Browsing by Author "Parry, Charles"

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    Availability of HIV prevention and treatment services for people who inject drugs: findings from 21 countries
    (BioMed Central Ltd, 2013) Petersen, Zaino; Myers, Bronwyn; van Hout, Marie-Claire; Pluddemann, Andreas; Parry, Charles
    BACKGROUND:About a third of the global HIV infections outside sub-Saharan Africa are related to injecting drug use (IDU), and this accounts for a growing proportion of persons living with HIV. This paper is a response to the need to monitor the state of the HIV epidemic as it relates to IDU and the availability of HIV treatment and harm reduction services in 21 high epidemic countries. METHODS: A data collection form was designed to cover questions on rates of IDU, prevalence and incidence of HIV and information on HIV treatment and harm reduction services available to people who inject drugs (PWID). National and regional data on HIV infection, IDU in the form of reports and journal articles were sought from key informants in conjunction with a systematic search of the literature. RESULTS: Completed data collection forms were received for 11 countries. Additional country-specific information was sourced via the literature search. The overall proportion of HIV positive PWID in the selected countries ranged from 3% in Kazakhstan to 58% in Vietnam. While IDU is relatively rare in sub-Saharan Africa, it is the main driver of HIV in Mauritius and Kenya, with roughly 47% and 36% of PWID respectively being HIV positive. All countries had antiretroviral treatment (ART) available to PWID, but data on service coverage were mainly missing. By the end of 2010, uptake of needle and syringe programmes (NSP) in Bangladesh, India and Slovakia reached the internationally recommended target of 200 syringes per person, while uptake in Kazakhstan, Vietnam and Tajikistan reached between 100-200 syringes per person. The proportion of PWID receiving opioid substitution therapy (OST) ranged from 0.1% in Kazakhstan to 32.8% in Mauritius, with coverage of less than 3% for most countries. CONCLUSIONS: In order to be able to monitor the impact of HIV treatment and harm reduction services for PWID on the epidemic, epidemiological data on IDU and harm reduction service provision to PWID needs to be regularly collected using standardised indicators.
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    Did COVID-19-Related Alcohol Sales Restrictions Reduce Alcohol Consumption? Findings from a National Online Survey in South Africa
    (2022-02-19) Theron, Marieke; Swart, Rina; Londani, Mukhethwa; Parry, Charles; Petersen Williams, Petal; Harker, Nadine
    Background: South Africa has a high prevalence of heavy episodic drinking (HED). Due to the high levels of alcohol misuse and violence, public hospital intensive care units were often overrun during the COVID-19 pandemic. This research investigated alcohol intake behaviour change during differing levels of lockdown restrictions, which included bans on alcohol sales. Methods: A self-reported Facebook survey ran from July to November 2020. The questions included socio-demographics, income, alcohol intake, purchasing behaviour, and reasoning. Chi-square tests/Fisher’s exact test for categorical data, Student’s t-test for normal continuous data, and the Mann–Whitney U test for non-normal data were applied. Multiple logistic regression was run for HED versus moderate drinkers. Results: A total of 798 participants took part in the survey, of which 68.4% were female. Nearly 50% of participants fell into the HED category and the majority bought alcohol illegally during restrictions. HED respondents who drank more alcohol than usual during restrictions reported that they felt stressed, needed to relax, and were bored. Conclusions: Policies intended to increase the pricing of alcohol may have the potential to reduce alcohol intake. Reducing stress and anxiety may be key to curtailing HED during emergency situations.
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    Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions
    (BioMed Central Ltd, 2013) Myers, Bronwyn; Kline, Tracy; Browne, Felicia; Carney, Tara; Parry, Charles; Johnson, Kim; Wechsberg, Wendee
    BACKGROUND: Alcohol and other drug (AOD) use among poor Black African and Coloured women in South Africa compounds their sexual risk for HIV. Given South Africa's history of ethnic disparities, ethnic differences in sex risk profiles may exist that should be taken into account when planning HIV risk reduction interventions. 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.METHOD:Cross-sectional data on 720 AOD-using women (324 Black African; 396 Coloured) recruited from poor communities in Cape Town were examined for ethnic differences in AOD use and AOD-related sexual risk behavior. RESULTS: Ethnic differences in patterns of AOD use were found; with self-reported drug problems, heavy episodic drinking and methamphetamine use being most prevalent among Coloured women and cannabis use being most likely among Black African women. However, more than half of Black African women reported drug-related problems and more than a third tested positive for recent methamphetamine use. More than a third of women reported being AOD-impaired and having unprotected sex during their last sexual encounter. Coloured women had four-fold greater odds of reporting that their last sexual episode was AOD-impaired and unprotected than Black African women. In addition, close to one in two women reported that their sexual partner was AOD-impaired at last sex, with Coloured women having three-fold greater odds of reporting that their partner was AOD-impaired at last sex than Black African women. CONCLUSIONS: Findings support the need to develop and test AOD risk reduction interventions for women from both ethnic groups. In addition, findings point to the need for tailored interventions that target the distinct profiles of AOD use and AOD-related sex risks for HIV among Black African and Coloured women.
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    Prevalence and predictors of problematic alcohol use, risky sexual practices and other negative consequences associated with alcohol use among safety and security employees in the Western Cape, South Africa
    (BioMed Central, 2014-03-04) Harker Burnhams, Nadine; Parry, Charles; Laubscher, Ria; London, Leslie
    Introduction: Harmful alcohol use can compromise worker health and productivity. Persons employed in safety-sensitive occupations are particularly vulnerable to hazardous alcohol use and its associated risks. This study describes the patterns of harmful alcohol use, related HIV risks and risk factors for the harmful use of alcohol among a sample of employees in South Africa working in the safety and security sector. Methods: A cross-sectional study that formed the baseline for a clustered randomized control trial was undertaken in 2011. A random sample of 325 employees employed within a safety and security sector of a local municipality in the Western Cape Province of South Africa participated in the study. Data were collected by means of an 18-page self-administered structured questionnaire and analyzed using SAS/STAT software version 9.2. For all significance testing, the F-statistic and p-values are reported. Results: Three hundred and twenty-five employees were surveyed. Findings suggest that more than half (76.1%) of the 78.9% of participants who consumed alcohol engaged in binge drinking, with close to a quarter reporting a CAGE score greater than the cut-off of 2, indicating potentially hazardous drinking patterns. The study further found that employees who use alcohol are more likely to engage in risky sexual practices when under the influence. A favorable drinking climate (p < 0.001) and poor levels of group cohesion (p = 0.009) were significantly correlated to binge drinking. Conclusion: This study identifies alcohol-related behaviors and associated risks in the context of safety-sensitive occupations at the workplace. It suggests that persons employed within such positions are at high risk for developing alcohol-related disorders and for contracting HIV. This study highlights the need for testing a comprehensive package of services designed to prevent hazardous alcohol use among safety and security employees.
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    Results of a cluster randomised controlled trial to reduce risky use of alcohol, alcohol-related HIV risks and improve help-seeking behaviour among safety and security employees in the Western Cape, South Africa
    (BioMed Central, 2015-05-08) Burnhams, Nadine H; London, Leslie; Laubscher, Ria; Nel, Elmarie; Parry, Charles
    Objective: To test the effectiveness of a programme aimed at reducing the risky use of alcohol and alcohol-related HIV risk and increase help-seeking behaviour among a sample of municipal employees in the Western Cape Province, South Africa. Methods: A clustered randomised controlled trial was conducted in 2011–2012 among 325 employees. The eight hour intervention, Team Awareness (TA), addressing behavioural risk among employees was administered to 168 employees in the intervention arm and the 157 employees in the control arm who received a one-hour wellness talk. Results: The results show that TA had the greatest impact on risky drinking practices and hangover effects. There was a significant group × time interaction (F (1, 117) = 25.16, p < 0.0001) with participants in the intervention condition reducing number of days on which they engaged in binge drinking. There was also a significant time effect with participants in the intervention condition reducing the likelihood of going to work with a hangover (F (1,117) = 4.10, p = 0.045). No reduction in HIV-related risk behaviours were found. Conclusions: This intervention study was able to demonstrate a modest but significant reduction in risky drinking practices and hangover effects. This provides encouraging evidence for the effectiveness of interventions that address risky use of alcohol among employed persons, further providing a launch pad for strengthening and replicating future RCT studies on workplace prevention, especially in developing country settings. Clinical Trial Registration Number: Pan-African Control Trial Registry (201301000458308) .
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    Results of a cluster randomised controlled trial to reduce risky use of alcohol, alcohol-related HIV risks and improve help-seeking behaviour among safety and security employees in the Western Cape, South Africa
    (BioMed Central, 2015-05-08) Burnhams, Nadine Harker; London, Leslie; Laubscher, Ria; Nel, Elmarie; Parry, Charles
    Objective: To test the effectiveness of a programme aimed at reducing the risky use of alcohol and alcohol-related HIV risk and increase help-seeking behaviour among a sample of municipal employees in the Western Cape Province, South Africa. Methods: A clustered randomised controlled trial was conducted in 2011–2012 among 325 employees. The eight hour intervention, Team Awareness (TA), addressing behavioural risk among employees was administered to 168 employees in the intervention arm and the 157 employees in the control arm who received a one-hour wellness talk. Results: The results show that TA had the greatest impact on risky drinking practices and hangover effects. There was a significant group × time interaction (F (1, 117) = 25.16, p < 0.0001) with participants in the intervention condition reducing number of days on which they engaged in binge drinking. There was also a significant time effect with participants in the intervention condition reducing the likelihood of going to work with a hangover (F (1,117) = 4.10, p = 0.045). No reduction in HIV-related risk behaviours were found. Conclusions: This intervention study was able to demonstrate a modest but significant reduction in risky drinking practices and hangover effects. This provides encouraging evidence for the effectiveness of interventions that address risky use of alcohol among employed persons, further providing a launch pad for strengthening and replicating future RCT studies on workplace prevention, especially in developing country settings. Clinical Trial Registration Number: Pan-African Control Trial Registry (201301000458308).
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    The effectiveness of an evidence-based workplace substance abuse and substance-related HIV prevention programme within a service industry in Cape Town, South Africa
    (2013) Burnhams, Nadine Catherine; London, Leslie; Parry, Charles
    This study tested the effectiveness of a substance abuse and substance-related HIV prevention programme designed for use within a South African workplace setting. The overarching study design used in this study was a clustered RCT which employed seven distinct phases. Phase 1 of the study required determining the effectiveness of programmes to prevent substance abuse and substance-related HIV risks at the workplace through a systematic review. This was followed by the selection of a substance abuse and substance related HIV prevention programme for implementation within a service industry in Cape Town, South Africa. Phase 2 employed a cross-sectional study design for collecting baseline data on substance abuse and substance-related HIV risks. Phase 3 of the study required the effective adaptation of the selected evidence-based substance abuse and substance-related HIV risks prevention programme for application in the workplace. This phase was followed by an outcomes evaluation on the implemented programme. Qualitative in-depth interviews with 8 participants, all senior management in the organization where study was conducted, concluded the study. For the clustered RCT, data were gathered from 325 employees who were employed in two divisions within a local municipality. The Team Awareness (TA) intervention, an eight hour evidence-based programme addressing behavioural risk among employees, was administered to 168 employees in the intervention arm. The 157 employees in the control arm received a one hour wellness talk. Self-report questionnaires were used to gather data on demographic variables, the work environment, policy and EAP service utilisation, substance abuse behaviours, co-worker substance abuse and substance-related HIV risks. Data was analysed using a random effects model accounting for clustering. This study found that alcohol is the more commonly substance abused by persons in this sample. Of the sample surveyed, more than three quarters indicated abuse of alcohol, with only a small proportion of employees reporting drug abuse. Close to a quarter had a positive CAGE score greater than the cut-off :!:2, suggesting hazardous drinking patterns. A third of employees in our sample, who use alcohol, reported engaging in risky sexual practices. The results suggest that employees who received TA showed significant reductions in the risky use of alcohol from baseline to three month follow-up. TA was also found to increase willingness to use the EAP service and improve employee knowledge in relation to workplace substance abuse polices. These findings highlight the need for evidence-based prevention programmes in workplace settings. It further highlights that application of one intervention programme, Team Awareness since TA was found to contribute to reductions in problem drinking and increases help-seeking behaviours. Additionally such prevention programmes create positive attitudes towards policies that regulate substance abuse within the workplace environment. The study makes useful recommendations for research practice and policy to help organisations address the burden of substance abuse.
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    Understanding the impact of hazardous and harmful use of alcohol and/or other drugs on ARV adherence and disease progression
    (Public Library of Science, 2015) Kader, Rehana; Govender, Rajen; Seedat, Soraya; Koch, John Randy; Parry, Charles
    The objective of this study was to understand the impact of hazardous and harmful use of alcohol and/or other drugs on ARV adherence and disease progression among HIV patients. A cross-sectional study design was used. A total of 1503 patients attending HIV clinics in Cape Town, South Africa were screened for problematic substance use. A sub-sample of 607 patients (303 patients who screened positive for problematic substance use and 304 who did not) participated in this study. Hazardous or harmful alcohol use and problematic drug use predicted missing and stopping ARVs which, in turn, was associated with a decrease in CD4 counts and more rapid HIV-disease progression and poorer health outcomes in people living with HIV/AIDS (PLWHA). The findings of this study underscore the need for an integrated approach to managing substance-use disorders in PLWHA.
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    Violence, alcohol and symptoms of depression and in Cape Town's poorest communities: results of a community survey
    (2018-04-20) Cassidy, Tali; Lloyd, Sam; Bowman, Brett; Myers, J E; Parry, Charles; Makanga, Tatenda; Corrigall, Joanne; Thompson, Mary Lou; Matzopoulos, Richard
    Introduction This paper summarises key findings from the first of three household surveys conducted in three high-violence areas in the Cape Town, investigating community members’ experiences of alcohol use, their built environment, violence and symptoms of depression, together with their views on alcohol and other interventions. Methods A stratified random sample of 1500 dwellings, 1200 in Khayelitsha and 300 in Gugulethu and Nyanga (“Gunya”) was selected using GIS address data for formal areas and aerial photography for informal areas. Fieldwork took place from July to November 2013. Responses to questions were summarized by area, gender, age and formal vs. informal settlement type. Results After substitution and data cleaning, 1213 Khayelitsha households and 286 Gunya households were included. In Gunya, 29% of respondents reported that they or their family members had been affected by at least one violent crime (murder, assault, domestic violence, rape) in the past year, compared with 12% in Khayelitsha. Using a CES-D-10 cut-off of 10, 44% of respondents were classified as depressed. More than half the respondents reported having experienced some form of alcohol nuisance. Respondents were supportive of alcohol interventions such as increased taxes and police regulation of outlets, particularly in Gunya (87%) and amongst female respondents (76%). Satisfaction with infrastructure such as street lighting and drainage was generally low. Conclusions The results describe the co-occurring burdens of alcohol and drug use, violence, depression and deprivation in our study populations.