Courtney Peasant Bonner1, Felicia A Browne1, Jacqueline W Ndirangu2, Brittni Howard1, William A Zule1, Ilene S Speizer3, Tracy Kline4, Wendee M Wechsberg1,3,5,6. 1. Substance Use, Gender, and Applied Research Program, RTI International , Research Triangle Park , NC , USA. 2. Substance Use, Gender, and Applied Research Program, RTI International , Washington , DC , USA. 3. Gillings School of Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA. 4. Social Statistics Program, RTI International , Research Triangle Park , NC , USA. 5. Psychology in the Public Interest, North Carolina State University , Raleigh , NC , USA. 6. Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham , NC , USA.
Abstract
Objective: South Africa has the highest prevalence of HIV among women, the highest prevalence of gender-based violence (GBV), and the highest rates of per capita alcohol consumption in the world. The nuanced associations between GBV, alcohol misuse, and HIV must be explored and protective factors identified. This study examines the associations between physical and sexual GBV and HIV infection and explores how alcohol misuse and sexual agency may mediate the GBV-HIV association. Method: Participants were 361 Black African women (Mean age = 28.39, SD = 7.92) who reported using alcohol and/or drugs weekly in the past 3 months, engaging in condomless sex, and having a boyfriend. Women were recruited from disadvantaged communities in Pretoria, South Africa. Individuals who met the eligibility criteria and enrolled in the study consented and completed a computer-assisted personal interview assessing GBV, alcohol misuse, and sexual agency and underwent HIV testing (i.e., blood test). Results: The indirect effect of physical assault on HIV status at enrollment through alcohol misuse was significant (log odds = 0.23, SE = 0.12, 95% CI [0.0151, 0.4998]). Conclusions: HIV prevention efforts focusing on reducing alcohol misuse may be more effective, which might reduce the HIV burden among this group of vulnerable South African women.
Objective: South Africa has the highest prevalence of HIV among women, the highest prevalence of gender-based violence (GBV), and the highest rates of per capita alcohol consumption in the world. The nuanced associations between GBV, alcohol misuse, and HIV must be explored and protective factors identified. This study examines the associations between physical and sexual GBV and HIV infection and explores how alcohol misuse and sexual agency may mediate the GBV-HIV association. Method: Participants were 361 Black African women (Mean age = 28.39, SD = 7.92) who reported using alcohol and/or drugs weekly in the past 3 months, engaging in condomless sex, and having a boyfriend. Women were recruited from disadvantaged communities in Pretoria, South Africa. Individuals who met the eligibility criteria and enrolled in the study consented and completed a computer-assisted personal interview assessing GBV, alcohol misuse, and sexual agency and underwent HIV testing (i.e., blood test). Results: The indirect effect of physical assault on HIV status at enrollment through alcohol misuse was significant (log odds = 0.23, SE = 0.12, 95% CI [0.0151, 0.4998]). Conclusions: HIV prevention efforts focusing on reducing alcohol misuse may be more effective, which might reduce the HIV burden among this group of vulnerable South African women.
Entities:
Keywords:
Alcohol abuse; HIV; South Africa; empowerment; protective factors; sexual negotiation; women
Authors: Wendee M Wechsberg; Winnie K Luseno; Rhonda S Karg; Siobhan Young; Nathaniel Rodman; Bronwyn Myers; Charles D H Parry Journal: Int J Drug Policy Date: 2008-01-18
Authors: Kristin L Dunkle; Rachel K Jewkes; Heather C Brown; Glenda E Gray; James A McIntryre; Siobán D Harlow Journal: Lancet Date: 2004-05-01 Impact factor: 79.321
Authors: Wendee M Wechsberg; Isa van der Drift; Brittni N Howard; Bronwyn Myers; Felicia A Browne; Courtney Peasant Bonner; Tara Carney; Jacqueline Ndirangu; Yukiko Washio Journal: Int J Environ Res Public Health Date: 2022-07-16 Impact factor: 4.614