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Efforts at HIV prevention that focus on high risk places might be more effective and less stigmatizing than those targeting high risk groups. The objective of the present study was to assess risk behaviour patterns, signs of current preventive interventions and apparent gaps in places where the risk of HIV transmission is high and in communities with high HIV prevalence.

Inhabitants of selected communities in Lusaka and Livingstone were interviewed about where people met new sexual partners. Signs of HIV preventive activities in these places were recorded. At selected venues, people were interviewed about their sexual behaviour. Peer educators and staff of NGOs were also interviewed. There were few active peer educators. Having no condom available was the most common reason for not using one. Condom use in Livingstone was higher among individuals socializing in places where condoms always were available.

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In the places studied we found a high prevalence of behaviours with a high potential for HIV transmission but few signs of HIV preventive interventions. Covering the gaps in prevention in these high exposure places should be given the highest priority.

Many efforts at HIV prevention in sub-Saharan Africa have been aimed at high risk groups as these are believed to contribute disproportionately to the spread of the epidemic [ 1 โ€” 3 ]. In settings with high prevalence in the general population, more transmission takes place among non-core individuals, but high risk groups can still be an important source of new infections [ 4 โ€” 6 ].

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Very few of these trials have, however, had randomized designs and comparable control groups. There is evidence that such interventions had an effect on the HIV incidence in the general population of Thailand [ 8 , 18 ] and Cambodia [ 21 , 22 ], but the potential impact on the population incidence in countries with much higher HIV prevalences, as in sub-Saharan Africa, is more uncertain [ 23 ].

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