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HIV Prevention Among Women Who Use Substances And Report Sex Work: Risk Groups Identified Among South African Women
Authors:Wendee M. Wechsberg  Tracy Kline  William A. Zule  Jacqueline Ndirangu  Felicia A. Browne  Colby Gabel  Charles van der Horst
Affiliation:1.Substance Use, Gender, and Applied Research Program,RTI International,Research Triangle Park,USA;2.Gillings School of Global Public Health,University of North Carolina,Chapel Hill,USA;3.Psychology in the Public Interest,North Carolina State University,Raleigh,USA;4.Psychiatry and Behavioral Sciences,Duke University School of Medicine,Durham,USA;5.Social Statistics Program,RTI International,Research Triangle Park,USA;6.Substance Use, Gender, and Applied Research Program,RTI International,Washington, DC,USA;7.Johns Hopkins Bloomberg School of Public Health,Johns Hopkins University,Baltimore,USA;8.University of North Carolina School of Medicine,University of North Carolina,Chapel Hill,USA
Abstract:
This cross-sectional study presents baseline data from women (n = 641) in a community-based randomized trial in Pretoria, South Africa. Women were eligible if they reported recent alcohol or other drug (AOD) use and condomless sex. Latent class analyses were conducted separately for those who reported sex work and those who did not. Among those who reported sex work, a Risky Sex class (n = 72, 28%) and Low Sexual Risk class (n = 190, 73%) emerged. Those in the Risky Sex class were more likely to report that their last episode of sexual intercourse was with their boyfriend (vs. a client/other partner) compared with the Low Sexual Risk class (p < 0.001). Among participants who did not report sex work, a Drug-Using, Violence-Exposed, and Impaired Sex class (n = 53; 14%) and Risky Sex and Moderate Drinking class (n = 326; 86%) emerged. The findings suggest that interventions for women who engage in sex work should promote safer sexual behavior and empowerment with main partners. Women who use AODs, experience physical or sexual violence, and have impaired sex may be a key population at risk for HIV and should be considered for tailored behavioral interventions in conjunction with South Africa’s plan to disseminate HIV prevention methods to vulnerable women. Trial Registration: ClinicalTrials.gov registration NCT01497405.
Keywords:
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