Barcelona 2013
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| Abstract #389 - Gender in the Equation: Not Just Treatment as Prevention | ||||
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Session: 20.1: Gender in the Equation: Not Just Treatment as Prevention (Workshop) on Monday @ 16.30-18.30 in Auditorium Chaired by Dr Wendee Wechsberg Authors: Presenting Author: Dr Wendee Wechsberg - RTI International, United States |
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| Additional Authors: | ||||
| Aim: A NIDA-funded study (DA032061) is currently reaching vulnerable alcohol and drug (AOD) using women using a prospective, geographically clustered, randomized design to compare the impact of HIV testing with a woman-focused HIV prevention intervention and linkages to treatment. | ||||
| Method / Issue: 238 vulnerable AOD using Black African women were recruited to date across Pretoria, South Africa, with 48% reported engaging in sex work. The mean age was 30.5 (7.2 SD) years old for sex workers (SW) and 28.2 (7.2 SD) for non-sex workers (NSW) (p<0.02). Many women (27%) considered themselves homeless, but slightly more SW (33%) reported than women who were NSW (22%) (p=0.077) | ||||
| Results / Comments: HIV infection. The baseline prevalence of HIV-infection was 58%. Although 90% had been previously tested for HIV at least once, 18% were newly diagnosed with HIV. Among SW, HIV prevalence was 69% and 50% knew they were infected. Among the NSW, 47% were HIV-infected and only 29% knew their diagnosis. Drug use. Significant differences were found in self-reported drug use: 65% of SW reported marijuana use compared to 53% of NSW (p=0.05). No differences were found between participants smoking Nyaope with a third of SW and NSW each reporting use (a combination of marijuana and heroin). When consuming alcohol during the previous 30 days, 69% and 42% of SW and NSW reported using drugs when they drink (p<0.0001). Sex Risk. Most participants (70%) used drugs during the last time they had sex, with no differences by SW status. However, more NSWs (66%) than SWs (47%) reported that their partner used drugs during their last sexual act (p=0.013). Condom use was low in general, but higher condom use was reported by SWs: 32% of SWs compared to 9% to NSWs reported consistent condom use with all partners during the previous 30 days (p<0.0001). Similarly, 75% of SWs and 14% of the NSWs reported using condoms during their last sexual act (p<0.0001).Violence. Although there were no statistically significant differences between SWs and NSWs for past victimization, substantially more sex workers felt concerned that someone would hurt them in the near future. Among all participants 20% and 23% reported a past history of physical abuse or rape, respectively. 33% of NSWs compared to 49% of SWs reported concern that someone may attack them with a weapon, physically abuse or rape them (p=0.011). | ||||
| Discussion: The preliminary sample of Black South African substance abusing women, recruited across the city, demonstrates not only differences but the challenges faced by women with homelessness and concern for violence. Many women become sex workers out of disparity and lack of alternative employment. The very high rates of HIV, and also newly diagnosed HIV raises serious questions as to South Africa?s reach with its testing and ARV campaign. The need to ensure linkages to clinical care and assessment is paramount but also it appears evident that programs need to address substance abuse, sexual risk and violence prevention. | ||||
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