MRC PhD students

Level of study: PhD

Title: Substance abuse practices among patients attending HIV clinics in the greater Cape Town: developing an intervention for the integration of substance abuse services into HIV clinics.

There is a growing body of research on the link between substance abuse and HIV, globally and in South Africa.  Integrated intervention approaches are needed for several reasons: First, substance abuse may impair people’s judgment and decision making processes which could lead to risky sexual behaviour which could increase the risk of HIV infection. Second, to decrease re-infection in people who are HIV positive. Third, to increase people’s adherence to anti-retroviral medication regimens.  Fourth, to decrease mechanisms whereby substance abuse can speed up the progression of HIV to AIDS.

In South Africa the integration of substance abuse and HIV services are very limited, with only a few substance abuse service providers incorporating HIV related interventions. Furthermore, HIV service providers rarely include substance abuse interventions in their programmes. Thus, people living with HIV and with substance abuse who attend HIV clinics may receive treatment only for their HIV status and would have to seek substance abuse treatment at another treatment facility.  This often discourages persons from seeking help for more than one problem.

Specific aims of the project are:

1. To investigate the nature and extent of substance abuse among patients attending HIV clinics in the Cape Metropole.
2. 1. To ascertain the extent to which substance use is assessed at HIV clinics.
   2. To assess the extent/level of training that staff working at HIV clinics have received on substance abuse.
   3. To assess the extent to which substance abuse is considered when putting patients on ARV’s and addressing medication compliance.
   4. To understand the factors within clinics that could hinder roll-out of a more integrated service.
3. To design an intervention strategy that would improve the way in which substance abuse is addressed in HIV clinics.
4. To provide recommendations for policy/practice changes to improve integration of substance abuse issues into HIV and AIDS service provision

Supervisor: Prof. Charles Parry, MRC Unit: Alcohol & Drug Abuse Research Unit
Study Institution: University of Stellenbosch