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Erschienen in: AIDS and Behavior 2/2010

01.04.2010 | Original Research

Stress, Substance Use and Sexual Risk Behaviors Among Primary Care Patients in Cape Town, South Africa

verfasst von: Lyndsay Ammon Avalos, Jennifer R. Mertens, Catherine L. Ward, Alan J. Flisher, Graham F. Bresick, Constance M. Weisner

Erschienen in: AIDS and Behavior | Ausgabe 2/2010

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Abstract

We assessed the relationship between stress, substance use and sexual risk behaviors in a primary care population in Cape Town, South Africa. A random sample of participants (and over-sampled 18–24-year-olds) from 14 of the 49 clinics in Cape Town’s public health sector using stratified random sampling (n = 2,618), was selected. We evaluated current hazardous drug and alcohol use and three domains of stressors (Personal Threats, Lacking Basic Needs, and Interpersonal Problems). Several personal threat stressors and an interpersonal problem stressor were related to sexual risk behaviors. With stressors included in the model, hazardous alcohol use, but not hazardous drug use, was related to higher rates of sexual risk behaviors. Our findings suggest a positive screening for hazardous alcohol use should alert providers about possible sexual risk behaviors and vice versa. Additionally, it is important to address a broad scope of social problems and incorporate stress and substance use in HIV prevention campaigns.
Literatur
Zurück zum Zitat Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109, 186–204.PubMed Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109, 186–204.PubMed
Zurück zum Zitat Biglan, A., Metzler, C. W., Wirt, R., Ary, D., Noell, J., Ochs, L., et al. (1990). Social and behavioral factors associated with high-risk sexual behavior among adolescents. Journal of Behavioral Medicine, 13, 245–261. doi:10.1007/BF00846833.CrossRefPubMed Biglan, A., Metzler, C. W., Wirt, R., Ary, D., Noell, J., Ochs, L., et al. (1990). Social and behavioral factors associated with high-risk sexual behavior among adolescents. Journal of Behavioral Medicine, 13, 245–261. doi:10.​1007/​BF00846833.CrossRefPubMed
Zurück zum Zitat Bradshaw, D., Pettifor, A., MacPhail, C., & Dorrington, R. (2004). Trends in youth risk for HIV. In P. Ijumba, C. Day, & A. Ntuli (Eds.), South African health review 2003/2004 (pp. 136–145). Durban: Health Systems Trust. Bradshaw, D., Pettifor, A., MacPhail, C., & Dorrington, R. (2004). Trends in youth risk for HIV. In P. Ijumba, C. Day, & A. Ntuli (Eds.), South African health review 2003/2004 (pp. 136–145). Durban: Health Systems Trust.
Zurück zum Zitat Dorrington, R. E., Johnson, L. F., Bradshaw, D., & Daniel, T. (2006). The demographic impact of HIV/AIDS in South Africa. National and provincial indicators for 2006. Cape Town: Center for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa. Dorrington, R. E., Johnson, L. F., Bradshaw, D., & Daniel, T. (2006). The demographic impact of HIV/AIDS in South Africa. National and provincial indicators for 2006. Cape Town: Center for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa.
Zurück zum Zitat Flisher, A. J., Kramer, R. A., Hoven, C. W., King, R. A., Bird, H. R., Davies, M., et al. (2000). Risk behavior in a community sample of children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 881–887. doi:10.1097/00004583-200007000-00017.CrossRefPubMed Flisher, A. J., Kramer, R. A., Hoven, C. W., King, R. A., Bird, H. R., Davies, M., et al. (2000). Risk behavior in a community sample of children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 881–887. doi:10.​1097/​00004583-200007000-00017.CrossRefPubMed
Zurück zum Zitat Henry-Edwards, S., Humeniuk, R., Ali, R., Poznyak, V., & Monteiro, M. (2003). The alcohol, smoking and substance involvement screening test (ASSIST): Guidelines for use in primary care (Version 5). Geneva: World Health Organization. Henry-Edwards, S., Humeniuk, R., Ali, R., Poznyak, V., & Monteiro, M. (2003). The alcohol, smoking and substance involvement screening test (ASSIST): Guidelines for use in primary care (Version 5). Geneva: World Health Organization.
Zurück zum Zitat Hilbe, J. M. (2007). Negative binomial regression. Cambridge: Cambridge University. Hilbe, J. M. (2007). Negative binomial regression. Cambridge: Cambridge University.
Zurück zum Zitat Hingson, R. W., Strunin, L., Berlin, B. M., & Heeren, T. (1990). Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents. American Journal of Public Health, 80, 295–299. doi:10.2105/AJPH.80.3.295.CrossRefPubMed Hingson, R. W., Strunin, L., Berlin, B. M., & Heeren, T. (1990). Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents. American Journal of Public Health, 80, 295–299. doi:10.​2105/​AJPH.​80.​3.​295.CrossRefPubMed
Zurück zum Zitat House, J. S., Robbins, C., & Metzner, H. L. (1982). The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology, 116, 123–140.PubMed House, J. S., Robbins, C., & Metzner, H. L. (1982). The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology, 116, 123–140.PubMed
Zurück zum Zitat Kalichman, S. C., Cain, D., Zweben, A., & Swain, G. (2003). Sensation seeking, alcohol use and sexual risk behaviors among men receiving services at a clinic for sexually transmitted infections. Journal of Studies on Alcohol, 64, 564–569.PubMed Kalichman, S. C., Cain, D., Zweben, A., & Swain, G. (2003). Sensation seeking, alcohol use and sexual risk behaviors among men receiving services at a clinic for sexually transmitted infections. Journal of Studies on Alcohol, 64, 564–569.PubMed
Zurück zum Zitat Kalichman, S. C., Simbayi, L. C., Jooste, S., Cain, D., & Cherry, C. (2006a). Sensation seeking, alcohol use, and sexual behaviors among sexually transmitted infection clinic patients in Cape Town, South Africa. Psychology of Addictive Behaviors, 20, 298–304. doi:10.1037/0893-164X.20.3.298.CrossRefPubMed Kalichman, S. C., Simbayi, L. C., Jooste, S., Cain, D., & Cherry, C. (2006a). Sensation seeking, alcohol use, and sexual behaviors among sexually transmitted infection clinic patients in Cape Town, South Africa. Psychology of Addictive Behaviors, 20, 298–304. doi:10.​1037/​0893-164X.​20.​3.​298.CrossRefPubMed
Zurück zum Zitat Kalichman, S. C., Simbayi, L. C., Jooste, S., Cherry, C., & Cain, D. (2005). Poverty-related stressors and HIV/AIDS transmission risks in two South African communities. Journal of Urban Health, 82, 237–249. doi:10.1093/jurban/jti048.PubMed Kalichman, S. C., Simbayi, L. C., Jooste, S., Cherry, C., & Cain, D. (2005). Poverty-related stressors and HIV/AIDS transmission risks in two South African communities. Journal of Urban Health, 82, 237–249. doi:10.​1093/​jurban/​jti048.PubMed
Zurück zum Zitat Kalichman, S. C., Simbayi, L. C., Kagee, A., Toefy, Y., Jooste, S., Cain, D., et al. (2006b). Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Social Science & Medicine, 62, 1641–1649. doi:10.1016/j.socscimed.2005.08.021.CrossRef Kalichman, S. C., Simbayi, L. C., Kagee, A., Toefy, Y., Jooste, S., Cain, D., et al. (2006b). Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Social Science & Medicine, 62, 1641–1649. doi:10.​1016/​j.​socscimed.​2005.​08.​021.CrossRef
Zurück zum Zitat Mnyika, K. S., Klepp, K. I., Kvale, G., & Ole-Kingori, N. (1997). Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania. International Journal of STD & AIDS, 8, 176–183. doi:10.1258/0956462971919840.CrossRef Mnyika, K. S., Klepp, K. I., Kvale, G., & Ole-Kingori, N. (1997). Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania. International Journal of STD & AIDS, 8, 176–183. doi:10.​1258/​0956462971919840​.CrossRef
Zurück zum Zitat Morojele, N. K., Kachieng’ab, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D. H., Nkowane, A. M., et al. (2006). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science & Medicine, 62, 217–227. doi:10.1016/j.socscimed.2005.05.031.CrossRef Morojele, N. K., Kachieng’ab, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D. H., Nkowane, A. M., et al. (2006). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science & Medicine, 62, 217–227. doi:10.​1016/​j.​socscimed.​2005.​05.​031.CrossRef
Zurück zum Zitat Newcombe, D. A., Humeniuk, R. E., & Ali, R. (2005). Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Report of results from the Australian site. Drug and Alcohol Review, 24, 217–226. doi:10.1080/09595230500170266.CrossRefPubMed Newcombe, D. A., Humeniuk, R. E., & Ali, R. (2005). Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Report of results from the Australian site. Drug and Alcohol Review, 24, 217–226. doi:10.​1080/​0959523050017026​6.CrossRefPubMed
Zurück zum Zitat Parry, C. D., Myers, B., & Pluddemann, A. (2004b). Drug policy for methamphetamine use urgently needed. South African Medical Journal, 94, 964–965.PubMed Parry, C. D., Myers, B., & Pluddemann, A. (2004b). Drug policy for methamphetamine use urgently needed. South African Medical Journal, 94, 964–965.PubMed
Zurück zum Zitat Rao, J. N. K., & Scott, A. J. (1984). On chi-squared tests for multiway contingency-tables with cell proportions estimated from survey data. Annals of Statistics, 12, 46–60. doi:10.1214/aos/1176346391.CrossRef Rao, J. N. K., & Scott, A. J. (1984). On chi-squared tests for multiway contingency-tables with cell proportions estimated from survey data. Annals of Statistics, 12, 46–60. doi:10.​1214/​aos/​1176346391.CrossRef
Zurück zum Zitat Sarason, I. G., Sarason, B. R., Potter, E. H., I. I. I., & Antoni, M. H. (1985). Life events, social support, and illness. Psychosomatic Medicine, 47, 156–163.PubMed Sarason, I. G., Sarason, B. R., Potter, E. H., I. I. I., & Antoni, M. H. (1985). Life events, social support, and illness. Psychosomatic Medicine, 47, 156–163.PubMed
Zurück zum Zitat 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, 291–300. doi:10.1080/14659890600625767.CrossRef 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, 291–300. doi:10.​1080/​1465989060062576​7.CrossRef
Zurück zum Zitat Simbayi, L. C., Kalichman, S. C., Jooste, S., Mathiti, V., Cain, D., & Cherry, C. (2004). Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Town, South Africa. Journal of Studies on Alcohol, 65, 434–442.PubMed Simbayi, L. C., Kalichman, S. C., Jooste, S., Mathiti, V., Cain, D., & Cherry, C. (2004). Alcohol use and sexual risks for HIV infection among men and women receiving sexually transmitted infection clinic services in Cape Town, South Africa. Journal of Studies on Alcohol, 65, 434–442.PubMed
Zurück zum Zitat Smit, J., Beksinska, M., Ramkissoon, A., Kunene, B., & Penn-Kekana, L. (2004). Reproductive health. In P. Ijumba, C. Day, & A. Ntuli (Eds.), South African review 2003/04 (pp. 59–81). Durban: Health Systems Trust. Smit, J., Beksinska, M., Ramkissoon, A., Kunene, B., & Penn-Kekana, L. (2004). Reproductive health. In P. Ijumba, C. Day, & A. Ntuli (Eds.), South African review 2003/04 (pp. 59–81). Durban: Health Systems Trust.
Zurück zum Zitat Smit, J., Myer, L., Middelkoop, K., Seedat, S., Wood, R., Bekker, L. G., et al. (2006). Mental health and sexual risk behaviours in a South African township: A community-based cross-sectional study. Public Health, 120, 534–542. doi:10.1016/j.puhe.2006.01.009.CrossRefPubMed Smit, J., Myer, L., Middelkoop, K., Seedat, S., Wood, R., Bekker, L. G., et al. (2006). Mental health and sexual risk behaviours in a South African township: A community-based cross-sectional study. Public Health, 120, 534–542. doi:10.​1016/​j.​puhe.​2006.​01.​009.CrossRefPubMed
Zurück zum Zitat Volkow, N. D., Wang, G. J., Fowler, J. S., Telang, F., Jayne, M., & Wong, C. (2007). Stimulant-induced enhanced sexual desire as a potential contributing factor in HIV transmission. The American Journal of Psychiatry, 164, 157–160. doi:10.1176/appi.ajp.164.1.157.CrossRefPubMed Volkow, N. D., Wang, G. J., Fowler, J. S., Telang, F., Jayne, M., & Wong, C. (2007). Stimulant-induced enhanced sexual desire as a potential contributing factor in HIV transmission. The American Journal of Psychiatry, 164, 157–160. doi:10.​1176/​appi.​ajp.​164.​1.​157.CrossRefPubMed
Zurück zum Zitat Ward, C. L., Mertens, J. R., Flisher, A. J., Bresick, G. F., Sterling, S. A., Little, F., et al. (2008). Prevalence and correlates of substance use among South african primary care clinic patients. Substance Use & Misuse, 43, 1395–1410. doi:10.1080/10826080801922744.CrossRef Ward, C. L., Mertens, J. R., Flisher, A. J., Bresick, G. F., Sterling, S. A., Little, F., et al. (2008). Prevalence and correlates of substance use among South african primary care clinic patients. Substance Use & Misuse, 43, 1395–1410. doi:10.​1080/​1082608080192274​4.CrossRef
Zurück zum Zitat WHO ASSIST Working Group. (2002). The alcohol, smoking and substance involvement screening test (ASSIST): Development, reliability and feasibility. Addiction (Abingdon, England), 97, 1183–1194. doi:10.1046/j.1360-0443.2002.00185.x. WHO ASSIST Working Group. (2002). The alcohol, smoking and substance involvement screening test (ASSIST): Development, reliability and feasibility. Addiction (Abingdon, England), 97, 1183–1194. doi:10.​1046/​j.​1360-0443.​2002.​00185.​x.
Zurück zum Zitat Wong, F. Y., Huang, Z. J., DiGangi, J. A., Thompson, E. E., & Smith, B. D. (2008). Gender differences in intimate partner violence on substance abuse, sexual risks, and depression among a sample of South Africans in Cape Town, South Africa. AIDS Education and Prevention, 20, 56–64. doi:10.1521/aeap.2008.20.1.56.CrossRefPubMed Wong, F. Y., Huang, Z. J., DiGangi, J. A., Thompson, E. E., & Smith, B. D. (2008). Gender differences in intimate partner violence on substance abuse, sexual risks, and depression among a sample of South Africans in Cape Town, South Africa. AIDS Education and Prevention, 20, 56–64. doi:10.​1521/​aeap.​2008.​20.​1.​56.CrossRefPubMed
Zurück zum Zitat World Health Organization. (1998). International classification of primary care (ICPC-2) (2nd ed.). Geneva: World Health Organization. World Health Organization. (1998). International classification of primary care (ICPC-2) (2nd ed.). Geneva: World Health Organization.
Metadaten
Titel
Stress, Substance Use and Sexual Risk Behaviors Among Primary Care Patients in Cape Town, South Africa
verfasst von
Lyndsay Ammon Avalos
Jennifer R. Mertens
Catherine L. Ward
Alan J. Flisher
Graham F. Bresick
Constance M. Weisner
Publikationsdatum
01.04.2010
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 2/2010
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-009-9525-2

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