STRIVE Tackling the structural drivers of HIV

This report by Raising Voices, London School of Hygiene & Tropical Medicine (LSHTM) and Centre for Domestic Violence Prevention (CEDOVIP) showcases the findings from the SASA! study and summarises the SASA! intervention’s comprehensive impact on intimate partner violence (IPV) and HIV prevention, including effects on relevant attitudes and behaviours. The study compares two groups – communities that received SASA! programming (intervention communities) and those where no programming took place (control communities).

Theoretical Foundations

• Stages of Change Model: A key quality of SASA! is that ideas are introduced over time and based on the readiness of individuals and the community. Using the Stages of Change Model, the SASA! approach scales up the stages of change observed in individuals (pre-contemplation, contemplation, preparation for action, action, maintenance) to a community level (start, awareness, support, action).
• Ecological Model: SASA! uses the Ecological Model for understanding what puts people at risk of violence and opportunities for prevention. It thus engages people and institutions in all circles of influence (individual, interpersonal, community, societal) in all phases of SASA!
• Gender-Power Analysis: SASA! uses a gender-power analysis of violence against women, bringing the concepts of power (power within, power over, power with, power to) to everyday language and experiences. With this approach, activists stimulate personal reflection and critical thinking among community members, enabling them to see the benefits of non-violence for all.

Specifically, the report explores:

• Norms regarding the acceptability of gender inequalities and IPV
• The prevalence of different types of violence against women
• Attitudes towards and prevalence of sexual risk behaviours
• Help-seeking behaviour and community activism in response to IPV

Findings

After nearly three years of SASA! programming, levels of IPV were lower in intervention communities than in control communities. Women in intervention communities were about half as likely to report experiencing IPV, and also less likely to report experiences of sexual IPV. These findings are promising, indicating that violence is preventable within programmatic timelines.

The report focuses on the SASA! RCT and is designed to make findings accessible to activists and programmers. Its key message is: Violence is preventable!