A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp
Objective: To assess the impact of the Women's Health CoOp (WHC) on drug abstinence among vulnerable women having HIV counselling and testing (HCT). Design: Randomised trial conducted with multiple follow-ups. Setting: 15 communities in Cape Town, South Africa. Participants: 720 drug-us...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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BMJ PUBLISHING GROUP
2013
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| Online Access: | http://hdl.handle.net/20.500.11937/85601 |
| _version_ | 1848764749471285248 |
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| author | Wechsberg, W.M. Jewkes, R. Novak, S.P. Kline, T. Myers-Franchi, Bronwyn Browne, F.A. Carney, T. Lopez, A.A.M. Parry, C. |
| author_facet | Wechsberg, W.M. Jewkes, R. Novak, S.P. Kline, T. Myers-Franchi, Bronwyn Browne, F.A. Carney, T. Lopez, A.A.M. Parry, C. |
| author_sort | Wechsberg, W.M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: To assess the impact of the Women's Health CoOp (WHC) on drug abstinence among vulnerable women having HIV counselling and testing (HCT).
Design: Randomised trial conducted with multiple follow-ups. Setting: 15 communities in Cape Town, South Africa.
Participants: 720 drug-using women aged 18-33, randomised to an intervention (360) or one of two control arms (181 and 179) with 91.9% retained at follow-up.
Interventions: The WHC brief peer-facilitated intervention consisted of four modules (two sessions), 2 h addressing knowledge and skills to reduce drug use, sex risk and violence; and included role-playing and rehearsal, an equal attention nutrition intervention, and an HCT-only control.
Primary outcome measures: Biologically confirmed drug abstinence measured at 12-month follow-up, sober at last sex act, condom use with main and casual sex partners, and intimate partner violence.
Results: At the 12-month endpoint, 26.9% (n=83/309) of the women in the WHC arm were abstinent from drugs, compared with 16.9% (n=27/160) in the Nutrition arm and 20% (n=31/155) in the HCT-only control arm. In the random effects model, this translated to an effect size on the log odds scale with an OR of 1.54 (95% CI 1.07 to 2.22) comparing the WHC arm with the combined control arms. Other 12-month comparison measures between arms were non-significant for sex risk and victimisation outcomes. At 6-month follow-up, women in the WHC arm (65.9%, 197/299) were more likely to be sober at the last sex act (OR1.32 (95% CI 1.02 to 1.84)) than women in the Nutrition arm (54.3%, n=82/152).
Conclusions: This is the first trial among drug-using women in South Africa showing that a brief intervention added to HCT results in greater abstinence from drug use at 12 months and a larger percentage of sexual activity not under the influence of substances. |
| first_indexed | 2025-11-14T11:24:18Z |
| format | Journal Article |
| id | curtin-20.500.11937-85601 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:24:18Z |
| publishDate | 2013 |
| publisher | BMJ PUBLISHING GROUP |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-856012021-10-07T04:23:21Z A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp Wechsberg, W.M. Jewkes, R. Novak, S.P. Kline, T. Myers-Franchi, Bronwyn Browne, F.A. Carney, T. Lopez, A.A.M. Parry, C. Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine WOMAN-FOCUSED INTERVENTION SUBSTANCE USE HIV PREVENTION CAPE-TOWN WORKERS ALCOHOL MEN Objective: To assess the impact of the Women's Health CoOp (WHC) on drug abstinence among vulnerable women having HIV counselling and testing (HCT). Design: Randomised trial conducted with multiple follow-ups. Setting: 15 communities in Cape Town, South Africa. Participants: 720 drug-using women aged 18-33, randomised to an intervention (360) or one of two control arms (181 and 179) with 91.9% retained at follow-up. Interventions: The WHC brief peer-facilitated intervention consisted of four modules (two sessions), 2 h addressing knowledge and skills to reduce drug use, sex risk and violence; and included role-playing and rehearsal, an equal attention nutrition intervention, and an HCT-only control. Primary outcome measures: Biologically confirmed drug abstinence measured at 12-month follow-up, sober at last sex act, condom use with main and casual sex partners, and intimate partner violence. Results: At the 12-month endpoint, 26.9% (n=83/309) of the women in the WHC arm were abstinent from drugs, compared with 16.9% (n=27/160) in the Nutrition arm and 20% (n=31/155) in the HCT-only control arm. In the random effects model, this translated to an effect size on the log odds scale with an OR of 1.54 (95% CI 1.07 to 2.22) comparing the WHC arm with the combined control arms. Other 12-month comparison measures between arms were non-significant for sex risk and victimisation outcomes. At 6-month follow-up, women in the WHC arm (65.9%, 197/299) were more likely to be sober at the last sex act (OR1.32 (95% CI 1.02 to 1.84)) than women in the Nutrition arm (54.3%, n=82/152). Conclusions: This is the first trial among drug-using women in South Africa showing that a brief intervention added to HCT results in greater abstinence from drug use at 12 months and a larger percentage of sexual activity not under the influence of substances. 2013 Journal Article http://hdl.handle.net/20.500.11937/85601 10.1136/bmjopen-2013-002622 English http://creativecommons.org/licenses/by/4.0/ BMJ PUBLISHING GROUP fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine WOMAN-FOCUSED INTERVENTION SUBSTANCE USE HIV PREVENTION CAPE-TOWN WORKERS ALCOHOL MEN Wechsberg, W.M. Jewkes, R. Novak, S.P. Kline, T. Myers-Franchi, Bronwyn Browne, F.A. Carney, T. Lopez, A.A.M. Parry, C. A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp |
| title | A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp |
| title_full | A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp |
| title_fullStr | A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp |
| title_full_unstemmed | A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp |
| title_short | A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: A randomised trial of the Women's Health CoOp |
| title_sort | brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in south africa: a randomised trial of the women's health coop |
| topic | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine WOMAN-FOCUSED INTERVENTION SUBSTANCE USE HIV PREVENTION CAPE-TOWN WORKERS ALCOHOL MEN |
| url | http://hdl.handle.net/20.500.11937/85601 |