Given the established link between alcohol consumption and risk taking behavior, it is plausible that neighborhoods with higher density of drinking establishments will be associated with increased prevalence of HIV. We conducted an ecological study comparing neighborhoods in Luderitz, Namibia, to evaluate this relationship. We observed increased prevalence of HIV comparing high densities of registered and unregistered shebeens, bars, and total number of drinking establishments, as compared with low densities, were associated with increased prevalence of HIV (PR=3.02, 95% CI: 2.04-4.47; PR=1.71, 95% CI: 1.42-2.07; PR=1.55, 95% CI: 1.19-2.02). Our observation of increased prevalence associated with higher densities of drinking establishments merits consideration.