AIDS and Behavior

, Volume 18, Issue 3, pp 511–518 | Cite as

Whoonga: Potential Recreational Use of HIV Antiretroviral Medication in South Africa

  • David J. GrelottiEmail author
  • Elizabeth F. Closson
  • Jennifer A. Smit
  • Zonke Mabude
  • Lynn T. Matthews
  • Steven A. Safren
  • David R. Bangsberg
  • Matthew J. Mimiaga
Original Paper


Whoonga is a drug cocktail in South Africa rumored to contain illicit drugs and HIV antiretroviral (ARV) medication. Although its use may adversely impact adherence to HIV treatment and may have the potential to generate ARV resistance, there is a paucity of research characterizing whoonga. We learned of whoonga during semi-structured interviews about substance abuse and HIV risk at “club-events” known as inkwaris in an urban township of Durban, South Africa. Whoonga was an emerging theme spontaneously identified as a problem for the community by 17 out of 22 informants. Perceptions of whoonga suggest that it is highly addictive, contains ARVs (notably efavirenz), is used by individuals as young as 14, and poses a threat to the health and safety of those who use it, including increasing the risk of HIV infection. Our informants provide preliminary evidence of the dangers of whoonga and reinforce the need for further study.


Recreational HIV antiretroviral use Substance abuse South Africa Whoonga and nyaope Antiretroviral diversion 


La whoonga es un cóctel de drogas en Sudáfrica sobre que se corre un rumor de que la contiene las drogas ilícitas y la medicación antirretroviral (ARV) del VIH. Aunque el uso de este cóctel podría afectar negativamente la adherencia al tratamiento del VIH y podría tener el potencial de generar resistencia a los ARV, hay una escasez de investigaciones que caracteriza la whoonga. Aprendíamos de la whoonga a través de entrevistas semi-estructuradas sobre el abuso de sustancias y el riesgo del VIH en los “eventos del club” que se llaman los inkwaris en un municipio urbano de Durban, Sudáfrica. La whoonga era un tema emergente que fue identificado espontáneamente como un problema para la comunidad por 17 de los 22 informantes. Las percepciones de la whoonga sugieren que es muy adictiva, que contiene los ARV (notablemente efavirenz), que es utilizado por los individuos tan joven como 14 años, y que la representa una amenaza para la salud y la seguridad para los que la utilizan, incluyendo aumentando el riesgo de infección por VIH. Nuestros informantes proveen evidencia inicial de los peligros de la whoonga y fortalecen la necesidad de más información.



This project was supported by a research grant from the Mark and Lisa Schwartz Foundation to Dr. Mimiaga. The authors would like to thank Jason Mattie and Angela Robertson for their assistance in preparing the manuscript. Dr. Grelotti, Ms. Closson, Dr. Matthews, Dr. Safren, Dr. Bangsberg, and Dr. Mimiaga receive salary support from the National Institutes of Health, United States. Dr. Safren is supported by Grant 5K24MH094214. Dr. Bangsberg is supported by Grant 10K24087227. Drs. Bangsberg and Safren are supported by the Harvard University Center for AIDS Research (CFAR; Walker) 5P30AI060354-09.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • David J. Grelotti
    • 1
    • 6
    Email author
  • Elizabeth F. Closson
    • 2
  • Jennifer A. Smit
    • 3
  • Zonke Mabude
    • 3
  • Lynn T. Matthews
    • 4
    • 5
  • Steven A. Safren
    • 2
    • 6
  • David R. Bangsberg
    • 4
    • 5
    • 7
  • Matthew J. Mimiaga
    • 1
    • 2
    • 6
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  2. 2.The Fenway Institute, Fenway HealthBostonUSA
  3. 3.Maternal, Adolescent and Child Health (MatCH), Department of Obstetrics and Gynaecology, Faculty of Health SciencesUniversity of the WitwatersrandDurbanSouth Africa
  4. 4.Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  5. 5.Massachusetts General Hospital Center for Global HealthBostonUSA
  6. 6.Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  7. 7.Ragon Institute of MGH, MIT and HarvardBostonUSA

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