Bronwyn Myers1, Tara Carney2, Wendee M Wechsberg3. 1. Alcohol, Tobacco and Other Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town 7505, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Anzio Road, Observatory 7900, South Africa. Electronic address: bronwyn.myers@mrc.ac.za. 2. Alcohol, Tobacco and Other Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town 7505, South Africa. 3. RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA; Gillings Global School of Public Health, University of North Carolina, Chapel Hill, NC, USA; Psychology in the Public Interest, North Carolina State University, Raleigh, NC, USA; Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Abstract
BACKGROUND: Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women's use of health services. METHODS: We conducted four focus groups with young women (aged 16-21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women's use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. RESULTS: The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. CONCLUSION: To reach young women who use AODs, interventions need to take cognisance of young women's risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda.
BACKGROUND: Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women's use of health services. METHODS: We conducted four focus groups with young women (aged 16-21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women's use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. RESULTS: The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. CONCLUSION: To reach young women who use AODs, interventions need to take cognisance of young women's risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda.
Authors: Wendee M Wechsberg; Hendree E Jones; William A Zule; Bronwyn J Myers; Felicia A Browne; Michelle R Kaufman; Winnie Luseno; Alan J Flisher; Charles D H Parry Journal: Am J Drug Alcohol Abuse Date: 2010-07 Impact factor: 3.829
Authors: Eileen V Pitpitan; Seth C Kalichman; Lisa A Eaton; Kathleen J Sikkema; Melissa H Watt; Donald Skinner Journal: Soc Sci Med Date: 2012-07-16 Impact factor: 4.634
Authors: R Chapman; R G White; L A Shafer; A Pettifor; O Mugurungi; D Ross; S Pascoe; F M Cowan; H Grosskurth; A Buve; R J Hayes Journal: Trop Med Int Health Date: 2010-03-16 Impact factor: 2.622
Authors: Wendee M Wechsberg; William A Zule; Jacqueline Ndirangu; Tracy L Kline; Nathaniel F Rodman; Irene A Doherty; Scott P Novak; Charles M van der Horst Journal: BMC Public Health Date: 2014-10-15 Impact factor: 3.295
Authors: Jessica F Magidson; John A Joska; Kristen S Regenauer; Emily Satinsky; Lena S Andersen; C J Seitz-Brown; Christina P C Borba; Steven A Safren; Bronwyn Myers Journal: Int J Drug Policy Date: 2019-05-10
Authors: Margaret W Gichane; Wendee M Wechsberg; Jacqueline Ndirangu; Felicia A Browne; Courtney Peasant Bonner; Ashraf Grimwood; Najma Shaikh; Brittni Howard; William A Zule Journal: Drug Alcohol Depend Date: 2020-08-01 Impact factor: 4.492
Authors: Jessica F Magidson; Lena S Andersen; Emily N Satinsky; Bronwyn Myers; Ashraf Kagee; Morgan Anvari; John A Joska Journal: Psychotherapy (Chic) Date: 2019-10-31