HIV/AIDS risk factors among young single mothers working in alcohol-serving establishments in Rwanda.

Introduction: Although prior studies suggest that female bar workers are vulnerable to HIV and engage in high-risk sexual practices, significant data gaps remain on HIV/AIDS risks among young single mothers in alcohol-serving establishments (ASEs), regardless of their roles. To address this gap in literature, this study explored both internal and external contextual factors that may contribute to heightened vulnerability to HIV/AIDS among young single mothers working in informal ASEs in Rwanda. Methods: This research employed a qualitative multi-method approach. It was conducted in informal ASEs located in both urban and semi-urban areas of Musanze District, Kigali City, as well as in the adjacent emerging semi-urban regions of Kamonyi and Gakenke Districts. The study population consisted of 101 young single mothers engaged in various job roles within pubs, bars, and restaurants, motels, guesthouses, and lodges. A maximum variation purposive sampling was used to sample the study sites. Participants were selected using both purposive and snowball sampling techniques. Data were collected from two distinct sources: YouTube, and key informant interviews. YouTube was searched to retrieve testimonies from female staff who had ever worked in ASEs to garner their experiences on ASEs' working conditions and how these increased their vulnerability to HIV. An interview guide featuring semi-structured questions was employed to facilitate the interviews. The data were analyzed using a thematic analysis approach supported by Dedoose software. Results: The findings suggest that vulnerabilities to HIV/AIDS among young single mothers working in ASEs may be shaped by persistent poverty, inadequate salaries, delays in salary payments, various forms of exploitation, exposure to alcohol, and engagement in transactional or multiple-partner sexual relationships within workplace contexts. Conclusion: This study identified a range of contextual factors that may influence HIV-related vulnerabilities among young single mothers working in ASEs. These findings highlight the potential value of targeted, multi-level interventions to support this population. Such interventions could address work-related stress and the intersecting demands of single parenthood, while promoting economic stability. In addition, programs may benefit from strengthening women's capacity to negotiate safer sex practices and supporting engagement with HIV prevention and treatment services.