Experiences of Violence and Association with Decreased Drug Abstinence Among Women in Cape Town, South Africa

Abstract

Drug abuse is a contributing factor in women’s HIV risk in low-income communities in Cape Town, South Africa. This study assessed whether experiencing violence is associated with reduced drug abstinence among adult women (n = 603) participating in a randomized field trial for an HIV prevention study in Cape Town. In relation to drug abstinence at 12-month follow-up, multivariable regression models were used to assess (1) baseline partner and non-partner victimization, and (2) victimization at 12-month follow-up among participants reporting baseline victimization. Baseline partner (AOR = 0.6; 95 % CI 0.4–0.9) and non-partner victimization (AOR = 0.6; 95 % CI 0.4–0.9) were associated with a reduced likelihood of drug abstinence at follow-up. Among participants who reported victimization at baseline, those no longer reporting victimization at follow-up did not differ significantly in drug abstinence compared with those who reported victimization at follow-up. The study findings highlight the lasting impact of victimization on women’s drug use outcomes, persisting regardless of whether violence was no longer reported at follow-up. Overall, the findings support the need for the primary prevention of violence to address the cycle of violence, drug use, and HIV among women in this setting.

Correlates of Lifetime Trauma Exposure Among Pregnant Women from Cape Town, South Africa

“…Given the cross-sectional nature of the data and evidence from our earlier studies that substance use increases risk for victimisation (Wechsberg et al, 2013), it is possible that lifetime substance use may have preceded exposure to trauma. Even if this is the case, given the negative impact of trauma exposure on women's ability to quit substance use (Reed, Myers, Novak, Browne, & Wechsberg, 2014), and our finding that almost a third of trauma-exposed pregnant women reported current substance use, efforts to mitigate the consequences of trauma exposure should include screening, brief interventions, and referral to treatment for substance use.…”

Relationship power, communication, and violence among couples: results of a cluster-randomized HIV prevention study in a South African township

“… 3 , 4 Alcohol and other drug use may exacerbate the effect of gender power imbalances and IPV on HIV risk. 5 , 6 …”

Aggressive behaviour among drug-using women from Cape Town, South Africa: ethnicity, heavy alcohol use, methamphetamine and intimate partner violence

“…Another major finding was that participants who had experienced recent violence by their main sexual partner were significantly more likely to exhibit verbal and physical aggression. This is not altogether surprising, since research has found that substance-using women in the Western Cape are at increased risk of interpersonal violence [ 10 ]. It is possible that being the victim of intimate partner violence may result in women becoming aggressive and violent themselves [ 16 ] if this trauma is left untreated.…”

“…There is a high prevalence of violence against women in some communities in the Western Cape. including among substance-using women whom studies have shown are especially vulnerable to interpersonal violence [ 10 , 11 ]. While traditionally men who engage in this type of violence have often witnessed it in their childhood and therefore hold traditional views on gender-norms, such gender-disparities in violence perpetration are likely to shift as traditional gender roles in South Africa evolve [ 12 , 13 ].…”