Cultural similarities and differences between a sample of Black/African and colored women in South Africa: convergence of risk related to substance use, sexual behavior, and violence.

South Africa is one of the six southern African countries where the HIV levels for childbearing women are 20% or higher. We conducted two focus groups aimed at developing an understanding of the intersections of substance abuse, sexual behavior, and violence affecting the lives of women of color in Cape Town, South Africa. Both Colored and Black/African participants reported using cannabis, methaqualone, and alcohol, although they differed on other drugs used. Black/African women also used heroin, and crack cocaine, whereas Colored women used methamphetamines. For participants in both groups, relationships with men affected sexual and substance use risk behaviors. Although the Black/African women did not trust men to use condoms, the Colored women in the study believed that almost all men use condoms. Both groups of women reported high rates of violence, with Colored participants reporting more gang violence and woman-on-woman violence compared with Black/African participants. The paper discusses these issues, as well as the implications for adapting a culturally specific, brief woman-focused HIV prevention intervention for the South African context.