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Drug Alcohol Depend. 2019 Feb 1;195:16-26. doi: 10.1016/j.drugalcdep.2018.10.036. Epub 2018 Dec 3.

Addressing the nexus of risk: Biobehavioral outcomes from a cluster randomized trial of the Women's Health CoOp Plus in Pretoria, South Africa.

Author information

1
Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, USA; Health Policy and Management, UNC Gillings School of Global Public Health, 135 Dauer Drive, 1101 McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC, USA; Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC, USA; Psychiatry and Behavioral Sciences, Duke University School of Medicine, 40 Duke Medicine Circle, Durham, NC, USA. Electronic address: wmw@rti.org.
2
Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, USA.
3
School of Medicine, University of North Carolina, 321 S. Columbia Street, Chapel Hill, NC, USA.
4
Substance Use, Gender, and Applied Research Program, RTI International, 701 13th Street NW, Suite 750, Washington, DC, USA.
5
Social Statistics Program, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, USA.
6
Research Computing Division, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, USA.

Abstract

BACKGROUND:

HIV prevalence has increased among South African women who use alcohol and other drugs (AOD). However, HIV prevention and treatment efforts have not focused on this population. This study presents the efficacy of the Women's Health CoOp Plus (WHC+) in a cluster-randomized trial to reduce AOD use, gender-based violence, and sexual risk and to increase linkage to HIV care among women who use AODs, compared with HIV counseling and testing alone.

METHODS:

Black African women (N = 641) were recruited from 14 geographic clusters in Pretoria, South Africa, and underwent either an evidence-based gender-focused HIV prevention intervention that included HIV counseling and testing (WHC+) or HIV counseling and testing alone. Participants were assessed at baseline, 6-months, and 12-months post enrollment.

RESULTS:

At 6-month follow-up, the WHC+ arm (vs. HCT) reported more condom use with a main partner and sexual negotiation, less physical and sexual abuse by a boyfriend, and less frequent heavy drinking (ps < 0.05). At 12-month follow-up, the WHC+ arm reported less emotional abuse (p < 0.05). Among a subsample of women, the WHC+ arm was significantly more likely to have a non-detectable viral load (measured by dried blood spots; p = 0.01).

CONCLUSION:

The findings demonstrate the WHC+'s efficacy to reduce HIV risk among women who use AODs in South Africa. Substance abuse rehabilitation centers and health centers that serve women may be ideal settings to address issues of gender-based violence and sexual risk as women engage in substance use treatment, HIV testing, or HIV care.

KEYWORDS:

Alcohol and other drug use; Gender-based violence; HIV care; HIV prevention; Sexual risk; Women

PMID:
30562676
PMCID:
PMC6415667
[Available on 2020-02-01]
DOI:
10.1016/j.drugalcdep.2018.10.036
[Indexed for MEDLINE]

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