Whoonga and the Abuse and Diversion of Antiretrovirals in Soweto, South Africa

Rough, Kathryn; Dietrich, Janan; Essien, Thandekile; Grelotti, David J.; Bansberg, David R.; Gray, Glenda; Katz, Ingrid T.

doi:10.1007/s10461-013-0683-x

Cited by 34 publications

(41 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[6][7][8] This is despite South Africa having the highest prevalence of HIV 9,10 and the largest rollout of ART in the world. 11,12 Few studies have explored the uptake of HIV testing among men or the factors that influence uptake in sub-Saharan Africa. 4,[13][14][15][16][17][18][19] In these studies, predictors of HIV testing include sociodemographic factors (age, education, occupation, wealth status, religion, area of residence, marital status and type of marriage), health services (access, cost, waiting time and confidentiality), sociocultural factors (mainly decision making and social beliefs), HIV knowledge/perception and self-perceived risk of HIV.…”

Section: Hiv Testingmentioning

confidence: 99%

Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys

Makusha

Mabaso

Richter³

et al. 2017

Public Health

View full text Add to dashboard Cite

show abstract

Section: Hiv Testingmentioning

confidence: 99%

Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys

Makusha

Mabaso

Richter³

et al. 2017

Public Health

View full text Add to dashboard Cite

show abstract

“…7,10,11 This approach is limited, since some individuals may be non-compliant with their treatment regimen, and some may acquire antiretroviral (ARV) drugs from other sources. 12,13 Self-report of ARV drug use has also shown to be unreliable in some research and clinic settings. 14–17 …”

Section: Introductionmentioning

confidence: 99%

Antiretroviral Drug Use in a Cross-Sectional Population Survey in Africa: NIMH Project Accept (HPTN 043)

Fogel

Clarke

Kulich

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Background Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence. Methods Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at four study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009–2011), using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors [NRTIs]; 3 non-nucleoside reverse transcriptase inhibitors [NNRTIs]; 9 protease inhibitors; maraviroc; raltegravir). Results ARV drugs were detected in 2,011 (27.4%) of 7,347 samples; 88.1% had 1 NNRTI +/− 1–2 NRTIs. ARV drug detection was associated with sex (women>men), pregnancy, older age (>24 years), and study site (p<0.0001 for all four variables). ARV drugs were also more frequently detected in adults who were widowed (p=0.006) or unemployed (p=0.02). ARV drug use was more frequent in intervention versus control communities early in the survey (p=0.01), with a significant increase in control (p=0.004) but not in intervention communities during the survey period. In KwaZulu-Natal, a 1% increase in ARV drug use was associated with a 0.14% absolute decrease in HIV incidence (p=0.018). Conclusions This study used an objective, biomedical approach to assess ARV drug use on a population level. This analysis identified factors associated with ARV drug use and provided information on ARV drug use over time. ARV drug use was associated with lower HIV incidence at one study site.

show abstract

“…Abuse of substances such as whoonga is a growing problem in South Africa (Grelotti et al, 2014; Rough et al, 2014) and appears to be partly responsible for poor ART adherence, particularly among young males (Michel et al, 2013). As substance use disorders can be a form of “escapism” from the reality of one's HIV diagnosis (Michel et al, 2013), HIV/ART interventions must be modified to better address substance abuse, mental health, and other medical co-morbidities.…”

Section: Discussionmentioning

confidence: 99%

Antiretroviral therapy initiation and adherence in rural South Africa: community health workers’ perspectives on barriers and facilitators

Loeliger

Niccolai

Mtungwa³

et al. 2016

AIDS Care

View full text Add to dashboard Cite

South Africa has the largest global HIV/AIDS epidemic, but barriers along the HIV care continuum prevent patients from initiating and adhering to antiretroviral therapy (ART). To qualitatively explore reasons for poor ART initiation and adherence rates from the unique perspective of community health workers (CHWs), we conducted focus groups during May–August 2014 with 21 CHWs in rural Msinga, KwaZulu-Natal. Interviews were audio-recorded, transcribed, and translated from Zulu into English. Hybrid deductive and inductive analytical methods were applied to identify emergent themes. Multiple psychosocial, socioeconomic, and socio-medical barriers acted at the level of the individual, social network, broader community, and healthcare environment to simultaneously hinder initiation of and adherence to ART. Key themes included insufficient patient education and social support, patient dissatisfaction with healthcare services, socioeconomic factors, and tension between ART and alternative medicine. Fear of lifelong therapy thwarted initiation whereas substance abuse principally impeded adherence. In conclusion, HIV/AIDS management requires patient counselling and support extending beyond initial diagnosis. Treating HIV/AIDS as a chronic rather than acute infectious disease is key to improving ART initiation and long-term adherence. Public health strategies include expanding CHWs' roles to strengthen healthcare services, provide longitudinal patient support, and foster collaboration with alternative medicine providers.

show abstract

Whoonga and the Abuse and Diversion of Antiretrovirals in Soweto, South Africa

Cited by 34 publications

References 6 publications

Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys

Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys

Antiretroviral Drug Use in a Cross-Sectional Population Survey in Africa: NIMH Project Accept (HPTN 043)

Antiretroviral therapy initiation and adherence in rural South Africa: community health workers’ perspectives on barriers and facilitators

Contact Info

Product

Resources

About