Advertisement

AIDS and Behavior

, Volume 13, Issue 5, pp 849–859 | Cite as

Rapid Assessment of HIV Risk Behavior in Drug Using Sex Workers in Three Cities in South Africa

  • Charles D. H. Parry
  • Sarah Dewing
  • Petal Petersen
  • Tara Carney
  • Richard Needle
  • Karen Kroeger
  • Latasha Treger
Original Paper

Abstract

A rapid assessment was undertaken with drug using commercial sex workers (CSWs) to investigate practices putting them at risk for contracting HIV. It included key informant (KI) (N = 67) and focus group (N = 10) interviews in locations with a high prevalence of drug use in Cape Town, Durban and Pretoria, South Africa. HIV testing of KIs was conducted. Cocaine, Ecstasy, heroin and methaqualone are used by CSWs prior to, during and after sex. Drugs enhance the sexual experience and prolong sex sessions. Interviews revealed inconsistent condom use among CSWs together with other risky sexual practices such as needle sharing. Among CSWs who agreed to HIV testing, 34% tested positive. Barriers to accessing drug treatment and HIV treatment and preventive services were identified. Interventions recognizing the role of drug abuse in HIV transmission should be prioritized, and issues of access to services, stigma and power relations must be considered.

Keywords

South Africa Drug use HIV transmission Risk factors Sex work 

Notes

Acknowledgments

The research was funded by the US President’s Emergency Fund for AIDS Relief (PEPFAR) through the US Centers of Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or PEPFAR. The authors would also like to acknowledge the support of our fields work staff and NGOs in Cape Town, Durban, and Pretoria; and Angeli Achrekar and Thelma Williams who assisted the project as part of the CDC International Experience and Technical Assistance (IETA) Program.

References

  1. Abdool, R., Sulliman, F. T., & Dhanoo, M. I. (2006). The injecting drug use and HIV/AIDS nexus in the republic of Mauritius. African Journal of Drug and Alcohol Studies, 5(2), 107–116.Google Scholar
  2. Adeleken, M. L., & Lawal, R. A. (2006). Drug use and HIV injection in Nigeria: A review of findings. African Journal of Drug and Alcohol Studies, 5(2), 117–128.Google Scholar
  3. Campbell, C. (2000). Selling sex in the time of AIDS: The psycho-social context of condom use by sex workers on a Southern African mine. Social Science and Medicine, 50, 479–494.PubMedCrossRefGoogle Scholar
  4. CDC. (2006). Methamphetamine use and HIV risk behaviors among heterosexual men: Preliminary results from five northern California Counties, December 2001–November 2003. Morbidity and Mortality Weekly Report, 5(10), 273–277.Google Scholar
  5. Cusick, L. (2006). Widening the harm reduction agenda: From drug use to sex work. International Journal of Drug Policy, 17, 3–11.CrossRefGoogle Scholar
  6. Dalla, R. L. (2002). Night moves: A qualitative investigation of street-level sex work. Psychology of Women Quarterly, 26, 63–73.CrossRefGoogle Scholar
  7. De Graaf, R., Vanweesenbeeck, I., Van Zessen, G., Straver, C. J., & Visser, J. H. (1995). Alcohol and drug use in heterosexual and homosexual prostitution, and it’s relation to protection behaviour. AIDS Care, 7, 35–47.PubMedCrossRefGoogle Scholar
  8. Dewing, S., Pluddeman, A., Myers, B. J., & Parry, C. D. H. (2006). Review of injection drug use in six African countries: Egypt, Kenya, Mauritius, Nigeria, South Africa and Tanzania. Drugs: Education, Prevention and Policy, 13(2), 121–137.CrossRefGoogle Scholar
  9. Dunkle, K. L., Beksinska, M. E., Rees, V. H., Ballard, R. C., Htun, Y., & Wilson, M. L. (2005). Risk factors for HIV infection among sex workers in Johannesburg, South Africa. International Journal of STD and AIDS, 16, 256–261.PubMedCrossRefGoogle Scholar
  10. Fick, N. (2005). Coping with stigma, discrimination and violence: Sex workers talk about their experiences. Cape Town: Sex Worker Education and Advocacy Taskforce.Google Scholar
  11. Izugbara, C. O. (2005). ‘Ashawo suppose shine her eyes’: Female sex workers and sex work risks in Nigeria. Health Risk and Society, 7(2), 141–159.CrossRefGoogle Scholar
  12. Karim, Q. A., Karim, S. S. A., Soldan, K., & Zondi, M. (1995). Reducing the risk of HIV infection among South African sex workers: Socioeconomic and gender barriers. American Journal of Public Health, 85, 1521–1525.PubMedCrossRefGoogle Scholar
  13. Kingree, J. B., & Betz, H. (2003). Risky sexual behavior in relation to marijuana and alcohol use among African-American, male adolescent detainees and their female partners. Drug and Alcohol Dependency, 72, 197–203.CrossRefGoogle Scholar
  14. Leggett, T. (1999). Crack, sex work, and HIV. AIDS Analysis Africa, 9, 3.PubMedGoogle Scholar
  15. Leggett, T. (2001a). Drugs, sex work, and HIV in three South African cities. Society in Transition, 32, 101–109.Google Scholar
  16. Leggett, T. (2001b). Rainbow vice: The drugs and sex industries in the new South Africa. Cape Town: David Philip.Google Scholar
  17. Lejuez, C. W., Bornovalova, M. A., Daughters, S. B., & Curtin, J. J. (2005). Differences in impulsivity and sexual risk behavior among inner-city crack/cocaine users and heroin users. Drug and Alcohol Dependency, 14, 169–175.CrossRefGoogle Scholar
  18. McCurdy, S. A., Williams, M. L., Kilonzo, G. P., Ross, M. W., & Leshabari, M. T. (2005). Heroin and HIV risk in Dar es Salaam, Tanzania: Youth hangouts, mageto and injecting practices. AIDS Care, 17(1), 65–76.CrossRefGoogle Scholar
  19. Morojele, N. K., Brook, J. S., & Kachienga, M. A. (2006). Perceptions of sexual risk behaviors and substance abuse among adolescents in South Africa: A qualitative investigation. AIDS Care, 18(3), 215–219.PubMedCrossRefGoogle Scholar
  20. Morris, C. N., Levine, B., Goodridge, G., Luo, N., & Ashley, J. (2006). Three country assessment of alcohol-HIV related policy and programmatic responses in Africa. African Journal of Drug and Alcohol Studies, 5(2), 169–184.Google Scholar
  21. Myers, T., Aguinaldo, J. P., Dakers, D., Fischer, B., Bullock, S., Millson, P., & Calzavara, L. (2004). How drug using men who have sex with men account for substance use during sexual behaviors: Questioning assumptions of HIV prevention and research. Addiction Research and Theory, 12, 213–229.CrossRefGoogle Scholar
  22. Myers, B., Louw, J., & Fakier, N. (in press). Alcohol and drug abuse: removing structural barriers to treatment for historically disadvantaged communities in Cape Town. International Journal of Social Welfare.Google Scholar
  23. Needle, R. H., Trotter, R. T., Singer, M., Bates, C., Page, B., Metzger, D., & Marcelin, L. H. (2003). Rapid assessment of the HIV/AIDS crisis in racial and ethnic minority communities: An approach for timely community interventions. American Journal of Public Health, 93, 970–979.PubMedCrossRefGoogle Scholar
  24. Nixon, K., Tutty, L., Downe, P., Gorkoff, K., & Ursel, J. (2002). The everyday occurrence: Violence in the lives of girls exploited through prostitution. Violence Against Women, 8, 1016–1043.Google Scholar
  25. Parry, C. D. H., Bhana, A., Pluddeman, A., Myers, B., Siegfried, N., Morojele, N. K., Flisher, A. J., & Kozel., N. J. (2002). The South African Community Epidemiology Network on Drug Use (SACENDU): Description, findings (1997–1999) and policy implications. Addiction, 97, 969–976.PubMedCrossRefGoogle Scholar
  26. Pauw, I., & Brener, L. (2003). “You are just whores—You can’t be raped”: Barriers to safer sex practices among women street sex workers in Cape Town. Culture, Health and Sexuality, 5, 465–481.CrossRefGoogle Scholar
  27. Rees, H., Beksinska, H. E., Dickson-Tetteh, K., Ballard, R. C., & Htun, Y. (2000). Commercial sex workers in Johannesburg: Risk behaviour and HIV status. South African Journal of Science, 96, 283–284.Google Scholar
  28. Semple, S. J., Zians, J., Grant, I., & Patterson, T. L. (2006). Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men. AIDS and Behavior, 40, 1797–1810.Google Scholar
  29. Shisana, O., Rehle, T., Simbayi, L. C., Parker, W., Zuma, K., Bhana, A., Connolly, C., Jooste, S., & Pillay, V. (2005). South African national HIV prevalence, HIV incidence, behaviour and communication survey, 2005. Pretoria: HSRC Press.Google Scholar
  30. Simbayi, L. C., Kalichman, S. C., Cain, D., Cherry, C., Henda, N., & Cloete, A. (2006). Methamphetamine use and sexual risks for HIV infection in Cape Town, South Africa. Journal of Substance Use, 11(4), 291–300.CrossRefGoogle Scholar
  31. Strotman, R., McLellan, E., MacQueen, K. M., & Milstein, B. (2002). AnSWR: Analysis Software for Word-based Records, Version 6.4. Atlanta: Centers for Disease Control and Prevention (CDC).Google Scholar
  32. Timpson, S., McCurdy, S. A., Leshabari, M. T., Kilonzo, G. P., Atkinson, J., Msami, A., & Williams, M. L. (2006). Substance abuse, HIV risk and HIV/AIDS in Tanzania. African Journal of Drug and Alcohol Studies, 5(2), 157–168.Google Scholar
  33. UNAIDS. (2006). 2006 report on the global AIDS epidemic. Accessed 21 June 2006, from http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp.
  34. Webb, D. (1997). HIV and AIDS in Africa. Cape Town: David Philip.Google Scholar
  35. Wechsberg, W. M., Luseno, W. K., & Lam, W. K. (2005). Violence against substance-abusing South African sex workers: Intersection with culture and HIV risk. AIDS Care, 17, S55–S64.PubMedCrossRefGoogle Scholar
  36. Wechsberg, W. M., Luseno, W. K., Lam, W. K., Parry, C. D. H., & Morojele, N. K. (2006). Substance use, sexual risk, and violence: HIV prevention intervention with sex workers in Pretoria. AIDS and Behavior, 10, 131–137.PubMedCrossRefGoogle Scholar
  37. Williamson, S., & Cluse-Tolar, T. (2002). Pimp-controlled prostitution: Still an integral part of street life. Violence Against Women, 8, 1074–1092.CrossRefGoogle Scholar
  38. Wojcicki, J. M. (2002). “She drank his money”: Survival sex and the problem of violence in taverns in Gauteng Province, South Africa. Medical Anthropology Quarterly, 16, 267–293.PubMedCrossRefGoogle Scholar
  39. Wojcicki, J. M., & Malala, J. (2001). Condom use, power and HIV/AIDS risk: Sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg. Social Science and Medicine, 53, 91–121.Google Scholar
  40. Woody, G. E., Gallop, R., Luborsky, L., Blaine, J., Frank, A., Salloum, I. M., Gastfriend, D., Crits-Christoph, P., & the Cocaine Psychotherapy Study Group. (2003). HIV risk reduction in the national institute on drug abuse cocaine collaborative treatment study. Journal of Acquired Immune Deficiency Syndromes, 33, 82–87.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Charles D. H. Parry
    • 1
    • 2
  • Sarah Dewing
    • 1
  • Petal Petersen
    • 1
  • Tara Carney
    • 1
  • Richard Needle
    • 3
  • Karen Kroeger
    • 3
  • Latasha Treger
    • 4
  1. 1.Alcohol and Drug Abuse Research UnitMedical Research CouncilTygerberg, Cape TownSouth Africa
  2. 2.Department of PsychiatryStellenbosch UniversityTygerbergSouth Africa
  3. 3.National Center for HIV, STD and TB Prevention, Global AIDS ProgramU.S. Centers for Disease Control & PreventionAtlantaUSA
  4. 4.CDC, Global AIDS Program, South AfricaPretoriaSouth Africa

Personalised recommendations