AIDS and Behavior

, Volume 20, Issue 10, pp 2387–2397 | Cite as

HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa

  • Christina S. Meade
  • Ryan R. Lion
  • Daniella M. Cordero
  • Melissa H. Watt
  • John A. Joska
  • Hetta Gouse
  • Warren Burnhams
Original Paper


South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.


South Africa Drug abuse Methamphetamine Sexual risk behavior Substance abuse treatment HIV transmission 


Sudáfrica está experimentando un problema de metanfetamina en crecimiento, y hay la preocupación que la metanfetamina pueda acelerar la transmisión de VIH. Ha habido poca investigación de las necesidades de prevención de VIH para los usuarios de metanfetamina recibiendo tratamiento de abuso de sustancias en Sudáfrica. Este estudio evaluó la prevalencia y correlatos de la conducta de riesgo de VIH entre 269 usuarios de metanfetamina que inician tratamiento por abuso de sustancias en dos clínicas en Ciudad del Cabo. La prevalencia de comportamientos sexuales de riesgo fue alta entre los participantes sexualmente activos: 34 % en múltiples parejas, el 26 % en relaciones sexuales sin protección con una pareja ocasional, y 24 % de comercio del sexo por dinero/metanfetamina. El predictor más fuerte de todos los comportamientos sexuales de riesgo fue el uso concomitante de otras drogas. Más de la mitad no había sido probado por el VIH en el último año, y el 25 % nunca había sido probado, aunque las actitudes hacia las pruebas de VIH fueron abrumadoramente positivas. Esta población de usuarios de metanfetamina no inyectables, principalmente heterosexuales, es un grupo de alto riesgo en la necesidad de intervenciones específicas de prevención del VIH. El tratamiento de abuso de sustancias es un escenario ideal en el que llega a los usuarios de metanfetamina los servicios de VIH.



This study was funded by a Grant from the Duke University Center for AIDS Research (P30-AI064518, with additional support from Grants awarded by the National Institute on Drug Abuse (K23-DA028660, R03-DA033828). The content is solely the responsibility of the authors and does not necessarily represent the official views of the United States National Institutes of Health. A scholarship from the Duke Global Health Institute provided Ryan Lion with funds for travel and living expenses in South Africa and a stipend to work on the study at Duke. We thank Ms. Sadieqa Barodien, Ms. Robyn Human, and other clinic staff for their assistance with data collection.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Christina S. Meade
    • 1
    • 2
  • Ryan R. Lion
    • 2
  • Daniella M. Cordero
    • 2
  • Melissa H. Watt
    • 2
  • John A. Joska
    • 3
  • Hetta Gouse
    • 3
  • Warren Burnhams
    • 4
  1. 1.Department of Psychiatry & Behavioral Sciences, Duke University School of MedicineDuke UniversityDurhamUSA
  2. 2.Duke Global Health InstituteDurhamUSA
  3. 3.Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
  4. 4.City Health, City of Cape TownCape TownSouth Africa

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