Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda

A community mobilization intervention piloted in Uganda significantly reduced social acceptance of gender inequality and intimate partner violence (IPV), as well as actual experience of IPV and risky sexual behavior.

Introduction

Recent global estimates suggest that 30% of women will experience physical or sexual violence from an intimate partner during their lifetime. Several recent studies have also identified intimate partner violence (IPV) as an independent risk factor for HIV infection as gender inequality is at the core of both IPV and HIV infection. Gender norms and power inequalities often limit the extent to which women can negotiate the circumstances of sex or insist on condom use, especially where violence or the threat of violence is common. This, in turn, reduces their ability to protect themselves from HIV infection from their partners. The lack of bargaining power are evidenced in sub-Saharan Africa, where women and girls constitute 58% of those living with the HIV.

Here, the authors aim to assess the effects of the SASA! intervention, designed to reduce intimate partner violence and HIV infection via community mobilization. The SASA! program involves training community activists and encouraging informal activities that stimulate discussion and critical analysis of power inequalities in society. This is the first cluster randomized control trial in sub-Saharan Africa to assess the community impact of a mobilization program on the social acceptability of IPV, the past year prevalence of IPV and levels of sexual concurrency.

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