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

Meade, Christina S.; Towe, Sheri L.; Watt, Melissa H.; Hobkirk, Andréa L.; Skinner, Donald G.; Myers, Bronwyn; Kimani, Stephen; Pieterse, Desiréé

doi:10.1007/s10461-014-0795-y

Cited by 5 publications

(7 citation statements)

References 9 publications

(10 reference statements)

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“…Among the HIV‐positive methamphetamine users in this study, a third were unaware of their infection, underscoring the importance of routine HIV testing in this population . Of participants with a prior HIV diagnosis who had been referred for antiretroviral therapy, less than half had initiated treatment.…”

Section: Discussionmentioning

confidence: 89%

HIV testing and sero‐prevalence among methamphetamine users seeking substance abuse treatment in Cape Town

Gouse

Joska

Lion

et al. 2015

Drug and Alcohol Review

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Introduction and Aims Methamphetamine use is highly prevalent in parts of South Africa, and there is concern this will contribute to the country’s substantial HIV epidemic. We examined the feasibility of implementing routine HIV testing at a community-based substance abuse treatment centre in Cape Town, and determined the HIV sero-prevalence among methamphetamine users seeking treatment at this site. Design and Methods In this cross-sectional study, 293 participants completed measures of demographics, substance use and HIV treatment. HIV sero-prevalence was determined by a rapid finger-prick HIV test, and prior HIV diagnosis was confirmed via clinic records. Results The majority of participants were male and self-identified as “Coloured,” with a mean age of 28. The HIV sero-prevalence was 3.8%. Of the 11 participants who tested HIV-positive, four were newly diagnosed. HIV-positive and HIV-negative participants were comparable on demographic and substance use factors. Uptake of HIV testing among all clients at the drug treatment centre increased from <5% prior to study initiation to 89% after study completion. Measures implemented to ensure high rates of HIV testing were regarded as sustainable. Discussion and Conclusions Our study suggests that integrating routine HIV testing into substance abuse treatment is feasible in a community-based health centre. The low HIV prevalence among this sample of treatment-seeking methamphetamine users highlights the potential benefits of supporting expanded efforts to optimise HIV prevention with this young adult population.

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Section: Discussionmentioning

confidence: 89%

HIV testing and sero‐prevalence among methamphetamine users seeking substance abuse treatment in Cape Town

Gouse

Joska

Lion

et al. 2015

Drug and Alcohol Review

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“…Other studies have documented HIV risk behaviors, including multiple partners and inconsistent condom use, among methamphetamine users in South Africa (Meade et al, 2014; Meade et al, 2012; Parry et al, 2011; Pluddemann, Flisher, Mathews, Carney, & Lombard, 2008; Simbayi et al, 2006; Wechsberg et al, 2010). Our data suggests that sex trading norms and behaviors may help to explain these risk behaviors.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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South Africa is facing an established epidemic of methamphetamine, known locally as “tik”. Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention.

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“…In our sample, half of participants had not been HIV tested in the past year, and a quarter had never been tested. A recent community-based study of methamphetamine users in South Africa had similar findings for HIV testing (47). Together, these studies highlight the importance of developing and evaluating novel approaches to reach methamphetamine users for HIV testing.…”

Section: Discussionmentioning

confidence: 60%

“…Our results suggest that offering HIV testing as part of substance abuse treatment may be an effective strategy for increasing uptake of HIV testing, and it was encouraging that participants overwhelmingly had positive attitudes toward HIV testing. However, the vast majority of methamphetamine users in South Africa do not seek substance abuse treatment services (20), and attitudes toward HIV testing in community-based samples have been less favorable (47). On a positive note, participants who were sexually active and engaged in risky sexual behaviors were more likely to have been HIV tested in the past year, suggesting that the riskiest sub-group is receiving regular testing.…”

Section: Discussionmentioning

confidence: 99%

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HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa

et al. 2016

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South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34% multiple partners, 26% unprotected intercourse with a casual partner, and 24% sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25% had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

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

Cited by 5 publications

References 9 publications

HIV testing and sero‐prevalence among methamphetamine users seeking substance abuse treatment in Cape Town

HIV testing and sero‐prevalence among methamphetamine users seeking substance abuse treatment in Cape Town

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

HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa

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