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.
abstract: OBJECTIVE
  To assess the impact of the Women's Health CoOp (WHC) on drug abstinence among vulnerable women having HIV counselling and testing (HCT).
  
  
  METHODS
  Randomised trial conducted with multiple follow-ups.
  
  
  METHODS
  15 communities in Cape Town, South Africa.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  NCT00729391 ClinicalTrials.gov.
authors.affiliation: Substance Abuse Treatment Evaluations and Intervention Research, RTI International, Durham, North Carolina, USA.
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
authors.forename: Rachel
authors.initials: R
authors.lastname: Jewkes
authors.forename: Scott P
authors.initials: SP
authors.lastname: Novak
authors.forename: Tracy
authors.initials: T
authors.lastname: Kline
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Myers
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Browne
authors.forename: Tara
authors.initials: T
authors.lastname: Carney
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Morgan Lopez
authors.forename: Charles
authors.initials: C
authors.lastname: Parry
keywords: Public Health