also will highlight proven approaches for incorporating stigma reduction efforts into HIV programs, new evidence about stigma and how the Stigma Action Network is working to reduce HIV-related stigma. 

Learn how you can partner with ICRW.

ICRW’s Jennifer McCleary-Sills to Speak at AIDS Conference

Mon, 07/23/2012

ICRW’s Jennifer McCleary-Sills will discuss how to address young people’s vulnerability to HIV in developing countries during the International AIDS Conference in Washington, D.C.

ICRW Social and Behavioral Scientist Jennifer McCleary-Sills on July 24 will participate in a panel discussion on how to strengthen the capacity of organizations to understand and address gender issues, HIV and AIDS in their communities. 

The event is part of the International AIDS Conference this week in Washington, D.C., and will take place from 6:30 p.m. to 8:30 p.m. in mini room 8 at the Walter E. Washington Convention Center downtown. 

McCleary-Sills will discuss approaches ICRW used to guide two Tanzanian groups on how to engage with and mobilize communities to understand and address teenage girls’ vulnerability to HIV. Her presentation will draw from ICRW’s experience designing and evaluating the pilot project, "Vitu Newala,” which took place from 2010 to 2011 in a remote Tanzanian district. The effort was funded by the Positive Action program at ViiV Healthcare, a pharmaceutical company that focuses solely on HIV. 

The following day, McCleary-Sills will participate in a discussion in the Positive Action Networking Zone of the Global Village on how to involve adolescents in HIV prevention programs, and explain why programs targeting girls must also involve boys. That event is scheduled for 11 a.m. on July 25.

Learn how you can partner with ICRW.

AIDS2012: Thought Leaders to Discuss Social Inequities Fueling Epidemic

ICRW co-hosts panel discussion to launch new global research consortium
Mon, 07/23/2012

ICRW on July 24 will co-host an event to launch STRIVE, a new global research consortium investigating how to address social inequities that continue to drive the AIDS epidemic. The discussion is part of this week’s International AIDS Conference in Washington, D.C.

The International Center for Research on Women (ICRW) on July 24 will co-host an event to launch a new global research consortium that will focus on investigating how to best address social inequalities that drive HIV.  The event is part of this week’s International AIDS Conference in Washington, D.C. 

Called STRIVE, the consortium is made up of six partners, including ICRW in Washington, D.C., and its Asia regional office in New Delhi, India, as well as other organizations from Tanzania, India and South Africa. The six-year effort is funded by the UK Department for International Development and managed by the London School of Hygiene & Tropical Medicine. 

“STRIVE represents an opportunity to build more evidence for what our research at ICRW has long shown—that a biomedical approach alone will not slow the rate of HIV infection throughout the world,” said Katherine Fritz, director of ICRW research and programs in global health. “It’s imperative that we also tackle the sometimes unseen but powerful forces at play – like poverty and gender inequality – that continue to make people more vulnerable to HIV and impede their access to critical treatment and prevention services.” 

The official kick off of STRIVE will include an introduction to the partner organizations and a panel discussion with leaders from around the world who are engaged in efforts to craft HIV programs that respond to the social, economic and political forces shaping the epidemic. 

STRIVE will aim to understand how forces such as gender inequality and violence, poor job prospects, stigma, and social norms around alcohol consumption fuel the AIDS epidemic – as well as undermine the effectiveness of HIV treatment and prevention programs. Researchers also will investigate what programs are effectively tackling these social, political and economic factors and how they can be expanded affordably. Finally, experts will determine how best to translate the STRIVE research into policy and on-the-ground programs. 

“If we intend to eliminate HIV from the planet,” Fritz said, “we have to design innovative programs that address these macro-level drivers of HIV risk by linking and engaging with development sectors outside of health.” 

Globally, there has been a resurgence in biomedical approaches – such as antiretroviral treatment as a prevention tool and medical male circumcision – to address the HIV epidemic.  At the same time, the global economic downturn has amplified calls to streamline HIV programs by concentrating funding into programs with proven impact. This has caused some governments and donor agencies to shy away from investing in multi-sectoral programs to address structural influences on the epidemic. Few of these types of programs have rigorous evidence of effectiveness. 

“This is why ICRW and its STRIVE partners believe that generating evidence to support the viability of addressing how social, political and economic issues in HIV programming is more important than ever,” Fritz said. 

Although ICRW’s specific contribution to STRIVE is still being finalized, Fritz suggested that ICRW could build on an existing body of work that examines the links between high alcohol consumption and HIV transmission. Under the consortium, researchers from ICRW’s Washington office also may address how to reduce stigma that inhibits pregnant women living with HIV from using services that could prevent transmission of the virus to their babies. 

Meanwhile, researchers based in New Delhi will expand Parivartan, an ICRW program for boys focused on changing norms around masculinity and violence against women. The expanded approach will now incorporate girls, and links between gender norms and violence, substance and alcohol use, sexuality and HIV. Under STRIVE, ICRW researchers also will document the adaptation and implementation of a stigma-reduction framework into five key sectors to advocate for a possible integration into India’s National AIDS Control Policy. 

Related content: Commentary: Getting to Zero

Gillian Gaynair is ICRW’s senior writer and editor.

Healthy Transitions: Supporting and Empowering Girls Living with HIV

Wed, 12/09/2015 - 9:00am - 11:00am
International Center for Research on Women
1120 20TH ST NW STE 500N
United States

Madhu Deshmukh

Chief Operating Officer, Asia Regional Office

As Chief Operating Officer of ICRW’s Asia Regional Office, Madhu Deshmukh oversees day-to-day operations for the regional office, implements systems to ensure ARO’s growth, provides programmatic leadership and support, and ensures effective implementation of projects. She has more than 23 years of experience and has managed programs globally in over 40 countries in the areas of social development, gender, women's empowerment and public health.

Madhu’s background in leadership, strategy, project design and management, working with vulnerable population, and policy advocacy make her well qualified to lead operations for ICRW’s Asia Regional Office. What she enjoys most about working at ICRW is having the opportunity to explore and work on cutting edge issues related to gender, violence against women and girls, and empowerment of women and girls. Madhu is passionate about grounding her work in maternal and child health, sexual and reproductive health and HIV, in a broader framework that takes into account gender disparities and women’s empowerment.

Madhu has extensive experience working at senior management level in various nongovernmental organizations, bilateral and multilateral donors, including: the Government of India, the U.K. Department for International Development (DFID); the United Nations Development Programme (UNDP); and the Joint United Nations Programme on HIV/AIDS (UNAIDS);

Prior to joining ICRW in 2014, Madhu was the president of Tenth Planet LLC where she provided advice on strategy and innovation around social development, gender and public health related issues to various organizations, some of which include: CARE USA; the United Nations Foundation; and Lebara Foundation UK. In previous roles at CARE and the United Nations Foundation, Madhu served as the director leading their global work on maternal, newborn and child health (MNCH), mobile health (mHealth) and gender. In 2012, she worked as a Global Director for HIV/AIDS for CARE, and in 2010, she worked as a Senior Advisor  – Maternal Health, Governance and Women’s Empowerment. Madhu was also the Chief of Party for CARE in 2011, for a project on maternal, child health and nutrition issues in the state of Bihar, India, funded by the Bill and Melinda Gates Foundation.

Follow her on Twitter at @MadhuDeshmukh or connect with her via email


HIV/AIDS, Sexual Reproductive and maternal health (SRMH), Policy analysis and Advocacy

Languages Spoken: 

English and Hindi


Madhu holds a Master’s degree in social work from Tata Institute of Social Sciences (TISS), India. 

Reducing HIV-related Stigma and Gender-based Violence in Guyana

Globally, stigma and discrimination fuel HIV transmission by impeding access to testing and treatment services for people living with HIV. In Guyana, stigmatizing attitudes in the general population and discriminatory treatment by people ranging from health care providers to local policy makers intensify the marginalization of vulnerable groups at highest risk, driving them further from the reach of health services and much-needed prevention, treatment, care, and support. Despite the rapid scale-up of HIV prevention care and treatment services in Guyana over the last decade, reaching key vulnerable populations who are most at risk, including men who have sex with men and sex workers remains a challenge and the epidemic persists.

Adult HIV prevalence in Guyana is 1.07%, yet the prevalence among men who have sex with men (MSM) is reportedly at 19.4%, and is reportedly 16.6% among female sex workers (FSW). As such, reducing the transmission of HIV and stigma and discrimination against these key populations has become a critical component of Guyana’s national response to the epidemic.

In response to nature of the epidemic in Guyana, ICRW is providing support to local NGOs under Advancing Partners & Communities (APC), a USAID funded project, implemented by JSI Research & Training Institute, Inc., in partnership with FHI 360.

ICRW is assisting in the implementation of the project in Guyana over the next three years, helping to strengthen the capacity of local organizations in Guyana to provide HIV prevention, care and treatment services to key populations at heightened risk of HIV infection, including women, men who have sex with men, transgender individuals and sex workers. Activities will include a rapid assessment of the current responses, gaps and challenges in providing HIV services to key populations in Guyana, the development of stigma reduction tools and a screening tool and protocol for gender-based violence, and technical support to NGOs to develop and implement HIV stigma reduction activities and implement GBV screening and referral activities. ICRW will also support government stakeholders to integrate GBV screening and stigma reduction into the National HIV Strategy.

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