Outcomes of substance use and sexual power among adolescent girls and young women in Cape Town: Implications for structural and cultural differences.

Journal: Global public health

Volume: 19

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  RTI International, Research Triangle Park, NC, USA. Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa. RTI International, Nairobi, Kenya.

Abstract summary 

Adolescent girls and young women (AGYW) in South Africa experience contextual barriers to HIV risk reduction including incomplete schooling, unintended pregnancy, substance use, and gender-based violence. A cluster randomised trial in Cape Town allocated 24 Black and Coloured communities to a gender-focused HIV risk-reduction intervention or HIV testing, with 500 AGYW total enrolled. We evaluated intervention efficacy by comparing mean differences overall, by community population group (Black and Coloured) and among those with structural barriers based on neighbourhood, education, and employment (n = 406). Both arms reported reductions in alcohol, cannabis, and condomless sex, with no intervention efficacy overall. Among AGYW with barriers, intervention participants reported fewer days of methamphetamine use at 6 months (t(210) = 2·08,  = ·04). In population group analysis, we found intervention effects on alcohol and sexual communication. Intervention participants in Black communities had fewer days of alcohol use at 12 months (t(136) = 2·10,  = ·04). Sexual discussion (t(147) = -2·47,  = ·02) and condom negotiation (t(146) = -2·51,  = ·01) increased for intervention participants at 12 months in Coloured communities. Gender-focused interventions must address population group differences and intersecting barriers to decrease substance use and increase education, skills, and sexual health protection.

Authors & Co-authors:  Wechsberg Wendee M WM Browne Felicia A FA Carney Tara T Kline Tracy L TL Howard Brittni N BN Russell Sara E SE van der Drift Isa I Myers Bronwyn B Minnis Alexandra M AM Bonner Courtney P CP Ndirangu Jacqueline W JW

Study Outcome 

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Statistics
Citations : 
Authors :  11
Identifiers
Doi : 10.1080/17441692.2024.2340500
SSN : 1744-1706
Study Population
Women,Girls
Mesh Terms
Humans
Other Terms
Sexual negotiation;condom use;education;heavy alcohol use;methamphetamine use
Study Design
Study Approach
Country of Study
South Africa
Publication Country
England