Gender differences in barriers to alcohol and other drug treatment in Cape Town, South Africa

Myers, Bronwyn; Louw, Johann; Pasche, Sonja

doi:10.4314/ajpsy.v14i2.7

Cited by 27 publications

(23 citation statements)

References 24 publications

(24 reference statements)

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“…While the findings regarding heavy alcohol use among vulnerable women are consistent with those reported by earlier population surveys [11–12], our findings are among the first to show that intense polydrug use is relatively common among AOD-using out-of-treatment women in Cape Town and highlight high levels of unmet treatment need. This is cause for concern because women from this region have limited access to and experience more barriers to accessing drug intervention services than men [27]. Our unexpectedly high rate of polydrug use highlights the need to improve access to drug risk reduction services for women in this region.…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Alcohol and Other Drug Use Typologies to Sex Risk Behaviors among Vulnerable Women in Cape Town, South Africa

et al. 2012

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Background Alcohol and other drug (AOD) use remains an important contributing factor to the spread of HIV in South Africa, mainly because of the strong associations found between AOD use and sex risk behaviors. Specifically, AOD use can lead to disinhibition and impaired judgment that may result in inconsistent condom use and other risky sex behaviors among vulnerable and disempowered women. Methods Latent Class Analysis was used to identify AOD use typologies among 720 vulnerable women from a randomized trial baseline assessment in Cape Town, South Africa and to examine whether these AOD use classes predict sex risk for HIV. Results Three classes emerged with distinct differences in AOD use: the Marijuana and Alcohol class (34.6%) mainly comprised participants who used marijuana and drank alcohol frequently; the High AOD Risk class (26.1%) mainly comprised participants who used methamphetamine and marijuana, reported heavy drinking, and moderate probabilities of Mandrax use; and the Polydrug use class (39.3%) predominately comprised participants who used methamphetamine, marijuana, and Mandrax. Participants in the Marijuana and Alcohol class were less likely to report past-month unprotected sex with their main sex partner compared with participants in the Polydrug Use class. When examining the adjusted model, Black African women were significantly less likely to report past-month unprotected sex with their main sex partner compared with Coloured women. Women who were HIV negative were more likely to report unprotected sex with their main sex partner than women who were HIV positive. Conclusion The fewer substances that women used seemed to serve as protective factors against engaging in AOD-impaired sex. This study provides an important contribution to understand the intersection of AOD use and sexual risk for HIV by measuring polydrug use among vulnerable women and its association with sexual risk taking.

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Section: Discussionmentioning

confidence: 99%

The Relationship of Alcohol and Other Drug Use Typologies to Sex Risk Behaviors among Vulnerable Women in Cape Town, South Africa

et al. 2012

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“…As several studies have found that women who use drugs experience high levels of perceived and enacted stigma [21], it is quite likely that attitudes towards women who use drugs are more stigmatizing than those towards men. If this is the case, this could partially explain why women with substance use disorders from disadvantaged communities in South Africa do not access treatment services as readily as men [22]. However, as previous studies have not examined differences in attitudes towards substance abusing men and women, this explanation remains unsupported by research.…”

Section: Introductionmentioning

confidence: 99%

Negative attributions towards people with substance use disorders in South Africa: Variation across substances and by gender

2012

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BackgroundLittle research has examined attitudes towards people who use substances in low and middle income countries (LMIC). Therefore, the present study examined the attributions made by the general South African population about people who use substances and whether these attributions differ by the type of substance being used, the gender of the person using the substance, or the characteristics of the person making the attribution.MethodA convenience sample of 868 members of the general public was obtained through street-intercept methods. One of 8 vignettes portraying alcohol, cannabis, methamphetamine or heroin, with either a male or female as the protagonist was presented to each respondent. Respondents’ attitudes towards the specific cases were investigated.ResultsRespondents held equally negative views of the presented substances, with the exception of the cannabis vignette which was considered significantly less “dangerous” than the alcohol vignette. Respondents were more likely to offer “help” to women who use alcohol, but more likely to suggest “coercion into treatment” for men. Individuals who scored higher on the ASSIST were more likely to hold negative attitudes towards substance users and black African respondents were more likely to offer help to individuals who use substances.ConclusionThe stigma associated with substance use in South Africa is high and not necessarily dependent on the drug of choice. However, a range of factors, including gender of the substance user, and ethnicity of the rater, may impact on stigma. Interventions designed to strengthen mental health literacy and gender-focused anti-stigma campaigns may have the potential to increase treatment seeking behaviour.

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“…Earlier studies of substance abuse treatment in South Africa have noted that women from disadvantaged communities often have very negative perceptions of substance abuse treatment that hinder their use of these facilities; with these perceptions centered around treatment facilities not being effective and not responding to their service needs48 and that women experience more barriers (childcare or partner violence) to accessing substance abuse treatment than men 49. This study builds on this earlier work by demonstrating that some women do not view substance abuse treatment facilities as helpful for creating substance-free social networks that can help maintain abstinence from drug use after completion of treatment.…”

Section: Discussionmentioning

confidence: 99%

The relevance of social contexts and social action in reducing substance use and victimization among women participating in an HIV prevention intervention in Cape Town, South Africa

Reed¹,

Emanuel²,

Myers

et al. 2013

SAR

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ObjectivesTo examine qualitatively how women’s social context and community mobilization (eg, mobilizing women to take social action and engaging their community in social change) influence substance use abstinence and victimization among women participating in a human immunodeficiency virus (HIV) intervention in Cape Town, South Africa.MethodsThirty women who had participated in a randomized controlled trial of a group-delivered intervention to address substance use, gender-based violence, and associated risk for HIV (The Women’s Health CoOp) were selected to participate in semi-structured interviews about their perceived impact of the intervention on their substance use and exposure to victimization. The Women’s CoOp intervention involved creating a new positive social environment for women within a group setting that also fostered women’s social action (eg, educating peers or family members) in the community. Interviews were analyzed using content analysis and coded to examine women’s descriptions of social contexts and social action, and the influence of these on women’s substance use abstinence and exposure to victimization.ResultsSocial support (eg, via program staff and other participants) and social action (eg, engaging others in the community on issues relevant to substance use prevention or other health topics) promoted within the program, as well as outside social influences within women’s life contexts (eg, support from non-substance using family or male partners, leaving male partners or other peer relationships characterized by drug use, or finding employment) were key factors reported by women in terms of facilitating their substance use abstinence and in reducing women’s exposures to victimization.ConclusionFindings highlight the potential for group-delivered interventions that include mobilizing women to take social action in the larger community to be effective approaches for facilitating substance use abstinence, reductions in victimization, and ultimately, to address the intersection between substance use, violence, and HIV risk among women in this high HIV prevalence setting.

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Gender differences in barriers to alcohol and other drug treatment in Cape Town, South Africa

Cited by 27 publications

References 24 publications

The Relationship of Alcohol and Other Drug Use Typologies to Sex Risk Behaviors among Vulnerable Women in Cape Town, South Africa

The Relationship of Alcohol and Other Drug Use Typologies to Sex Risk Behaviors among Vulnerable Women in Cape Town, South Africa

Negative attributions towards people with substance use disorders in South Africa: Variation across substances and by gender

The relevance of social contexts and social action in reducing substance use and victimization among women participating in an HIV prevention intervention in Cape Town, South Africa

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