Shebeen patrons happy to have a beer and an Aids test

IF a pilot study conducted in rural KwaZulu-Natal is anything to go by, back-yard shebeens will soon be a testing site for HIV/Aids.

That’s after research conducted in Msinga, in the Umzinyathi district, among 503 shebeen patrons between March and September last year, showed that over 90% of men were willing to be tested in shebeens.

The study was conducted by Dr Sheela Shenoi, an assistant professor in the Aids programme of the infectious diseases section at Yale University School of Medicine, with Dr Tony Moll, clinical manager at the Church of Scotland Hospital in Tugela Ferry, as the principal investigator.

Moll said the US-funded pilot study to determine if shebeens were a suitable testing site was presented at the three-day South African Aids Conference in Durban this week.

Details of the study are still to be published in a medical journal but it found that shebeens were a good place to test young people and determine their high-risk behaviour, given the stigma around being tested at clinics and that men were a “hard to reach” group for HIV and TB screening

Shebeens are popular among young people, especially at weekends.

During the pilot project, three male community health workers were stationed in a van outside shebeens in Tugela Ferry, where they mingled with patrons. They offered health education and screening for HIV and TB, and random glucose and automated blood pressure measurement.

As expected, testing at shebeens showed that a high number of young people were engaging in high-risk behaviour.

Moll, who presented the study at the Aids conference, said 17 000 people had been screened in other community settings which reached mostly women and only a few men of an older age group.

“We tried looking for venues where we could find young men, and shebeens were the ones we first went for. While our main objective was to provide screening for HIV and TB, we also assessed risk factors such as harmful levels of alcohol use and high-risk sexual behaviour which would contribute to HIV acquisition.”

The average age of patrons in the study was 26. Questions on high-risk behaviour showed that 27.9% of the men had smoked dagga, 63.8% of the men and 48.5% of the women were consuming harmful levels of alcohol, and inconsistent condom use was at 75%.

Of men tested in the shebeen study, 7.7% were HIV-positive and 92.3% negative.

Moll said they had anticipated 10% to 15% positive. “However, 7.7% is not an unusual finding for this age group. HIV distribution among men is quite low at 20 to 25 years, lagging a lot behind the stats for women. For men, it reaches its peak around 35 years, where over 20% are positive.”

The positive outcome, Moll said, was that they were catching the men before they became infected and this could be an excellent opportunity for prevention.

“We were successful in linking the [HIV-]positive men to care, finding that the neutral venue of an NGO was much more acceptable than conventional clinics and public health facilities.”

He said the pilot provided an opportunity to care for the 7.7% of men who were HIV-positive, and an opportunity to present prevention strategies to the 92.3% who were HIV-negative. They could be provided with prevention packages including the new pre-exposure prophylaxis.

We tried looking for venues where we could find young men