Rapid assessment response (RAR) study: drug use and health risk - Pretoria, South Africa

Abstract

BackgroundWithin a ten year period South Africa has developed a substantial illicit drug market. Data on HIV risk among drug using populations clearly indicate high levels of HIV risk behaviour due to the sharing of injecting equipment and/or drug-related unprotected sex. While there is international evidence on and experience with adequate responses, limited responses addressing drug use and drug-use-related HIV and other health risks are witnessed in South Africa. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research.MethodsA Rapid Assessment and Response (RAR) methodology was adopted for the study. For individual and focus group interviews a semi-structured questionnaire was utilised that addressed key issues. Interviews were conducted with a total of 84 key informant (KI) participants, 63 drug user KI participants (49 males, 14 females) and 21 KI service providers (8 male, 13 female).Results and DiscussionAdverse living conditions and poor education levels were cited as making access to treatment harder, especially for those living in disadvantaged areas. Heroin was found to be the substance most available and used in a problematic way within the Pretoria area. Participants were not fully aware of the concrete health risks involved in drug use, and the vague ideas held appear not to allow for concrete measures to protect themselves. Knowledge with regards to substance related HIV/AIDS transmission is not yet widespread, with some information sources disseminating incorrect or unspecific information.ConclusionsThe implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered. HIV testing and treatment services also need to be made available in places accessed by drug users.

A plea of those who are affected most by HIV: The utterances by women who inject Nyaope residing in the City of Tshwane Municipality, Gauteng

“…Instead of waiting for the women who come to where testing is done, HIV testing services must go to where people are. 30 Human Immunodeficiency Virus Counselling and Testing is the first step for multiple interventions for HIV prevention and care, and further serves as an entry point for HIV prevention services. 31 …”

“…Instead of waiting for the women who come to where testing is done, HIV testing services must go to where people are. 30 Human Immunodeficiency Virus Counselling and Testing is the first step for multiple interventions for HIV prevention and care, and further serves as an entry point for HIV prevention services. 31 Poor socioeconomic status can act as an obstacle to educational prospects, the opportunity to approach healthcare and employment, generating a conducive environment for HIV incidence.…”

Rapid Assessment Response (RAR) study: drug use, health and systemic risks—Emthonjeni Correctional Centre, Pretoria, South Africa

“…Heroin and cannabis mixed together and smoked, which were most commonly used prior to incarceration, are also drugs that are prevalent within the greater vicinity of Tshwane [20]. Both KI offenders and staff state that drugs are smuggled into the centre by officials, by visitors and from the adult sections of the correctional centre.…”

“…Study findings indicate that a large proportion of offenders use drugs before entering the correctional centre, similar findings to that in the survey undertaken by Stöver and Michels [ 19 ]. Heroin and cannabis mixed together and smoked, which were most commonly used prior to incarceration, are also drugs that are prevalent within the greater vicinity of Tshwane [ 20 ]. Both KI offenders and staff state that drugs are smuggled into the centre by officials, by visitors and from the adult sections of the correctional centre.…”