142nd APHA Annual Meeting and Exposition

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Promise of a couples' intervention in reducing alcohol and other drug use: Results from a cluster randomized trial in South Africa

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Wendee Wechsberg, Ph.D. , Substance Abuse Treatment Evaluations & Interventions Research, RTI International, Durham, NC
Alexandra Minnis, MPH, PhD , Women's Global Health Imperative, RTI International, San Francisco, CA
Irene Doherty, MPH, PhD , Substance Abuse Treatment Evaluations & Interventions, RTI International, Research Triangle Park, NC
William A. Zule, DrPH , Substance Abuse Treatment Evaluations and Interventions, RTI International, Research Triangle Park, NC
Jackie Ndirangu, MSC-GH , Substance Abuse Treatment Evaluations & Intervention Research Program, RTI International, Pretoria, South Africa
Bronwyn Myers, PhD , Alcohol and Drug Abuse Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
Tara Carney, MA , Alcohol & Drug Abuse Research Unit, Medical Research Council, Tygerberg (Cape Town), 7505, South Africa
Charles Parry, PhD , Alcohol and Drug Abuse Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
Background: Alcohol and other drug use (AOD) contribute to substantial morbidity among young South Africans and heighten risk for HIV and other adverse health outcomes. Adapted interventions were fielded with workshops conducted within each smaller community with couples living in a large high-density Cape Town township (R01AA018076).

Methods:  290 heterosexual couples recruited from drinking establishments in 30 neighborhoods were randomized to either: couple’s intervention; separate women’s and men’s group interventions; and women’s intervention only.  All participants received biological testing and completed baseline and six-month follow-up interviews with 94% completion. We used multivariable Poisson and logistic regression, adjusted for neighborhood clustering and baseline measures, to compare cannabis, methamphetamine, and alcohol use by gender between participants randomized to the couples’ intervention and those in the comparison groups.

Results: The mean age was 25 years. At baseline, 10% of women and 37% of men used cannabis, 4% of women and 15% of men used methamphetamine, and 31% of women and 70% of men reported frequent binge drinking. At follow-up, the odds of cannabis use was lower among women (OR=0.21; 95% CI: 0.05, 0.90) and men (OR=0.14; 95% CI: 0.07, 0.31) in the couples’ intervention relative to the comparison groups. Men in the couples’ intervention reported a lower odds of methamphetamine use (OR=0.28; 95% CI: 0.11, 0.68), and a lower rate of binge drinking (IRR: 0.75; 95% CI: 0.66, 0.85).

Conclusions: A couples-focused intervention led to reductions in cannabis use among women and men and reductions in methamphetamine use and binge drinking among men.

Learning Areas:

Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe differences by gender in alcohol and drug use among young Black South African couples in three types of intervention conditions. Demonstrate differences by gender in behavioral outcomes in alcohol and drug use in the experimental condition relative to the other two groups.

Keyword(s): Alcohol Use, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator on the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4179.0: Marijuana and Other Issues