Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters

Wechsberg, Wendee M.; Browne, Felicia; Bonner, Courtney Peasant; Washio, Yukiko; Howard, Brittni Nicole; Drift, Isa van der

doi:10.1007/s11904-021-00558-x

Cited by 6 publications

(7 citation statements)

References 81 publications

(120 reference statements)

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“…Multiple intersecting issues, including the syndemics of gender violence, HIV/STIs, and sexual risk as well as mental health comorbidities and psychological trauma arising from exposure to violence, are highly prevalent among many of the targeted study populations [ 34 , 108 , 109 , 110 ]. This review is important because it highlights the need to include HIV and target gender issues in interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Alcohol is a primary substance of use across Africa with dire consequences [ 22 ]. Interventions to reduce AOD use among key populations in Africa have been developed and tested in trials, and previous reviews of their effectiveness have been conducted [ 32 , 33 , 34 , 35 , 36 ]. However, to the best of our knowledge, no reviews have synthesized evidence in support of their effectiveness while also examining the impact of culturally adapted and gender-specific interventions.…”

Section: Introductionmentioning

confidence: 99%

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Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa

Wechsberg

Drift

Howard

et al. 2022

IJERPH

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Heavy alcohol consumption and other drug use are prominent across Africa and increase the risk of exposure to violence, HIV acquisition, and other life-threatening injuries. This review synthesizes evidence on alcohol and other drug (AOD) interventions in Africa; evaluates the differences between interventions that do and do not specifically target populations that use AODs; and highlights the impact of comprehensive vs. brief interventions and those that address syndemic issues from a gender and contextualized lens. Literature searches were conducted to identify research outcomes of randomized interventions published between January 2010 and May 2022 that address AOD use in Africa. Thirty-five full-text articles were included in this review. Most of the identified research studies were concentrated in a few countries. Most studies were conducted in South Africa. Many of the studies comprised brief interventions. However, the most comprehensive interventions were the most effective for AOD outcomes. Several studies indicated the importance of addressing AOD use alongside gender-based violence, mental health needs, gender roles, and other social determinants that affect health outcomes. Intervening on AOD use and addressing social determinants from a gender and contextually relevant perspective is essential to ensuring the long-term health and well-being of people in Africa.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa

Wechsberg

Drift

Howard

et al. 2022

IJERPH

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“…For example, different gender expectations may result in greater vulnerability to mothers and children. Promising gender-sensitive practices in health have also emerged to address the HIV/AIDS epidemic and influence maternal and child health outcomes 18–21…”

Section: Introductionmentioning

confidence: 99%

Examining vulnerability and resilience in maternal, newborn and child health through a gender lens in low-income and middle-income countries: a scoping review

Uthman

Olamijuwon²,

Ichegbo³

et al. 2022

BMJ Glob Health

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IntroductionGender lens application is pertinent in addressing inequities that underlie morbidity and mortality in vulnerable populations, including mothers and children. While gender inequities may result in greater vulnerabilities for mothers and children, synthesising evidence on the constraints and opportunities is a step in accelerating reduction in poor outcomes and building resilience in individuals and across communities and health systems.MethodsWe conducted a scoping review that examined vulnerability and resilience in maternal, newborn and child health (MNCH) through a gender lens to characterise gender roles, relationships and differences in maternal and child health. We conducted a comprehensive search of peer-reviewed and grey literature in popular scholarly databases, including PubMed, ScienceDirect, EBSCOhost and Google Scholar. We identified and analysed 17 published studies that met the inclusion criteria for key gendered themes in maternal and child health vulnerability and resilience in low-income and middle-income countries.ResultsSix key gendered dimensions of vulnerability and resilience emerged from our analysis: (1) restricted maternal access to financial and economic resources; (2) limited economic contribution of women as a result of motherhood; (3) social norms, ideologies, beliefs and perceptions inhibiting women’s access to maternal healthcare services; (4) restricted maternal agency and contribution to reproductive decisions; (5) power dynamics and experience of intimate partner violence contributing to adverse health for women, children and their families; (6) partner emotional or affective support being crucial for maternal health and well-being prenatal and postnatal.ConclusionThis review highlights six domains that merit attention in addressing maternal and child health vulnerabilities. Recognising and understanding the gendered dynamics of vulnerability and resilience can help develop meaningful strategies that will guide the design and implementation of MNCH programmes in low-income and middle-income countries.

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“…A recent global review of alcohol interventions in PLWH found that over 60% of intervention studies almost exclusively enrolled men. Furthermore, very few studies have actively addressed both alcohol use and ART adherence (or other HIV outcomes) in the intervention [ 25 ]. There is a clear need to intentionally integrate gender into the design and analyses of interventions for this population to ensure interventions are effective for both genders.…”

Section: Introductionmentioning

confidence: 99%

Gender Moderates Results of a Randomized Clinical Trial for the Khanya Intervention for Substance Use and ART Adherence in HIV Care in South Africa

et al. 2022

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Little is known about gender effects of alcohol and drug use (AOD) among people living with HIV (PLWH) in resource-limited settings. Using multilevel models, we tested whether gender moderated the effect of Khanya, a cognitive-behavioral therapy-based intervention addressing antiretroviral (ART) adherence and AOD reduction. We enrolled 61 participants from HIV care and examined outcomes at 3- and 6-months compared to enhanced treatment as usual (ETAU). Gender significantly moderated the effect of Khanya on ART adherence (measured using electronically-monitored and biomarker-confirmed adherence), such that women in Khanya had significantly lower ART adherence compared to men in Khanya; no gender differences were found for AOD outcomes. Exploratory trajectory analyses showed men in Khanya and both genders in ETAU had significant reductions in at least one AOD outcome; women in Khanya did not. More research is needed to understand whether a gender lens can support behavioral interventions for PLWH with AOD.Trial registry ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018.

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Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters

Cited by 6 publications

References 81 publications

Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa

Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa

Examining vulnerability and resilience in maternal, newborn and child health through a gender lens in low-income and middle-income countries: a scoping review

Gender Moderates Results of a Randomized Clinical Trial for the Khanya Intervention for Substance Use and ART Adherence in HIV Care in South Africa

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