Beer halls as a focus for HIV prevention activities in rural Zimbabwe.

OBJECTIVE: The authors conducted an assessment of the role of beer halls in the HIV epidemic of rural Zimbabwe as part of the ongoing identification of risky places for the targeting of prevention activities. STUDY: A population-based survey of 9480 adults collected data on number of visits to beer halls in the last month, together with sociodemographics, sexual behavior, and HIV infection from 1998-2000. RESULTS: Fifty percent of men, but only 4% of women, had been to a beer hall in the last month. They reported higher levels of sexual behavior and stronger associations with commercial sex than those who had not been to a beer hall. A recent visit to a beer hall was also associated with HIV infection (men: odds ratio [OR] = 1.9, P <0.001; women: OR = 1.7, P = 0.001) and with ever having experienced urethral/vaginal discharge or genital sores. Only 225 respondents experienced an HIV prevention activity at a beer hall in the last 6 months. CONCLUSIONS: Beer hall attendance is associated with high-risk behavior for HIV infection and cofactor sexually transmitted infections. Beer halls represent an underused focus for HIV prevention.