title: The Relationship of Alcohol and Other Drug Use Typologies to Sex Risk Behaviors among Vulnerable Women in Cape Town, South Africa.
abstract: BACKGROUND: Alcohol and other drug (AOD) use remains an important contributing factor to the spread of HIV in South Africa, mainly because of the strong associations found between AOD use and sex risk behaviors. Specifically, AOD use can lead to disinhibition and impaired judgment that may result in inconsistent condom use and other risky sex behaviors among vulnerable and disempowered women.  METHODS: Latent Class Analysis was used to identify AOD use typologies among 720 vulnerable women from a randomized trial baseline assessment in Cape Town, South Africa and to examine whether these AOD use classes predict sex risk for HIV.  RESULTS: Three classes emerged with distinct differences in AOD use: the Marijuana and Alcohol class (34.6%) mainly comprised participants who used marijuana and drank alcohol frequently; the High AOD Risk class (26.1%) mainly comprised participants who used methamphetamine and marijuana, reported heavy drinking, and moderate probabilities of Mandrax use; and the Polydrug use class (39.3%) predominately comprised participants who used methamphetamine, marijuana, and Mandrax. Participants in the Marijuana and Alcohol class were less likely to report past-month unprotected sex with their main sex partner compared with participants in the Polydrug Use class. When examining the adjusted model, Black African women were significantly less likely to report past-month unprotected sex with their main sex partner compared with Coloured women. Women who were HIV negative were more likely to report unprotected sex with their main sex partner than women who were HIV positive.  CONCLUSION: The fewer substances that women used seemed to serve as protective factors against engaging in AOD-impaired sex. This study provides an important contribution to understand the intersection of AOD use and sexual risk for HIV by measuring polydrug use among vulnerable women and its association with sexual risk taking.
authors: Senior Director, Substance Abuse Treatment and Interventions Research, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC, USA ; Adjunct Professor, Health Policy and Administration, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA ; Adjunct Professor, Psychology in the Public Interest, North Carolina State University (NCSU), Raleigh, NC, USA ; Adjunct Associate Professor, Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
authors: Wendee M
authors: WM
authors: Wechsberg
authors: Bronwyn
authors: B
authors: Myers
authors: Tracy L
authors: TL
authors: Kline
authors: Tara
authors: T
authors: Carney
authors: Felicia A
authors: FA
authors: Browne
authors: Scott P
authors: SP
authors: Novak
keywords: Alcohol and other drug use; Latent class analysis; Sex risk; South Africa; Women
references: AIDS Patient Care STDS. 2008 Sep;22(9):745-51
references: 18754704
references: Int J Drug Policy. 2008 Apr;19(2):130-9
references: 18207723
references: AIDS Behav. 2009 Oct;13(5):849-59
references: 18324470
references: Afr J Psychiatry (Johannesbg). 2011 Mar;14(1):30-7
references: 21509408
references: Drug Alcohol Depend. 2011 Nov 1;118(2-3):237-43
references: 21530105
references: Women Health. 2006;43(2):73-92
references: 17000612
references: Am J Drug Alcohol Abuse. 2010 Jul;36(4):208-13
references: 20560840
references: Soc Sci Med. 2004 Oct;59(8):1581-92
references: 15279917
references: J Urban Health. 2005 Mar;82(1 Suppl 1):i120-6
references: 15738313
references: Afr J Psychiatry (Johannesbg). 2011 May;14(2):146-53
references: 21687914
references: J Subst Abuse Treat. 2008 Oct;35(3):279-84
references: 18329225
references: Health Place. 2011 Mar;17(2):525-35
references: 21195013
references: Eur J Public Health. 2010 Apr;20(2):202-6
references: 19726591
references: Subst Use Misuse. 2006;41(5):729-41
references: 16603457
references: Subst Use Misuse. 2008 Jul;43(8-9):1186-201
references: 18649238
references: Am J Addict. 2009 Jan-Feb;18(1):65-72
references: 19219667
references: AIDS Behav. 2006 Mar;10(2):131-7
references: 16482408
references: Int J Pediatr. 2011;2011:353410
references: 21541067
references: S Afr Med J. 2009 May;99(5 Pt 2):339-44
references: 19588796
references: Drug Alcohol Depend. 2012 May 1;122(3):220-7
references: 22030276
references: Drug Alcohol Rev. 2007 Jan;26(1):49-54
references: 17364836
references: Curr Opin Psychiatry. 2010 May;23(3):205-9
references: 20308902