HHS Public Access Author manuscript Author Manuscript
Drug Alcohol Rev. Author manuscript; available in PMC 2017 September 01. Published in final edited form as: Drug Alcohol Rev. 2016 September ; 35(5): 580–583. doi:10.1111/dar.12371.
HIV testing and sero-prevalence among methamphetamine users seeking substance abuse treatment in Cape Town
Author Manuscript
Hetta Gouse, PhD1 [Senior Researcher], John A. Joska, MBChB, MMed (psych), PhD, FC Psych (SA)2 [Associate Professor and Director], Ryan R. Lion, MSc3 [Graduate Research Assistant], Melissa H. Watt, PhD3 [Assistant Professor], Warren Burnhams, MAHWM4 [Supervisor], Adam W. Carrico, Ph.D5 [Assistant Professor], and Christina S. Meade, PhD6 [Associate Professor] 1Department
of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
2HIV
Mental Health Research Unit, Division of Neuropsychiatry, University of Cape Town, Cape Town, South Africa 3Duke
Global Health Institute, Duke University, Durham, NC, USA
4Substance 5School
Abuse, City Health, City of Cape Town, South Africa
of Nursing, University of California, San Francisco, CA, USA
6Department
of Psychiatry & Behavioral Sciences and Duke Global Health Institute, Duke University School of Medicine, Durham, NC, USA
Author Manuscript
Abstract Introduction and Aims—Methamphetamine use is highly prevalent in parts of South Africa, and there is concern this will contribute to the country’s substantial HIV epidemic. We examined the feasibility of implementing routine HIV testing at a community-based substance abuse treatment centre in Cape Town, and determined the HIV sero-prevalence among methamphetamine users seeking treatment at this site. Design and Methods—In this cross-sectional study, 293 participants completed measures of demographics, substance use and HIV treatment. HIV sero-prevalence was determined by a rapid finger-prick HIV test, and prior HIV diagnosis was confirmed via clinic records.
Author Manuscript
Results—The majority of participants were male and self-identified as “Coloured,” with a mean age of 28. The HIV sero-prevalence was 3.8%. Of the 11 participants who tested HIV-positive, four were newly diagnosed. HIV-positive and HIV-negative participants were comparable on demographic and substance use factors. Uptake of HIV testing among all clients at the drug treatment centre increased from 27) risk for methamphetamine-related health problems. The demographics questionnaire assessed gender, age, race, marital status, education, employment and drug treatment history. A selfreport questionnaire assessed history of HIV testing and treatment. For HIV-positive participants, prior diagnosis and treatment information were also extracted from clinic records. Data analysis
Author Manuscript
Descriptive statistics were calculated for demographics, substance abuse and HIV seroprevalence. We compared the HIV-positive and HIV-negative participants on these variables using t-tests (continuous variables), chi-square tests (categorical variables) and Fisher’s exact tests (categorical variables with expected frequencies ≤5). To assess feasibility of implementing routine HIV testing, we determined the proportion of participants who refused an HIV test. We also compared HIV testing rates before study initiation versus after its closure using clinic-level data provided by the municipal health department.
Drug Alcohol Rev. Author manuscript; available in PMC 2017 September 01.
Gouse et al.
Page 4
Author Manuscript
Results The sample included 116 women and 177 men ranging in age from 18 to 54 years [mean = 28, SD = 6.27]. Most were Coloured (99%), not married (72%), currently unemployed (86%) and seeking drug treatment for the first time (71%). In addition to methamphetamine, many reported concurrent use of alcohol (48%), marijuana (64%) and Mandrax (methaqualone) (42%).
Author Manuscript
HIV sero-prevalence was 3.8%. Of the 11 participants who tested positive, four (36%) were newly diagnosed. Of those with a new HIV diagnosis, 25% had no prior history of HIV testing. HIV was diagnosed on average 5.5 years (SD= 5.3) following initial methamphetamine use; only one participant reported receiving an HIV diagnosis before initiating methamphetamine use. The mean recent CD4 cell count was 479 (SD= 291.9, range= 118–1107, n= 10). Among the seven participants with a previous diagnosis, four (57%) were on antiretroviral therapy. The HIV-positive and HIV-negative groups were comparable in all respects (see Table 1). Prior to study initiation, clients were simply informed that HIV testing was available at the health centre. Uptake of HIV testing on this basis was very low; staff estimated that it was
Drug Alcohol Rev. Author manuscript; available in PMC 2017 September 01. Published in final edited form as: Drug Alcohol Rev. 2016 September ; 35(5): 580–583. doi:10.1111/dar.12371.
HIV testing and sero-prevalence among methamphetamine users seeking substance abuse treatment in Cape Town
Author Manuscript
Hetta Gouse, PhD1 [Senior Researcher], John A. Joska, MBChB, MMed (psych), PhD, FC Psych (SA)2 [Associate Professor and Director], Ryan R. Lion, MSc3 [Graduate Research Assistant], Melissa H. Watt, PhD3 [Assistant Professor], Warren Burnhams, MAHWM4 [Supervisor], Adam W. Carrico, Ph.D5 [Assistant Professor], and Christina S. Meade, PhD6 [Associate Professor] 1Department
of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
2HIV
Mental Health Research Unit, Division of Neuropsychiatry, University of Cape Town, Cape Town, South Africa 3Duke
Global Health Institute, Duke University, Durham, NC, USA
4Substance 5School
Abuse, City Health, City of Cape Town, South Africa
of Nursing, University of California, San Francisco, CA, USA
6Department
of Psychiatry & Behavioral Sciences and Duke Global Health Institute, Duke University School of Medicine, Durham, NC, USA
Author Manuscript
Abstract Introduction and Aims—Methamphetamine use is highly prevalent in parts of South Africa, and there is concern this will contribute to the country’s substantial HIV epidemic. We examined the feasibility of implementing routine HIV testing at a community-based substance abuse treatment centre in Cape Town, and determined the HIV sero-prevalence among methamphetamine users seeking treatment at this site. Design and Methods—In this cross-sectional study, 293 participants completed measures of demographics, substance use and HIV treatment. HIV sero-prevalence was determined by a rapid finger-prick HIV test, and prior HIV diagnosis was confirmed via clinic records.
Author Manuscript
Results—The majority of participants were male and self-identified as “Coloured,” with a mean age of 28. The HIV sero-prevalence was 3.8%. Of the 11 participants who tested HIV-positive, four were newly diagnosed. HIV-positive and HIV-negative participants were comparable on demographic and substance use factors. Uptake of HIV testing among all clients at the drug treatment centre increased from 27) risk for methamphetamine-related health problems. The demographics questionnaire assessed gender, age, race, marital status, education, employment and drug treatment history. A selfreport questionnaire assessed history of HIV testing and treatment. For HIV-positive participants, prior diagnosis and treatment information were also extracted from clinic records. Data analysis
Author Manuscript
Descriptive statistics were calculated for demographics, substance abuse and HIV seroprevalence. We compared the HIV-positive and HIV-negative participants on these variables using t-tests (continuous variables), chi-square tests (categorical variables) and Fisher’s exact tests (categorical variables with expected frequencies ≤5). To assess feasibility of implementing routine HIV testing, we determined the proportion of participants who refused an HIV test. We also compared HIV testing rates before study initiation versus after its closure using clinic-level data provided by the municipal health department.
Drug Alcohol Rev. Author manuscript; available in PMC 2017 September 01.
Gouse et al.
Page 4
Author Manuscript
Results The sample included 116 women and 177 men ranging in age from 18 to 54 years [mean = 28, SD = 6.27]. Most were Coloured (99%), not married (72%), currently unemployed (86%) and seeking drug treatment for the first time (71%). In addition to methamphetamine, many reported concurrent use of alcohol (48%), marijuana (64%) and Mandrax (methaqualone) (42%).
Author Manuscript
HIV sero-prevalence was 3.8%. Of the 11 participants who tested positive, four (36%) were newly diagnosed. Of those with a new HIV diagnosis, 25% had no prior history of HIV testing. HIV was diagnosed on average 5.5 years (SD= 5.3) following initial methamphetamine use; only one participant reported receiving an HIV diagnosis before initiating methamphetamine use. The mean recent CD4 cell count was 479 (SD= 291.9, range= 118–1107, n= 10). Among the seven participants with a previous diagnosis, four (57%) were on antiretroviral therapy. The HIV-positive and HIV-negative groups were comparable in all respects (see Table 1). Prior to study initiation, clients were simply informed that HIV testing was available at the health centre. Uptake of HIV testing on this basis was very low; staff estimated that it was
