Development of a trauma-informed substance use and sexual risk reduction intervention for young South African women.

Journal: Patient preference and adherence

Volume: 12

Issue: 

Year of Publication: 

Affiliated Institutions:  Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa, bmyers@mrc.ac.za. Substance Use and Gender Research (SUGAR) Program, RTI International, Research Triangle Park, NC, USA.

Abstract summary 

To develop a trauma-informed substance use and sexual risk reduction intervention for young South African women at risk of HIV.Guided by the ADAPT-ITT framework for intervention development, we selected four focus groups (n=26) to assess the service needs and preferences of trauma-exposed young women (aged 18-25 years) who use substances. We used findings to develop a needs-based and contextually appropriate intervention. In addition four focus groups (n=30) were selected to explore potential service users' views of this intervention and recommendations for improving acceptability and appeal. Expert stakeholders were also consulted.Young women described therapeutic, self-care, and social support needs for coping with traumatic experiences and reducing substance- and sexual-related risks for HIV and further trauma. To address these needs, we expanded the Women's Health Co-Operative (WHC; an evidence-based HIV prevention program) to include trauma-related psychoeducation; cognitive-behavioral strategies for coping with the emotional impact of trauma, stress, and substance use craving; social support strategies; and self-care components to help young women create a life with purpose. This novel and expanded six-session group-based intervention is called the trauma-informed WHC. Focus group participants and expert stakeholders viewed the trauma-informed WHC as highly relevant and acceptable. They provided recommendations for modifications to the intervention structure and reformatting of intervention materials to enhance the intervention's appeal and the feasibility of reaching and retaining young women in the program.Engaging women as potential service users in the process of developing a trauma-informed substance use and sexual risk reduction intervention helped identify service needs not commonly addressed in trauma-informed substance use interventions but critical for recovery and local relevance. It also enhanced the acceptability and appeal of the intervention. While potentially acceptable, the trauma-informed WHC requires feasibility testing before establishing its efficacy in a larger trial.

Authors & Co-authors:  Myers Bronwyn B Carney Tara T Browne Felicia A FA Wechsberg Wendee M WM

Study Outcome 

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Statistics
Citations :  Pitpitan EV, Kalichman SC, Eaton LA, Sikkema KJ, Watt MH, Skinner D. Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town. Soc Sci Med. 2012;75(8):1417–1425.
Authors :  4
Identifiers
Doi : 10.2147/PPA.S175852
SSN : 1177-889X
Study Population
Women
Mesh Terms
Other Terms
ADAPT-ITT;HIV;mental health;participatory approach;substance use
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
New Zealand