Social Network Approaches to Recruitment, HIV Prevention, Medical Care, and Medication Adherence

Latkin, Carl A.; Davey‐Rothwell, Melissa; Knowlton, Amy R.; Alexander, Kamila A.; Williams, Chyvette T.; Boodram, Basmattee

doi:10.1097/qai.0b013e3182928e2a

Cited by 96 publications

(82 citation statements)

References 53 publications

(47 reference statements)

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“…Future studies might test the effectiveness of respondent driven sampling to identify methamphetamine users and deliver education, with the goal of linking them to care. Peer-led interventions with hard-to-reach drug users have shown success in facilitating entry into and engagement with harm reduction services in other parts of the world and could be adapted for this population and context (Latkin et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study

Meade

Towe

Watt

et al. 2015

Drug and Alcohol Dependence

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Background Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and treatment experiences of a community-recruited sample of methamphetamine users in Cape Town. Methods Using respondent driven sampling, 360 methamphetamine users (44% female) completed structured clinical interviews to assess substance abuse and treatment history and computerized surveys to assess drug-related risks. A sub-sample of 30 participants completed in-depth interviews to qualitatively explore experiences with methamphetamine use and drug treatment. Results Participants had used methamphetamine for an average of 7.06 years (SD=3.64). They reported using methamphetamine on an average of 23.49 of the past 30 days (SD=8.90); 60% used daily. The majority (90%) met ICD-10 criteria for dependence, and many reported severe social, financial, and legal consequences. While only 10% had ever received drug treatment, 90% reported that they wanted treatment. In the qualitative interviews, participants reported multiple barriers to treatment, including beliefs that treatment is ineffective and relapse is inevitable in their social context. They also identified important motivators, including desires to be drug free and improve family functioning. Conclusion This study yields valuable information to more effectively respond to emerging methamphetamine epidemics in South Africa and other low- and middle-income countries. Interventions to increase uptake of evidence-based services must actively seek out drug users and build motivation for treatment, and offer continuing care services to prevent relapse. Community education campaigns are also needed.

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Section: Discussionmentioning

confidence: 99%

Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study

Meade

Towe

Watt

et al. 2015

Drug and Alcohol Dependence

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“…Lack of insurance is described as a contributor to gaps in HIV care, poor retention, and staying out of care entirely for specific risk subgroups such as persons with drug or alcohol use. 30,32,33 Level of social support and social capital 10,34–37 can influence visit adherence and gaps in HIV primary care, particularly among persons who report IDU, 35 persons of younger age, 33 and racial/ethnic minority MSM. 38 Access barriers, particularly with respect to ART, have been shown to contribute to HIV prevalence and overall mortality in the United States.…”

Section: Discussionmentioning

confidence: 99%

The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

et al. 2015

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Objectives We explored the contribution of missed primary HIV care visits (“no-show”) to observed disparities in virological failure (VF) among Black persons and persons with injection drug use (IDU) history. Methods We used patient-level data from 6 academic clinics, before the Centers for Disease Control and Prevention and Health Resources and Services Administration Retention in Care intervention. We employed staged multivariable logistic regression and multivariable models stratified by no-show visit frequency to evaluate the association of sociodemographic factors with VF. We used multiple imputations to assign missing viral load values. Results Among 10 053 patients (mean age = 46 years; 35% female; 64% Black; 15% with IDU history), 31% experienced VF. Although Black patients and patients with IDU history were significantly more likely to experience VF in initial analyses, race and IDU parameter estimates were attenuated after sequential addition of no-show frequency. In stratified models, race and IDU were not statistically significantly associated with VF at any no-show level. Conclusions Because missed clinic visits contributed to observed differences in viral load outcomes among Black and IDU patients, achieving an improved understanding of differential visit attendance is imperative to reducing dispar ities in HIV.

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“…For sexual health promotion, such interventions include HIV testing, education about HIV acquisition and transmission, and availability of condoms. Peer-based interventions with drug-using populations have shown success in delivering sexual health interventions in other parts of the world and could be adapted for this context (Latkin et al, 2013). There is also a need for harm reduction interventions related to sexual violence in the context of sex trading.…”

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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Social Network Approaches to Recruitment, HIV Prevention, Medical Care, and Medication Adherence

Cited by 96 publications

References 53 publications

Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study

Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study

The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

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

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