Substance use referral, treatment utilization, and patient costs associated with problematic substance use in people living with HIV in Cape Town, South Africa

Belus, Jennifer M.; Regenauer, Kristen S.; Hutman, Elizabeth; Rose, Alexandra L.; Burnhams, Warren; Andersen, Lena S.; Myers, Bronwyn; Joska, John; Magidson, Jessica F.

doi:10.1016/j.dadr.2022.100035

Cited by 3 publications

(2 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, referral systems and support structures were described as lacking in healthcare facilities and in the community. This is not surprising as other studies have highlighted the lack of referral pathways for patients attending primary care clinics who disclose problems related to alcohol use (34,35). Unclear or non-existent guidelines for referring women for non-medical reasons related to alcohol use limits the extent to which women are able to access the services they need.…”

Section: Discussionmentioning

confidence: 99%

Community-based counselling programme for pregnant women with alcohol problems in Cape Town, South Africa: a qualitative study of the views of pregnant women and healthcare professionals

et al. 2023

Self Cite

View full text Add to dashboard Cite

IntroductionSouth Africa lacks services to detect and address alcohol use during pregnancy, particularly outside of health-care facilities. This study aimed to explore pregnant women and healthcare providers’ perceptions of the acceptability, feasibility and appeal of a community-based counselling programme for pregnant women with alcohol problems.MethodsTwenty-eight in-depth interviews with pregnant women who drink, Community Health Workers (CHWs) and antenatal service providers were conducted. Transcribed interviews were analyzed thematically using a combined deductive and inductive approach.ResultsWomen reported feeling uncomfortable seeking help for their alcohol use at antenatal clinics, limiting usefulness of current support services. All stakeholders perceived a community-based intervention to be acceptable and feasible as it could be integrated with other CHW-delivered services. Participants thought an intervention should facilitate early linkage to antenatal services and should include partners or family members. The feasibility of an intervention may depend on the relationship between CHWs and clinic-based antenatal staff, and their relationships with pregnant women. Clinic and community challenges to implementation were raised. Clinic-level challenges included shortage of space, staff capacity, high number of pregnant women, long waiting times, financial burden of having to travel to a clinic, lack of comfort and privacy and staff attitudes. Community-level challenges included crime, lack of privacy, lack of attention given competing interests in the home, fear due to abuse, and stigma and discrimination from other community members. Suggestions for overcoming these challenges were provided.ConclusionFindings provide essential information to facilitate the adaptation of a community-based alcohol counselling programme for greater acceptability, feasibility and cultural appropriateness for the South African context. Intensive training, supervision and support is required to ensure the programme is delivered as planned.

show abstract

Section: Discussionmentioning

confidence: 99%

Community-based counselling programme for pregnant women with alcohol problems in Cape Town, South Africa: a qualitative study of the views of pregnant women and healthcare professionals

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Non-specialists in HIV/TB care also face systemic frustrations when providing MH or SU care, which likely impact stress. For instance, HIV care providers in South Africa reported that referral processes to formal MH/SU services were unclear or time-consuming, even when such referrals were to a co-located clinic (Sorsdahl et al, 2021 ; Belus et al, 2022 ). Additionally, when task sharing of MH/SU services is implemented without providing additional support or appropriate compensation to non-specialists, this can be perceived as “task dumping,” increasing their work-related stress (Jacobs et al, 2021 ; Sorsdahl et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“Early in the morning, there’s tolerance and later in the day it disappears” – The intersection of resource scarcity, stress and stigma in mental health and substance use care in South Africa

Hines,

Rose,

Regenauer

et al. 2024

Camb. prisms Glob. ment. health

Self Cite

View full text Add to dashboard Cite

Stress is a challenge among non-specialist health workers worldwide, particularly in low-resource settings. Understanding and targeting stress is critical for supporting non-specialists and their patients, as stress negatively affects patient care. Further, stigma toward mental health and substance use conditions also impacts patient care. However, there is little information on the intersection of these factors. This sub-analysis aims to explore how substance use and mental health stigma intersect with provider stress and resource constraints to influence the care of people with HIV/TB. We conducted semi-structured interviews (N=30) with patients (n=15) and providers (n=15, non-specialist health workers) within a low-resource community in Cape Town, South Africa. Data were analyzed using thematic analysis. Three key themes were identified: (1) resource constraints negatively affect patient care and contribute to non-specialist stress; (2) in the context of stress, non-specialists are hesitant to work with patients with mental health or substance use concerns, who they view as more demanding and (3) stress contributes to provider stigma, which negatively impacts patient care. Findings highlight the need for multilevel interventions targeting both provider stress and stigma toward people with mental health and substance use concerns, especially within the context of non-specialist-delivered mental health services in low-resource settings.

show abstract

Strategies for supporting the implementation of a task-shared psychological intervention in South Africa’s chronic disease services: qualitative insights from health managers’ experiences of project MIND

Brooke-Sumner

Williams

Sorsdahl

et al. 2022

Global Health Action

View full text Add to dashboard Cite

Substance use referral, treatment utilization, and patient costs associated with problematic substance use in people living with HIV in Cape Town, South Africa

Cited by 3 publications

References 45 publications

Community-based counselling programme for pregnant women with alcohol problems in Cape Town, South Africa: a qualitative study of the views of pregnant women and healthcare professionals

Community-based counselling programme for pregnant women with alcohol problems in Cape Town, South Africa: a qualitative study of the views of pregnant women and healthcare professionals

“Early in the morning, there’s tolerance and later in the day it disappears” – The intersection of resource scarcity, stress and stigma in mental health and substance use care in South Africa

Strategies for supporting the implementation of a task-shared psychological intervention in South Africa’s chronic disease services: qualitative insights from health managers’ experiences of project MIND

Contact Info

Product

Resources

About