ArticlePLOS global public health2026
Influence of alcohol-serving venue characteristics on yield of HIV status-neutral screening in rural East Africa.
Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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19 authors.
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Abstract
Alcohol-serving venues are high-risk sites for HIV transmission in East Africa. Understanding how venue characteristics influence HIV screening outcomes may help to target venue-based outreach. In eight rural communities in Kenya and Uganda, we mapped all alcohol-serving venues (N = 530) and invited owners to participate in a cluster-randomized trial to promote biomedical HIV prevention uptake: 527 (99%) owners agreed to participate. We distributed cards recruiting adults (≥18 years) for free HIV testing with rapid initiation of HIV biomedical prevention or treatment. We characterized the yield of venue-based recruitment and evaluated venue-level correlates of being newly diagnosed with HIV, being previously diagnosed but out-of-care, and having self-reported HIV risk. Of 480 participating venues (Kenya = 89, Uganda = 391; 41 closed pre-recruitment and 6 had no one present), 61 (13%) had rooms for sex work; 91 (19%) offered condoms, and the median patrons/venue was 10/weekend-day. Staff distributed 9,375 cards and 7,744 (83%) adults participated in HIV screening. Of those screened, the median age was 34 years (IQR:26-43), 62% were men, and 1,620 (21%) had HIV. Among persons without known HIV, 141/6,265 (2.3%) were newly-diagnosed with HIV. Among persons with known HIV, 78/1,479 (5.3%) were out-of-care. Among persons without HIV, 2,285/6,124 (37%) reported HIV risk. The odds of having newly-diagnosed HIV increased significantly with each additional patron/weekend-day at a given venue (adjusted odds ratio [aOR]=1.03, 95%CI:1.00-1.05, p = 0.025). The odds of being previously diagnosed but out-of-care were significantly lower among attendees at venues with condoms on site (aOR=0.39, 95%CI:0.16-0.99, p = 0.047). The odds of reporting HIV risk were significantly higher among attendees at venues with condoms (aOR=1.25, 95%CI:1.04-1.49, p = 0.015), more patrons/weekday (aOR=1.01, 95%CI:1.00-1.02, p = 0.022), and more barmaids (aOR=1.07, 95%CI:1.01-1.13, p = 0.013). Alcohol-serving venue characteristics were predictive of the yield of persons with untreated HIV or high HIV risk, and could aid programs in targeting venues for HIV prevention and treatment.
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