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APHA Scientific Session and Event Listing

Lyndsay Ammon, MPH¹, Jennifer Mertens, MA², Catherine Ward, PhD³, Alan Flisher, PhD⁴, Graham Bresick, MD, MPH⁵, and Constance Weisner, DrPH, MSW². (1) Alcohol Research Group, 2000 Hearst Ave Ste 300, Berkeley, CA 94709, 510-642-5208, lammon@arg.org, (2) Drug and Alcohol Research Team, Kaiser Permanente Division of Research, 2000 Broadway, 3rd floor, Oakland, CA 94612, (3) Child, Youth, Family & Social Development, Human Sciences Research Council, Private Bag X9182, 12th Floor, Plein Park Building, Plein Street, Cape Town, South Africa, (4) Adolescent Health Research Centre, Department of Psychiatry and Mental Health, University of Cape Town, Anzio Rd, Observatory, Cape Town, 7925, South Africa, (5) Division of Family Medicine, Department of Public Health and Primary Health Care, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa

Background: To evaluate the relationship of hazardous substance use and poverty-related stressors to HIV risk behaviors. Methods: Participants (1,128 males and 1,490 females) were recruited and interviewed from 14 public primary care clinics in Cape Town, South Africa. Recruitment was conducted using a multi-stage clustered, stratified sampling design, with patients aged 18-24 over-sampled. Data were weighted to represent the public health system in Cape Town. Questions included information on demographics; sexual behaviors; substance use (Alcohol, Smoking, and Substance Involvement Screening Test, [ASSIST]); stress related to personal threats (e.g. had important things stolen), lacking basic needs (e.g. problems getting food/water) and interpersonal problems (e.g. problems with relationships). Results: Of the participants, 29% reported at least one sexual risk behavior. In bivariate analyses, hazardous substance use (n=557) was related to each (and more) sexual risk behavior. Due to the distribution of the sexual risk behavior variable, a negative binomial regression was fit to calculate incidence rate ratios (IRR). In the adjusted analysis, an increased rate of sexual risk behaviors was found for hazardous substance use (IRR=1.6, 95%CI: 1.02, 2.6), males (IRR=2.7, 95%CI: 2.0, 3.7) traditional disparity-related race groups of blacks vs coloureds (IRR=1.5, 95%CI: 1.1, 2.0) those aged 18-24 (IRR=1.4, 95%CI: 1.2,1.7) and various personal-threat stressors. A decreased rate of risky sexual behaviors was found for those with less than a highschool degree (IRR=0.6, 95%CI: 0.4, 0.8) and for multiple lacking basic needs stressors. Conclusions: HIV interventions should target hazardous substance users as well as people who have suffered personal threats.

Learning Objectives:

At the end of the presentation one, will be able to
• Describe the prevalence of HIV risk behaviors among primary health care patients in South Africa,
• Describe the relationship between hazardous substance use, poverty-related stressors and risky HIV behaviors,
• Discuss populations for targeted HIV risk interventions.

Keywords: Substance Abuse, International Public Health

Presenting author's disclosure statement:

Not Answered