The impact of methamphetamine (“tik”) on a peri-urban community in Cape Town, South Africa

Abstract

Background Over the last decade, South Africa’s Western Cape has experienced a dramatic increase in methamphetamine (“tik”) use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. Methods We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). Results Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. Conclusions Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels.

“Nothing Is Free”: A Qualitative Study of Sex Trading Among Methamphetamine Users in Cape Town, South Africa

“…Respondents often noted desperation for getting the drug, and the setting of high poverty and unemployment meant that people often had to turn to illicit or informal means to procure drugs. While men often participate in petty or violent crime to support their drug habit (Watt et al, 2014), women did not appear to have this option. This disparity in access to resources made sex a tradable resource, and sex trading appeared to be a way that women could share in men's spoils from criminal activity and gain access to drugs.…”

“…Only about 27% of residents of Delft have completed a high school education or more, and very few have steady employment (Statistics South Africa, 2012). Previous research in Delft has suggested that tik use is highly prevalent with far-reaching impacts on the community (Watt et al, 2014). …”

Global patterns of methamphetamine use

“…In South Africa, methamphetamine use is described as 'ubiquitous' in some communities and its impact can be quantified on an individual, interpersonal and community basis [37]. Its use among different populations poses different threats to the individual's and community's health and wellbeing, depending on the infrastructure, economic, and social reserve of that population.…”

“…These women were also at increased risk for sexually transmitted infection than nonmethamphetamine users. Uniformly, they cited methamphetamine as the 'power drug' that increases their functioning capacity and enabling them to work longer hours and see more clients [13,37,40]. When methamphetamine was used in conjunction with other injected drugs, it was associated with risky injection practices such as needlesharing, hurried injection, and reuse of injection equipment leading to increased HIV seroconversion [22,38,41,42].…”

HIV Testing Behaviors and Attitudes Among Community Recruited Methamphetamine Users in a South African Township

“…In South Africa, methamphetamine users living in peri-urban township communities are a population that could benefit from STTR efforts. In this setting, methamphetamine users are a hard-to-reach group due to the illegal nature of the behavior and a strong stigma against users [7]. To date, there is very little data on HIV testing behaviors, attitudes towards testing, and HIV prevalence in this population.…”