PT  - JOURNAL ARTICLE
AU  - Wechsberg, Wendee M
AU  - Jewkes, Rachel
AU  - Novak, Scott P
AU  - Kline, Tracy
AU  - Myers, Bronwyn
AU  - Browne, Felicia A
AU  - Carney, Tara
AU  - Morgan Lopez, Antonio A
AU  - Parry, Charles
TI  - A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: a randomised trial of the Women’s Health CoOp
AID  - 10.1136/bmjopen-2013-002622
DP  - 2013 Jan 01
TA  - BMJ Open
PG  - e002622
VI  - 3
IP  - 5
4099  - http://bmjopen.bmj.com/content/3/5/e002622.short
4100  - http://bmjopen.bmj.com/content/3/5/e002622.full
SO  - BMJ Open2013 Jan 01; 3
AB  - Objective To assess the impact of the Women's Health CoOp (WHC) on drug abstinence among vulnerable women having HIV counselling and testing (HCT). Design Randomised trial conducted with multiple follow-ups. Setting 15 communities in Cape Town, South Africa. Participants 720 drug-using women aged 18–33, randomised to an intervention (360) or one of two control arms (181 and 179) with 91.9% retained at follow-up. Interventions The WHC brief peer-facilitated intervention consisted of four modules (two sessions), 2 h addressing knowledge and skills to reduce drug use, sex risk and violence; and included role-playing and rehearsal, an equal attention nutrition intervention, and an HCT-only control. Primary outcome measures Biologically confirmed drug abstinence measured at 12-month follow-up, sober at last sex act, condom use with main and casual sex partners, and intimate partner violence. Results At the 12-month endpoint, 26.9% (n=83/309) of the women in the WHC arm were abstinent from drugs, compared with 16.9% (n=27/160) in the Nutrition arm and 20% (n=31/155) in the HCT-only control arm. In the random effects model, this translated to an effect size on the log odds scale with an OR of 1.54 (95% CI 1.07 to 2.22) comparing the WHC arm with the combined control arms. Other 12-month comparison measures between arms were non-significant for sex risk and victimisation outcomes. At 6-month follow-up, women in the WHC arm (65.9%, 197/299) were more likely to be sober at the last sex act (OR1.32 (95% CI 1.02 to 1.84)) than women in the Nutrition arm (54.3%, n=82/152). Conclusions This is the first trial among drug-using women in South Africa showing that a brief intervention added to HCT results in greater abstinence from drug use at 12 months and a larger percentage of sexual activity not under the influence of substances. Trial registration number NCT00729391 ClinicalTrials.gov