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

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Abstract

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.

Resumen

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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Duke University, Box 90519, Durham, NC, 27708, USA

    Christina S. Meade

  2. Duke Global Health Institute, Durham, NC, USA

    Christina S. Meade, Ryan R. Lion, Daniella M. Cordero & Melissa H. Watt

  3. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

    John A. Joska & Hetta Gouse

  4. City Health, City of Cape Town, Cape Town, South Africa

    Warren Burnhams

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  1. Christina S. Meade
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  2. Ryan R. Lion
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Correspondence to Christina S. Meade.

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Meade, C.S., Lion, R.R., Cordero, D.M. et al. HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa. AIDS Behav 20, 2387–2397 (2016). https://doi.org/10.1007/s10461-016-1333-x

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