Browsing by Subject "Substance abuse"

Now showing 1 - 4 of 4
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    Adapting an evidence-based HIV behavioral intervention for South African couples
    (Biomed Central Ltd, 2015) Wechsberg, Wendee; El-Bassel, Nabila; Carney, Tara; Browne, Felicia; Myers, Bronwyn; Zule, William
    BACKGROUND: In South Africa, heterosexual couples are at risk for HIV infection and transmission through substance use, gender-based violence and traditional gender roles, and sex risk behaviors such as having multiple partners and unsafe sex. METHODS: To address these interconnected HIV risks among heterosexual couples, we used the ADAPT framework to modify an existing, efficacious women's HIV prevention intervention (the Western Cape Women's Health CoOp) to include components of an evidence-based couple's intervention from the United States (Project Connect) and components from the Men as Partners program that has been used successfully in South Africa. We conducted focus groups with men, women and couples, and obtained feedback from a long-standing Community Collaborative Board (CCB) to guide the synthesis of elements of these three interventions into a new intervention. We then piloted the adapted intervention for feasibility and acceptability. RESULTS: The new intervention is called the Couples' Health CoOp. This intervention targets men who use alcohol and other drugs and engage in unprotected sex, and their main female sex partners. The intervention addresses substance use, sex risk, HIV and other sexually transmitted infections, gender roles, gender-based violence, communication skills, and goal-setting activities to increase sexy (eroticize) safe-sex behaviors. The Couples' Health CoOp also includes "voices" from the focus group members to ground the intervention in the experiences of these at-risk couples. In addition, it utilizes a participant handbook that reiterates workshop content and includes homework assignments for couples to complete together to increase problem-solving skills within their relationship, and to improve their sexual relationship and help sustain HIV risk-reduction strategies. All of these adaptations were based on participants' suggestions made during formative work and pilot testing. CONCLUSIONS: The Couples' Health CoOp is a couple-based HIV prevention intervention that targets alcohol and other drug use to reduce sexual risk, reduce gender-based violence and offer alternatives for conflict resolution, promote healthy relationships, and modify traditional gender roles in South Africa.TRIAL REGISTRATION NUMBER:NCT01121692.
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    Can social protection improve Sustainable Development Goals for adolescent health?
    (Public Library of Science, 2016) Cluver, Lucie D; Orkin, F Mark; Meinck, Franziska; Boyes, Mark E; Yakubovich, Alexa R; Sherr, Lorraine
    BACKGROUND: The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa. METHODS: We conducted a longitudinal survey of adolescents (10-18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision) and 'care' (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models. FINDINGS: Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens. Interpretation National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.
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    Personality traits of alcohol and other drug users in Cape Town, South Africa
    (2015) Hendrickson, Blake Edward
    The Substance Use Risk Profile Scale (SURPS) is a relatively new questionnaire that assesses individual personality risk for substance-related problems. Preliminary findings have indicated that the SURPS is a useful measure for identifying characteristics predisposing some individuals to alcohol and other drug (AOD) use. High levels of hopelessness, anxiety sensitivity, sensation seeking, and impulsivity are each associated with specific patterns of substance use caused by underlying motivational susceptibilities. Furthermore, incorporating these traits into tailored prevention and treatment efforts have shown value in other countries. The present study enrolled a community sample in Cape Town, South Africa and asked respondents about their demographics, history of AOD use, personality as measured by the SURPS, and other mental health indicators. This information was used to identify personality risks in the local population and validate the utility of the SURPS for the first time in Sub-Saharan Africa. Results found that sensation seekers had a significantly higher risk for alcohol, tobacco, cannabis, cocaine, and hallucinogen use compared to other personality groups and controls. As expected, respondents demonstrating anxiety sensitivity also showed high-risk use of alcohol, but less high-risk illicit drug use . Finally, the hopelessness group exhibited a higher risk for opioid use but overall, hopelessness and impulsivity had little impact on concurrent substance use, which contrasts with other literature. Unlike findings from mostly European and North American samples that indicate generalizability, this study did not find structural or concurrent validity for the SURPS. This provides evidence against it being adopted as a culturally appropriate assessment tool in a diverse South African population.
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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.