HIV infections can be prevented by reducing substance use and gender-based violence in high-risk populations

CAPE TOWN, South Africa — Researchers from RTI International and the South African Medical Research Council's (SAMRC) Alcohol, Tobacco and Other Drug Research Unit presented findings from two intervention studies that showed that HIV infections can be prevented by reducing substance use and gender-based violence among high-risk populations.

The findings were presented at a policy forum co-hosted by RTI and SAMRC to address the state of populations most-at-risk for HIV in Cape Town, South Africa. 

The studies aimed to reduce behavioral risks for HIV among high-risk women and couples from poor communities in the Western Cape.  The studies tested a brief, two session intervention that empowered participants with information and skills to reduce their substance use, risks for victimization and sexual risk behaviors.  

Results from the Women's Health CoOp study show that women who participated in the intervention were significantly more likely to be drug-free than women who did not.  Women living with HIV who received the intervention were also more likely to be abstinent from alcohol than HIV-positive women in the control group. 

However, findings also show that to realize the potential of this intervention for reducing substance-related risks for HIV among women, more work is needed to link women to substance abuse treatment, employment and other income generation opportunities to help them sustain these positive changes to their substance use. The findings also show that more needs to be done to link women with histories of victimization to mental health services. 

Similarly, results from the Couples Health CoOp study show that men who received this intervention together with their main relationship partner were less likely to drink heavily and were more likely to report protected sex than men in the control groups. These behavior changes impacted the rate of HIV occurrence among women, with lower rates of HIV incidence among women in the Couples Health CoOp intervention. These findings suggest that there is an added prevention benefit to engaging couples in HIV prevention interventions. 

The findings show that through reducing substance use and sexual risk behavior, interventions can impact HIV incidence rates in high-risk populations. These findings are particularly significant in South Africa where substance use is highly prevalent and HIV incidence continues to be unacceptably high, particularly among young women of reproductive age. 

"Our research has demonstrated that multilevel HIV prevention interventions have the potential to reduce the spread of HIV among most-at-risk vulnerable populations," said Wendee Wechsberg, Ph.D., director of Substance Abuse Treatment Evaluations and Interventions at RTI and lead of the NIH-funded Women's Health CoOp and Couples Health CoOp studies. "What is needed now is a coordinated effort to make these interventions widely available in communities, substance use treatment services and health care settings. Whether you are a policymaker, or clinician, health care administrator or public health planner, you can take steps to begin protecting vulnerable populations from HIV by implementing these interventions."