title: Experiences of violence and association with decreased drug abstinence among women in Cape Town, South Africa.
abstract: Drug abuse is a contributing factor in women's HIV risk in low-income communities in Cape Town, South Africa. This study assessed whether experiencing violence is associated with reduced drug abstinence among adult women (n = 603) participating in a randomized field trial for an HIV prevention study in Cape Town. In relation to drug abstinence at 12-month follow-up, multivariable regression models were used to assess (1) baseline partner and non-partner victimization, and (2) victimization at 12-month follow-up among participants reporting baseline victimization. Baseline partner (AOR = 0.6; 95 % CI 0.4-0.9) and non-partner victimization (AOR = 0.6; 95 % CI 0.4-0.9) were associated with a reduced likelihood of drug abstinence at follow-up. Among participants who reported victimization at baseline, those no longer reporting victimization at follow-up did not differ significantly in drug abstinence compared with those who reported victimization at follow-up. The study findings highlight the lasting impact of victimization on women's drug use outcomes, persisting regardless of whether violence was no longer reported at follow-up. Overall, the findings support the need for the primary prevention of violence to address the cycle of violence, drug use, and HIV among women in this setting.
authors.affiliation: Division of Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Drive, Mail code 0507, La Jolla, CA, 92093, USA, lizreed@ucsd.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Reed
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Myers
authors.forename: Scott P
authors.initials: SP
authors.lastname: Novak
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Browne
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
mesh_terms: D000328:Adult; D019548:Crime Victims; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D057566:Self Report; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012931:Social Environment; D013019:South Africa / Q000453:epidemiology; D013179:Spouse Abuse / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014754:Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*