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Reducing Alcohol-Related HIV Risk in Kabila, Namibia

Alcohol use is associated with HIV risk behavior, according to a growing body of research. Programs that address the link between alcohol and HIV are urgently needed, but extremely rare.

ICRW and its partners will design and monitor a community-based intervention the informal settlement of Kabila, Namibia, located on the outskirts of the capital city, Windhoek. Many residents have migrated from rural areas in search of a viable income, and brewing and selling alcohol is one of the few profitable businesses.  

The project goal is to design, implement and assess the feasibility of an intervention to reduce the prevalence of heavy drinking and decrease alcohol-related sexual risk behavior among bar patrons in the community. ICRW will conduct formative research to better understand the impact of alcohol and related risky behavior on women and men. Research findings will inform the design of a demonstration program that applies multiple strategies to decrease alcohol-related HIV risk behavior. The results of this study will be used to inform future programming targeted at addressing links between alcohol and HIV risk.

This project is coordinated by AIDSTAR-One. As an AIDSTAR-One partner organization, ICRW provides technical oversight for this project.

Duration: 
2010 – 2012
Location(s): 
Namibia

Redistributing Power

Redistributing Power
Stories from Women Leading the Fight Against AIDS

Cynthia Powell, Eva V. Cantrell, Reshma Trasi
2011

In 2006, the “Advancing Women’s Leadership and Advocacy for AIDS Action” initiative was launched to equip and empower a cadre of women from around the world with the knowledge and skills to strengthen and lead the global response to AIDS. Implemented by a consortium led by the Centre for Development and Population Activities and including the International Center for Research on Women, the International Community of Women Living with HIV/AIDS and the National Minority AIDS Council, the initiative consisted of six global, regional and national workshops designed to enhance participants’ confidence and self-efficacy, strengthen their program management skills and expand their professional networks.

This publication profiles seven extraordinary women who passed through the program. From civil war-torn northern Uganda to the edge of the Rocky Mountains in the United States, these women leaders share their struggles, their evolution and the passion they have for empowering those around them.

(4.99 MB)

We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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Implementing Multiple Gender Strategies to Improve HIV and AIDS Interventions

Implementing Multiple Gender Strategies to Improve HIV and AIDS Interventions
A Compendium of Programs in Africa

International Center for Research on Women
2010

Gender norms strongly influence HIV vulnerability and how women and men respond to the epidemic. There is growing recognition that using multiple approaches in HIV programs to address gender-based vulnerabilities is more effective than single strategies. These gender approaches include reducing violence against women, increasing legal protection for women, engaging men and boys, and creating income opportunities for women.

This compendium describes how 31 programs in Africa are using gender strategies to improve HIV services and reduce vulnerability to HIV infection. It provides examples of how strategies are combined, where gaps exist, lessons learned, and common experiences across programs.

The compendium was prepared by the AIDSTAR-One project. As an AIDSTAR-One partner organization, ICRW provided technical oversight on this publication. An online, interactive version of this compendium is available at AIDSTAR-One.

(835.24 KB)

We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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Prevention of Alcohol-related HIV Risk Behavior

Prevention of Alcohol-related HIV Risk Behavior
Technical Brief

Katherine Fritz
2010

A growing body of research suggests that alcohol consumption is associated with the sexual behaviors that put people at risk for HIV. In developing countries battling severe HIV epidemics, addressing harmful drinking in conjunction with interventions to reduce sexual risk behavior may reduce HIV transmission more quickly than conventional HIV prevention interventions alone.

This technical brief reviews the evidence on new and innovative programs in this emerging area. Developed for program planners and implementers, the brief catalogs what is known about the relationship between harmful alcohol use and HIV sexual risk behavior and offers a critical analysis of interventions to address the issue.

This brief was prepared by the AIDSTAR-One project. As an AIDSTAR-One partner organization, ICRW provided technical oversight on this publication.

Related publications:
Wising Up to Alcohol-related HIV Risk
Alcohol Consumption and HIV Risk

(413.04 KB)

We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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Wising Up to Alcohol-related HIV Risk

Wising Up to Alcohol-related HIV Risk
A Counseling Program for STI Patients Attending Primary Health Care Clinics in Cape Town, South Africa

Katherine Fritz
2010

Programs that specifically address the link between alcohol and HIV are extremely rare. However, a small number of promising interventions have recently been developed and implemented in sub-Saharan Africa and India. These provide valuable lessons about the feasibility, acceptability, and effectiveness of several approaches to reducing alcohol-related risky sexual behavior.

This case study examines a program in South Africa, where rates of alcohol consumption and HIV are among the highest in the world, and sexual risk taking and drinking frequently intersect. In Cape Town, the Phaphama (“Wise Up”) program demonstrated dramatic behavior change in the months following a single, 60-minute counseling session offered to repeat patients at a sexually transmitted infection clinic.

This case study was prepared by the AIDSTAR-One project. As an AIDSTAR-One partner organization, ICRW provided technical oversight on this publication. An online, interactive version of this case study is available at AIDSTAR-One.

Related publications:
Prevention of Alcohol-related HIV Risk Behavior
Alcohol Consumption and HIV Risk

(867.47 KB)

We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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Evolving Men

Evolving Men
Initial Results from the International Men and Gender Equality Survey (IMAGES)

Gary Barker, Manuel Contreras, Brian Heilman, Ajay Singh, Ravi Verma, Marcos Nascimento
2011

This report summarizes multi-country findings from the International Men and Gender Equality Survey (IMAGES), a comprehensive household questionnaire on men’s attitudes and practices – along with women’s opinions and reports of men’s practices – on a wide variety of topics related to gender equality. From 2009 to 2010, household surveys were administered to more than 8,000 men and 3,500 women ages 18 to 59 in Brazil, Chile, Croatia, India, Mexico and Rwanda. The report focuses on the initial comparative analysis of results from men’s questionnaires across the six countries with women’s reports on key variables. Topics included health practices, parenting, relationship dynamics, sexual behavior and use of violence.

IMAGES is a component of the Men and Gender Equality Policy Project coordinated by ICRW and Instituto Promundo.

(1.39 MB)

We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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Men and Violence: Risk Factors Vary

Survey Highlights Risks Tied to Men’s Use of Violence Against Women
Tue, 01/25/2011

ICRW study provides insight into men’s use of violence against women and factors associated with it.

An analysis of new findings from the International Center for Research on Women (ICRW) affirms that an integrated approach – one that experts say should aim to prevent violence by addressing men's risk factors – is key to reducing men's use of violence against women.

Initial findings from the International Men and Gender Equality Survey (IMAGES) – to be released today – illustrate the varied experiences that lead some men to physically or sexually abuse an intimate female partner. The three-year study consisted of nearly 12,000 interviews with men and women ages 18 to 59 in Brazil, Chile, Croatia, India, Mexico and Rwanda about their health practices, parenting, relationship dynamics, sexual behavior and use of violence.

Researchers crafted the questions about violence based on existing data on the correlation between men’s use of violence, their experiences with it during childhood and social norms that dictate how they should act. While there have been numerous studies on men and violence, IMAGES provides a deeper look at factors associated with why some men are violent against women. Researchers asked men detailed questions about their experiences with violence as an observer and perpetrator. Women were interviewed on the matter, too.

“There are numerous social and cultural factors that contribute to men’s use of violence,” said ICRW’s Gary Barker, lead researcher on IMAGES. “Our methodology on IMAGES allowed us to explore a broad range of these with men and compare men’s responses with women’s from the same settings. This gave us a more accurate assessment of the factors and extent of violence.”

Experts say programs and policies that work to end violence against women could be more effective by understanding how some men view violence and the sometimes invisible social factors that drive their behavior.

“To truly reduce violence, program designers and policy makers should consider how to create more comprehensive interventions that take into account such things as men’s attitudes about gender, their childhood experiences of violence, their work-related stress and their use of alcohol,” said Barker, who in February will become international director of Instituto Promundo, a Brazilian nongovernmental organization that coordinates the Men and Gender Equality Policy Project with ICRW. IMAGES is a component of this project.

Contributing factors

To measure men’s use of violence against a partner, IMAGES applied a slightly modified version of the approach used in a pioneering 2005 World Health Organization (WHO) study on domestic violence. The 10-country study yielded some of the first comprehensive, multi-site data on the various forms of violence women experience at the hands of a male partner and its consequences. Ten to 70 percent of women surveyed said they had been physically abused by an intimate partner at some point in their lives.

For IMAGES, researchers asked men about specific types of violence, such as slapping, against their female partners. Women also were asked about their experiences with the same forms of violence. Between 25 to nearly 40 percent of the men surveyed said they had been violent with an intimate partner. Meanwhile, 27 to 41 percent of women said they had been abused by a man at least once in their lives, suggesting that in most cases, men’s reports of the violence they used were fairly accurate.

IMAGES results across all countries also showed that men who generally view themselves as superior to women are more likely to report physical and sexual violence against an intimate partner. The same was true for men who abused alcohol, witnessed violence in their childhood home and, except for Mexicans surveyed, those who felt stressed about work or income. Rwandan men were not asked about work stress.

“The IMAGES findings make an important contribution to existing knowledge about gender-based violence by bringing in men's perspectives about their experiences of violence in diverse settings, as well as their attitudes about women’s rights and roles within the household," said ICRW's Mary Ellsberg, vice president of research and programs and co-author of the WHO domestic violence study. "We hope to do additional analysis of the data in the future, to compare the experiences and attitudes of both men and women around these issues."

Laws about violence

Many governments worldwide are increasingly adopting legislation to combat violence against women. It’s the policy issue that has received the most attention in efforts, including by ICRW, to involve men in creating more equitable societies. And, IMAGES found it’s the issue most men have heard about, either through an advertisement or campaign.

Between 88 and 96 percent of men surveyed said they knew about laws related to violence against women in their countries, however this does not correlate with a decrease in their use of violence against their wives or girlfriends. IMAGES also shows the contradictory attitudes men have about existing laws related to violence: Despite their knowledge of the laws, the vast majority of men also thinks the laws make it too easy to bring charges against them.

“Given the relatively small number of men actually charged under those laws in all the countries, this opinion is a misperception,” Barker said. He added that IMAGES results suggest that some men don’t understand anti-violence policies and may see the laws as being against them. “We may need more long-term, nuanced public education targeting men about the laws."

Far fewer men surveyed for IMAGES reported hearing messages about other themes that might interest them, or that they might perceive as positive, such as promoting that men participate in care giving and be more involved fathers.

“While we can’t let men off the hook in terms of violence, we also need to consider the source of men’s violence,” Barker said. “Our policies need to understand these factors and design prevention strategies accordingly.”

Gillian Gaynair is ICRW’s writer/editor.

International Men and Gender Equality Survey (IMAGES)

International Men and Gender Equality Survey (IMAGES)
Questionnaire

International Center for Research on Women (ICRW) and Instituto Promundo
2010

The International Men and Gender Equality Survey (IMAGES) is a comprehensive household questionnaire on men’s attitudes and practices – along with women’s opinions and reports of men’s practices – on a wide variety of topics related to gender equality.

Topics include: gender-based violence; health and health-related practices; household division of labor; men’s participation in caregiving and as fathers; men’s and women’s attitudes about gender and gender-related policies; transactional sex; men’s reports of criminal behavior; and quality of life.

From 2009 to 2010, household surveys were administered to more than 8,000 men and 3,500 women ages 18-59 in Brazil, Chile, Croatia, India, Mexico and Rwanda. The report, Evolving Men: Initial Results of the International Men and Gender Equality Survey (IMAGES), summarizes these initial multi-country comparative findings.

IMAGES is a component of the Men and Gender Equality Policy Project coordinated by ICRW and Instituto Promundo.

(932.99 KB)

We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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A Sale for Survival

Researcher Receives Harsh Reminder of Poverty at its Extreme

On my last trip to Rwanda, I assisted the Rwanda Men’s Resource Centre, a local nongovernmental organization, in implementing the International Men and Gender Equality Survey (IMAGES) among men and women ages 18 to 59. I helped the organization adapt the original survey to reflect a Rwandan context and trained about 80 data collectors.

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