PIs: Kathleen J. Sikkema and Seth Kalichman (University of Connecticut) Investigators: Melissa Watt Funder: NIAAA, R01, 2008-2014 Site: Cape Town, South Africa This study, conducted in Cape Town, South Africa, aimed to understand women's HIV risks in the context of alcohol-serving establishments in one urban township. The data included in-depth qualitative interviews with a range of stakeholders, repeated cross-sectional surveys of venue patrons, and a longitudinal cohort of women who frequent the study venues. 12 distinct venues were selected for involvement in the study. Over four time points in one year, 2,783 patrons completed the surveys, and a cohort of 560 women were followed longitudinally.

An overarching theme among this population was the presence of poor mental health, particularly PTSD and depression, coupled with HIV risk behaviors and high alcohol consumption. The team has published over a dozen papers, both quantitative and qualitative, examining issues such as mental health, alcohol use, traumatic experiences, and food insecurity. Outcomes indicate a large presence of substance use among this population, particularly heavy alcohol consumption and use of methamphetamine. Both qualitative and quantitative data point to the pervasive practice of gender-based violence, sometimes facilitated by the venue atmosphere. Specifically, forced sex and other traumatic experiences were endorsed by the majority of women.