Women-Focused HIV Prevention in the Western Cape

Summary

Principal Investigator: W M Wechsberg
Affiliation: RTI International
Country: USA
Abstract: Results from a 2005 antenatal survey conducted in all nine South African provinces indicate that the Western Cape Province had the highest rate of increase of HIV infection among all provinces: from 13.1% in 2003 to 15.7% in 2005. Among Black African and Coloured women, noninjecting drug use is associated with high-risk sexual behavior, HIV seropositivity, and sexually transmitted infections (STIs). In addition, violence against women is widespread in South Africa, which further exacerbates their HIV risks. A recent pilot study conducted in the Western Cape townships explored an evidence-based woman-focused intervention to reduce drug use, sexual risk, and victimization by addressing the intersection of these factors among poor, substance-using women. The pilot study explored the feasibility and promise of the woman-focused intervention in both an individual and group-based format through a small randomized trial. Both Black African and Coloured women reported high levels of substance abuse, as well as high levels of sexual risk behavior (e.g., multiple partners and unprotected sex) and victimization. Findings from the pilot study suggest that women reduced substance use (with biological verification), sexual risk behavior, and victimization. The group intervention, however, created an ongoing effect in the community in which women who participated in the two group sessions continued to meet after the study ended to provide support for one another and reinforce positive changes. The group format complemented the strong sense of community cohesion intrinsic to the Western Cape townships. The proposed revised study builds on this pilot study and is designed to reach a larger sample of women via a full-scale effectiveness study by adding a woman-focused intervention after voluntary counseling and testing (VCT). This multi-method research will conduct an extensive evaluation using qualitative and quantitative methods, repeated measures, and biological testing to determine the effectiveness of the woman-focused intervention to increase knowledge and skills to reduce substance abuse, sexual risk behaviors, and victimization. Former pilot study participants indigenous to the target communities will be trained as outreach workers to screen, recruit, and track 900 female study participants. The primary aim of the study is: Aim 1. To test the effectiveness, through a randomized controlled trial, of VCT plus a woman-focused intervention relative to VCT only to increase knowledge and skills to reduce substance abuse, sexual risk, and victimization, and to an equal-attention (nutrition) control group at 3-, 6-, 9-, and 12-month follow-ups. The secondary aim of the study is as follows: Aim 2. To examine the moderating effect of victimization (i.e., sexual and physical) and the mediating effects of HIV risk knowledge, condom use skills, sexual negotiation assertiveness, and relationship power on the effectiveness of the woman-focused groups to decrease risk related to drug use, sexual risk, and sex-related- victimization relative to the rapid testing group and to the equal-attention control group.
Funding Period: ----------------2007 - ---------------2012-
more information: NIH RePORT

Top Publications

  1. pmc The intersecting risks of substance use and HIV risk among substance-using South African men and women
    Felicia A Browne
    RTI International, Substance Abuse Treatment, Evaluations and Interventions Research Program, Research Triangle Park, North Carolina 27709 2194, USA
    Curr Opin Psychiatry 23:205-9. 2010
  2. pmc Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions
    Bronwyn Myers
    Alcohol and Drug Abuse Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg 7505, South Africa
    BMC Public Health 13:174. 2013
  3. pmc Perceived need for substance use treatment among young women from disadvantaged communities in Cape Town, South Africa
    Bronwyn Myers
    Alcohol and Drug Abuse Research Unit, South African Medical Research Council, Cape Town, South Africa
    BMC Psychiatry 14:100. 2014
  4. pmc Pregnant and nonpregnant women in cape town, South Africa: drug use, sexual behavior, and the need for comprehensive services
    Hendree E Jones
    Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA
    Int J Pediatr 2011:353410. 2011
  5. ncbi Dual HIV risk and vulnerabilities among women who use or inject drugs: no single prevention strategy is the answer
    Nabila El-Bassel
    Columbia University School of Social Work, New York, New York, USA
    Curr Opin HIV AIDS 7:326-31. 2012

Scientific Experts

Detail Information

Publications7

  1. pmc The intersecting risks of substance use and HIV risk among substance-using South African men and women
    Felicia A Browne
    RTI International, Substance Abuse Treatment, Evaluations and Interventions Research Program, Research Triangle Park, North Carolina 27709 2194, USA
    Curr Opin Psychiatry 23:205-9. 2010
    ....
  2. pmc Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions
    Bronwyn Myers
    Alcohol and Drug Abuse Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg 7505, South Africa
    BMC Public Health 13:174. 2013
    ..This paper aims to describe ethnic differences in AOD use and AOD-related sexual risks for HIV among vulnerable women from Cape Town, South Africa...
  3. pmc Perceived need for substance use treatment among young women from disadvantaged communities in Cape Town, South Africa
    Bronwyn Myers
    Alcohol and Drug Abuse Research Unit, South African Medical Research Council, Cape Town, South Africa
    BMC Psychiatry 14:100. 2014
    ..Yet little is known about the factors that influence perceived need for treatment (a determinant of treatment entry) within this population...
  4. pmc Pregnant and nonpregnant women in cape town, South Africa: drug use, sexual behavior, and the need for comprehensive services
    Hendree E Jones
    Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA
    Int J Pediatr 2011:353410. 2011
    ..Moreover, findings support the urgent need for women-focused and pregnancy-specific treatment services for methamphetamine use. Finally, a job-skills training/employment component focus is suggested...
  5. ncbi Dual HIV risk and vulnerabilities among women who use or inject drugs: no single prevention strategy is the answer
    Nabila El-Bassel
    Columbia University School of Social Work, New York, New York, USA
    Curr Opin HIV AIDS 7:326-31. 2012
    ....