title: Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa.
abstract: BACKGROUND
  This study examined cross-sectional data collected from substance-using female sex workers (FSW) and non-sex workers (non-SW) in Pretoria, South Africa, who entered a randomized controlled trial.
  
  
  METHODS
  Women who reported alcohol use and recently engaging in sex work or unprotected sex were recruited for a randomized study. The study sample (N = 506) comprised 335 FSW and 171 female non-SW from Pretoria and surrounding areas. Self-reported data about alcohol and other drug use as well as treatment needs and access were collected from participants before they entered a brief intervention.
  
  
  RESULTS
  As compared with female non-SW, FSW were found to have a greater likelihood of having a past year diagnosis of alcohol or other drug abuse or dependence, having a family member with a history of alcohol or other drug abuse, having been physically abused, having used alcohol before age 18, and having a history of marijuana use. In addition, the FSW were more likely to perceive that they had alcohol or other drug problems, and that they had a need for treatment and a desire to go for treatment. Less than 20% of participants in either group had any awareness of alcohol and drug treatment programs, with only 3% of the FSW and 2% of the non-SW reporting that they tried but were unable to enter treatment in the past year.
  
  
  CONCLUSIONS
  FSW need and want substance abuse treatment services but they often have difficulty accessing services. The study findings suggest that barriers within the South African treatment system need to be addressed to facilitate access for substance-using FSW. Ongoing research is needed to inform policy change that fosters widespread educational efforts and sustainable, accessible, woman-sensitive services to ultimately break the cycle for current and future generations of at-risk South African women.
authors.affiliation: Substance Abuse Treatment Evaluations and Interventions Research Program, RTI International (Research Triangle Institute), 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, North Carolina 27709-2194, USA. wmw@rti.org
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.forename: William A
authors.initials: WA
authors.lastname: Zule
authors.forename: Charles D
authors.initials: CD
authors.lastname: Parry
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Browne
authors.forename: Winnie K
authors.initials: WK
authors.lastname: Luseno
authors.forename: Tracy
authors.initials: T
authors.lastname: Kline
authors.forename: Amanda
authors.initials: A
authors.lastname: Gentry
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D011477:Sex Work / Q000523:psychology*; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology*