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Rapid Assessment of HIV Risk Behavior in Drug Using Sex Workers in Three Cities in South Africa

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Abstract

A rapid assessment was undertaken with drug using commercial sex workers (CSWs) to investigate practices putting them at risk for contracting HIV. It included key informant (KI) (N = 67) and focus group (N = 10) interviews in locations with a high prevalence of drug use in Cape Town, Durban and Pretoria, South Africa. HIV testing of KIs was conducted. Cocaine, Ecstasy, heroin and methaqualone are used by CSWs prior to, during and after sex. Drugs enhance the sexual experience and prolong sex sessions. Interviews revealed inconsistent condom use among CSWs together with other risky sexual practices such as needle sharing. Among CSWs who agreed to HIV testing, 34% tested positive. Barriers to accessing drug treatment and HIV treatment and preventive services were identified. Interventions recognizing the role of drug abuse in HIV transmission should be prioritized, and issues of access to services, stigma and power relations must be considered.

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References

  • Abdool, R., Sulliman, F. T., & Dhanoo, M. I. (2006). The injecting drug use and HIV/AIDS nexus in the republic of Mauritius. African Journal of Drug and Alcohol Studies, 5(2), 107–116.

    Google Scholar 

  • Adeleken, M. L., & Lawal, R. A. (2006). Drug use and HIV injection in Nigeria: A review of findings. African Journal of Drug and Alcohol Studies, 5(2), 117–128.

    Google Scholar 

  • Campbell, C. (2000). Selling sex in the time of AIDS: The psycho-social context of condom use by sex workers on a Southern African mine. Social Science and Medicine, 50, 479–494.

    Article  PubMed  CAS  Google Scholar 

  • CDC. (2006). Methamphetamine use and HIV risk behaviors among heterosexual men: Preliminary results from five northern California Counties, December 2001–November 2003. Morbidity and Mortality Weekly Report, 5(10), 273–277.

    Google Scholar 

  • Cusick, L. (2006). Widening the harm reduction agenda: From drug use to sex work. International Journal of Drug Policy, 17, 3–11.

    Article  Google Scholar 

  • Dalla, R. L. (2002). Night moves: A qualitative investigation of street-level sex work. Psychology of Women Quarterly, 26, 63–73.

    Article  Google Scholar 

  • De Graaf, R., Vanweesenbeeck, I., Van Zessen, G., Straver, C. J., & Visser, J. H. (1995). Alcohol and drug use in heterosexual and homosexual prostitution, and it’s relation to protection behaviour. AIDS Care, 7, 35–47.

    Article  PubMed  Google Scholar 

  • Dewing, S., Pluddeman, A., Myers, B. J., & Parry, C. D. H. (2006). Review of injection drug use in six African countries: Egypt, Kenya, Mauritius, Nigeria, South Africa and Tanzania. Drugs: Education, Prevention and Policy, 13(2), 121–137.

    Article  Google Scholar 

  • Dunkle, K. L., Beksinska, M. E., Rees, V. H., Ballard, R. C., Htun, Y., & Wilson, M. L. (2005). Risk factors for HIV infection among sex workers in Johannesburg, South Africa. International Journal of STD and AIDS, 16, 256–261.

    Article  PubMed  CAS  Google Scholar 

  • Fick, N. (2005). Coping with stigma, discrimination and violence: Sex workers talk about their experiences. Cape Town: Sex Worker Education and Advocacy Taskforce.

    Google Scholar 

  • Izugbara, C. O. (2005). ‘Ashawo suppose shine her eyes’: Female sex workers and sex work risks in Nigeria. Health Risk and Society, 7(2), 141–159.

    Article  Google Scholar 

  • Karim, Q. A., Karim, S. S. A., Soldan, K., & Zondi, M. (1995). Reducing the risk of HIV infection among South African sex workers: Socioeconomic and gender barriers. American Journal of Public Health, 85, 1521–1525.

    Article  PubMed  CAS  Google Scholar 

  • Kingree, J. B., & Betz, H. (2003). Risky sexual behavior in relation to marijuana and alcohol use among African-American, male adolescent detainees and their female partners. Drug and Alcohol Dependency, 72, 197–203.

    Article  CAS  Google Scholar 

  • Leggett, T. (1999). Crack, sex work, and HIV. AIDS Analysis Africa, 9, 3.

    PubMed  CAS  Google Scholar 

  • Leggett, T. (2001a). Drugs, sex work, and HIV in three South African cities. Society in Transition, 32, 101–109.

    Google Scholar 

  • Leggett, T. (2001b). Rainbow vice: The drugs and sex industries in the new South Africa. Cape Town: David Philip.

    Google Scholar 

  • Lejuez, C. W., Bornovalova, M. A., Daughters, S. B., & Curtin, J. J. (2005). Differences in impulsivity and sexual risk behavior among inner-city crack/cocaine users and heroin users. Drug and Alcohol Dependency, 14, 169–175.

    Article  Google Scholar 

  • McCurdy, S. A., Williams, M. L., Kilonzo, G. P., Ross, M. W., & Leshabari, M. T. (2005). Heroin and HIV risk in Dar es Salaam, Tanzania: Youth hangouts, mageto and injecting practices. AIDS Care, 17(1), 65–76.

    Article  Google Scholar 

  • Morojele, N. K., Brook, J. S., & Kachienga, M. A. (2006). Perceptions of sexual risk behaviors and substance abuse among adolescents in South Africa: A qualitative investigation. AIDS Care, 18(3), 215–219.

    Article  PubMed  Google Scholar 

  • Morris, C. N., Levine, B., Goodridge, G., Luo, N., & Ashley, J. (2006). Three country assessment of alcohol-HIV related policy and programmatic responses in Africa. African Journal of Drug and Alcohol Studies, 5(2), 169–184.

    Google Scholar 

  • Myers, T., Aguinaldo, J. P., Dakers, D., Fischer, B., Bullock, S., Millson, P., & Calzavara, L. (2004). How drug using men who have sex with men account for substance use during sexual behaviors: Questioning assumptions of HIV prevention and research. Addiction Research and Theory, 12, 213–229.

    Article  Google Scholar 

  • Myers, B., Louw, J., & Fakier, N. (in press). Alcohol and drug abuse: removing structural barriers to treatment for historically disadvantaged communities in Cape Town. International Journal of Social Welfare.

  • Needle, R. H., Trotter, R. T., Singer, M., Bates, C., Page, B., Metzger, D., & Marcelin, L. H. (2003). Rapid assessment of the HIV/AIDS crisis in racial and ethnic minority communities: An approach for timely community interventions. American Journal of Public Health, 93, 970–979.

    Article  PubMed  Google Scholar 

  • Nixon, K., Tutty, L., Downe, P., Gorkoff, K., & Ursel, J. (2002). The everyday occurrence: Violence in the lives of girls exploited through prostitution. Violence Against Women, 8, 1016–1043.

    Google Scholar 

  • Parry, C. D. H., Bhana, A., Pluddeman, A., Myers, B., Siegfried, N., Morojele, N. K., Flisher, A. J., & Kozel., N. J. (2002). The South African Community Epidemiology Network on Drug Use (SACENDU): Description, findings (1997–1999) and policy implications. Addiction, 97, 969–976.

    Article  PubMed  Google Scholar 

  • Pauw, I., & Brener, L. (2003). “You are just whores—You can’t be raped”: Barriers to safer sex practices among women street sex workers in Cape Town. Culture, Health and Sexuality, 5, 465–481.

    Article  Google Scholar 

  • Rees, H., Beksinska, H. E., Dickson-Tetteh, K., Ballard, R. C., & Htun, Y. (2000). Commercial sex workers in Johannesburg: Risk behaviour and HIV status. South African Journal of Science, 96, 283–284.

    Google Scholar 

  • Semple, S. J., Zians, J., Grant, I., & Patterson, T. L. (2006). Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men. AIDS and Behavior, 40, 1797–1810.

    Google Scholar 

  • Shisana, O., Rehle, T., Simbayi, L. C., Parker, W., Zuma, K., Bhana, A., Connolly, C., Jooste, S., & Pillay, V. (2005). South African national HIV prevalence, HIV incidence, behaviour and communication survey, 2005. Pretoria: HSRC Press.

    Google Scholar 

  • Simbayi, L. C., Kalichman, S. C., Cain, D., Cherry, C., Henda, N., & Cloete, A. (2006). Methamphetamine use and sexual risks for HIV infection in Cape Town, South Africa. Journal of Substance Use, 11(4), 291–300.

    Article  Google Scholar 

  • Strotman, R., McLellan, E., MacQueen, K. M., & Milstein, B. (2002). AnSWR: Analysis Software for Word-based Records, Version 6.4. Atlanta: Centers for Disease Control and Prevention (CDC).

    Google Scholar 

  • Timpson, S., McCurdy, S. A., Leshabari, M. T., Kilonzo, G. P., Atkinson, J., Msami, A., & Williams, M. L. (2006). Substance abuse, HIV risk and HIV/AIDS in Tanzania. African Journal of Drug and Alcohol Studies, 5(2), 157–168.

    Google Scholar 

  • UNAIDS. (2006). 2006 report on the global AIDS epidemic. Accessed 21 June 2006, from http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp.

  • Webb, D. (1997). HIV and AIDS in Africa. Cape Town: David Philip.

    Google Scholar 

  • Wechsberg, W. M., Luseno, W. K., & Lam, W. K. (2005). Violence against substance-abusing South African sex workers: Intersection with culture and HIV risk. AIDS Care, 17, S55–S64.

    Article  PubMed  Google Scholar 

  • Wechsberg, W. M., Luseno, W. K., Lam, W. K., Parry, C. D. H., & Morojele, N. K. (2006). Substance use, sexual risk, and violence: HIV prevention intervention with sex workers in Pretoria. AIDS and Behavior, 10, 131–137.

    Article  PubMed  Google Scholar 

  • Williamson, S., & Cluse-Tolar, T. (2002). Pimp-controlled prostitution: Still an integral part of street life. Violence Against Women, 8, 1074–1092.

    Article  Google Scholar 

  • Wojcicki, J. M. (2002). “She drank his money”: Survival sex and the problem of violence in taverns in Gauteng Province, South Africa. Medical Anthropology Quarterly, 16, 267–293.

    Article  PubMed  Google Scholar 

  • Wojcicki, J. M., & Malala, J. (2001). Condom use, power and HIV/AIDS risk: Sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg. Social Science and Medicine, 53, 91–121.

    Google Scholar 

  • Woody, G. E., Gallop, R., Luborsky, L., Blaine, J., Frank, A., Salloum, I. M., Gastfriend, D., Crits-Christoph, P., & the Cocaine Psychotherapy Study Group. (2003). HIV risk reduction in the national institute on drug abuse cocaine collaborative treatment study. Journal of Acquired Immune Deficiency Syndromes, 33, 82–87.

    PubMed  Google Scholar 

Download references

Acknowledgments

The research was funded by the US President’s Emergency Fund for AIDS Relief (PEPFAR) through the US Centers of Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or PEPFAR. The authors would also like to acknowledge the support of our fields work staff and NGOs in Cape Town, Durban, and Pretoria; and Angeli Achrekar and Thelma Williams who assisted the project as part of the CDC International Experience and Technical Assistance (IETA) Program.

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Authors and Affiliations

  1. Alcohol and Drug Abuse Research Unit, Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town, 7505, South Africa

    Charles D. H. Parry, Sarah Dewing, Petal Petersen & Tara Carney

  2. Department of Psychiatry, Stellenbosch University, P.O. Box 19063, Tygerberg, 7505, South Africa

    Charles D. H. Parry

  3. National Center for HIV, STD and TB Prevention, Global AIDS Program, U.S. Centers for Disease Control & Prevention, 1600 Clifton Road, Mailstop E-04, Atlanta, GA, 30333, USA

    Richard Needle & Karen Kroeger

  4. CDC, Global AIDS Program, South Africa, 877 Pretorius Street, Pretoria, 0001, South Africa

    Latasha Treger

Authors
  1. Charles D. H. Parry
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  2. Sarah Dewing
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  3. Petal Petersen
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  4. Tara Carney
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  5. Richard Needle
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  6. Karen Kroeger
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  7. Latasha Treger
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Correspondence to Charles D. H. Parry.

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Parry, C.D.H., Dewing, S., Petersen, P. et al. Rapid Assessment of HIV Risk Behavior in Drug Using Sex Workers in Three Cities in South Africa. AIDS Behav 13, 849–859 (2009). https://doi.org/10.1007/s10461-008-9367-3

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  • DOI: https://doi.org/10.1007/s10461-008-9367-3

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