Gender Moderates Results of a Randomized Clinical Trial for the Khanya Intervention for Substance Use and ART Adherence in HIV Care in South Africa.

Journal: AIDS and behavior

Volume: 26

Issue: 11

Year of Publication: 2022

Affiliated Institutions:  Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland. jennifer.belus@unibas.ch. HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Department of Psychology, University of Maryland, College Park, MD, USA. Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa. Department of Psychology, University of Miami, Miami, FL, USA.

Abstract summary 

Little is known about gender effects of alcohol and drug use (AOD) among people living with HIV (PLWH) in resource-limited settings. Using multilevel models, we tested whether gender moderated the effect of Khanya, a cognitive-behavioral therapy-based intervention addressing antiretroviral (ART) adherence and AOD reduction. We enrolled 61 participants from HIV care and examined outcomes at 3- and 6-months compared to enhanced treatment as usual (ETAU). Gender significantly moderated the effect of Khanya on ART adherence (measured using electronically-monitored and biomarker-confirmed adherence), such that women in Khanya had significantly lower ART adherence compared to men in Khanya; no gender differences were found for AOD outcomes. Exploratory trajectory analyses showed men in Khanya and both genders in ETAU had significant reductions in at least one AOD outcome; women in Khanya did not. More research is needed to understand whether a gender lens can support behavioral interventions for PLWH with AOD.Trial registry ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018.

Authors & Co-authors:  Belus Jennifer M JM Joska John A JA Bronsteyn Yosef Y Rose Alexandra L AL Andersen Lena S LS Regenauer Kristen S KS Myers Bronwyn B Hahn Judith A JA Orrell Catherine C Safren Steve A SA Magidson Jessica F JF

Study Outcome 

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Statistics
Citations :  Simbayi LC, Zuma K, Zungu N, Moyo S, Marinda E, Jooste S, et al. South African national HIV prevalence, incidence, behaviour and communication survey, 2017. Cape Town: HSRC Press; 2019.
Authors :  11
Identifiers
Doi : 10.1007/s10461-022-03765-8
SSN : 1573-3254
Study Population
Men,Women
Mesh Terms
Anti-Retroviral Agents
Other Terms
ART adherence;Behavioral intervention;Gender differences;South Africa;Substance use
Study Design
Randomized Control Trial,Exploratory Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States