Nearly one-third of South African men report enacting intimate partner violence (IPV). Beyond direct health consequences for women, IPV is also linked to varied risk behaviours among men who enact it, including alcohol abuse, risky sex, and poor health care uptake. Little is known about how to reduce IPV perpetration among men. We conducted retrospective, in-depth interviews with men (n=53) who participated in a rural South African program that targeted masculinities, HIV risk, and IPV. We conducted computer-assisted thematic qualitative coding alongside a simple rubric to understand how the program may lead to changes in IPV perpetration. Many men described new patterns of reduced alcohol intake and improved partner communication, allowing them to respond in ways that did not lead to the escalation of violence. Sexual decision-making changed via reduced sexual entitlement and increased mutuality about whether to have sex. Men articulated the intertwined nature of each of these topics, suggesting a syndemic lens may be useful for understanding IPV. These data suggest that alcohol and sexual relationship skills may be useful levers for future IPV programming, and that IPV may be a tractable issue as men learn new skills for enacting masculinities in their household and in intimate relationships.
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