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Article ; Online: Latent class analysis of substance use typologies associated with mental and sexual health outcomes among sexual and gender minority youth.

Tara Carney / Seul Ki Choi / Rob Stephenson / Jose A Bauermeister / Adam W Carrico

PLoS ONE, Vol 18, Iss 9, p e

2023 Volume 0290781

Abstract: Little is known about sexual and gender minority youth (SGMY) who have sex with men's unique patterns of substance use, even though they are at risk for substance use and adverse mental and other health outcomes. We used latent class analysis to examine ... ...

Abstract	Little is known about sexual and gender minority youth (SGMY) who have sex with men's unique patterns of substance use, even though they are at risk for substance use and adverse mental and other health outcomes. We used latent class analysis to examine typologies of substance use and multinomial logistic regression to investigate mental health outcomes (depression and anxiety) and HIV/STI testing correlates associated with different classes of substance use in a sample of SGMY who have sex with men in the USA and use substances (n = 414) who participated in an online survey. The average age was 22.50 years old (SD = 3.22). A four-class solution was identified representing: 'depressant and stimulant use' (3.4%), 'high polysubstance use' (4.6%), 'low substance use with moderate cannabis use' (79.2%), and 'high cannabis, stimulant and alcohol use' (12.8%). Membership to a specified substance use class varied by age, previous arrest, gender identity, anxiety, and lifetime HIV testing. Multivariate logistic regression results indicated that participants in the high polysubstance use (AOR = 5.48, 95% CI 1.51, 19.97) and high cannabis use class (AOR = 3.87, 95% CI 1.25, 11.94) were significantly more likely than those in the low substance use with moderate cannabis use class to report previous arrest. Those in the high polysubstance use class were also significantly less likely to have been tested for HIV than those in the low substance use with moderate cannabis use class (AOR = 0.21, 95% CI 0.05, 0.93). Findings will guide the development and implementation of tailored approaches to addressing the intersection of substance use and HIV risk among SGMY.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Latent class analysis of substance use typologies associated with mental and sexual health outcomes among sexual and gender minority youth

Tara Carney / Seul Ki Choi / Rob Stephenson / Jose A. Bauermeister / Adam W. Carrico

PLoS ONE, Vol 18, Iss

2023 Volume 9

Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Association of Recurrent and Multiple Types of Abuse with Adverse Mental Health, Substance Use, and Sexual Health Outcomes among Out-of-School Adolescent Girls and Young Women in Cape Town, South Africa

Bronwyn Myers / Felicia A. Browne / Tara Carney / Tracy Kline / Courtney Peasant Bonner / Wendee M. Wechsberg

International Journal of Environmental Research and Public Health, Vol 18, Iss 11403, p

2021 Volume 11403

Abstract: Although physical and sexual abuse exposure is a well-established risk for poor health, the dimensions of abuse associated with health among socially vulnerable adolescent girls and young women (AGYW) remain underexamined. This article describes ... ...

Abstract	Although physical and sexual abuse exposure is a well-established risk for poor health, the dimensions of abuse associated with health among socially vulnerable adolescent girls and young women (AGYW) remain underexamined. This article describes associations between combinations of abuse type and timing with mental health, substance use, and sexual risk outcomes among a sample of 499 AGYW (aged 16 to 19) who had left school early and were recruited for a cluster randomized trial in Cape Town, South Africa. Approximately one-third (33.5%; 95% CI: 28.7, 38.6) of participants reported lifetime abuse. Exposure to more than one type of abuse was associated with increased risk of depression (β = 3.92; 95% CI: 2.25, 5.59) and anxiety (β = 3.70; 95% CI: 2.11, 5.28), and greater odds of polydrug use (OR = 2.10; 95% CI: 1.02, 4.34) and substance-impaired sex (OR = 2.17; 95% CI: 1.31, 3.86). Exposure to multiple types of abuse during childhood/early adolescence and again in late adolescence was associated with increased risk of depression (β = 4.65; 95% CI: 3.15, 6.14), anxiety (β = 4.35; 95% CI: 2.70, 6.02), and polydrug use (OR = 2.37; 95% CI: 1.03, 5.73). Findings underscore the need for trauma-informed interventions that reduce mental health, substance use, and sexual risks among AGYW who have experienced multiple forms of abuse and recurrent abuse.
Keywords	young women ; mental health ; physical and sexual abuse ; gender-based violence ; substance use ; trauma-informed interventions ; Medicine ; R
Subject code	360
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ‘We have goals but [it is difficult]’. Barriers to antiretroviral therapy adherence among women using alcohol and other drugs living with HIV in South Africa

Jacqueline W. Ndirangu / Margaret W. Gichane / Felicia A. Browne / Courtney P. Bonner / William A. Zule / Erin N. Cox / Kevin M. Smith / Tara Carney / Wendee M. Wechsberg

Health Expectations, Vol 25, Iss 2, Pp 754-

2022 Volume 763

Abstract: Abstract Background Women living with HIV who misuse alcohol and live in economically disadvantaged settings in South Africa experience a multitude of contextual barriers as they navigate the HIV care continuum. The Women's Health CoOp (WHC), a brief, ... ...

Abstract	Abstract Background Women living with HIV who misuse alcohol and live in economically disadvantaged settings in South Africa experience a multitude of contextual barriers as they navigate the HIV care continuum. The Women's Health CoOp (WHC), a brief, woman‐focused, behavioural, evidence‐based intervention, has been shown to be effective in reducing heavy drinking and improving HIV‐related outcomes among this key population. However, these women face other broader socioecological barriers to antiretroviral therapy (ART) adherence. Methods The WHC was implemented in a modified, stepped‐wedge implementation science trial in public health clinics and substance use treatment programmes in Cape Town, South Africa. A qualitative substudy was conducted to explore barriers to HIV treatment adherence among women enrolled in this trial. Eight focus group discussions were conducted with 69 participants 6 months after completion of the WHC workshops. Focus groups were audio‐recorded (with consent), transcribed verbatim and analysed using a thematic approach. Results The mean age of the participants was 33 years and the mean self‐reported number of drinks per day was 13. The main contextual factors influencing participants’ ART adherence were intrapersonal‐level factors (substance use, financial constraints, food insecurity; community‐level factors (anticipated and enacted stigma, community violence) and institutional‐level factors (patient–provider relationships, health facility barriers, environmental stigma). Conclusion Comprehensive interventions addressing the contextual barriers and unique challenges faced by women who misuse alcohol in low‐resource settings that intersect with HIV treatment nonadherence should be implemented in tandem with successful biobehavioural HIV interventions for long‐term effectiveness and sustainability. Patient or Public Contribution Our South African community collaborative board has been involved throughout this study; participants and clinic staff voices have been essential in our ...
Keywords	alcohol and other drugs (AOD) ; antiretroviral therapy (ART) ; gender‐focused ; HIV care continuum ; implementation science ; socioecological barriers ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Reducing substance use and sexual risk behaviour among men who have sex with men in South Africa

Petal Petersen Williams / Tara Carney / Charles D.H. Parry

South African Journal of Science, Vol 112, Iss 9/10, Pp 5-

2016 Volume 5

Abstract: Men who have sex with men have been identified as a population at risk of acquiring and transmitting HIV. Studies in South Africa have reported a high prevalence of HIV, as well as high levels of alcohol and other drug use, among men who have sex with ... ...

Abstract	Men who have sex with men have been identified as a population at risk of acquiring and transmitting HIV. Studies in South Africa have reported a high prevalence of HIV, as well as high levels of alcohol and other drug use, among men who have sex with men, and the use of substances (alcohol and drugs) to facilitate their sexual encounters. Since 2007, interventions focused on prevention have been rolled out to vulnerable men who have sex with men and who also use alcohol or other drugs. The interventions include community-based outreach; provision of information on HIV/AIDS, substance abuse, and safer sex practices; and the development of risk-reduction plans. Among 195 men who participated in our study, there were significant reductions in the proportion who used cannabis and ecstasy, including the use of these drugs during sex. No reduction was observed in the use of any other substances. In general, after the intervention our participants reported less frequent use of alcohol and drugs and greater engagement in safer sexual practices. Despite these encouraging findings, the combination of substance use while engaging in sex had actually increased. The study findings suggest that interventions that target men who have sex with men, and who use alcohol and other drugs, could reduce risk behaviours in this population. Significance: • Contributes to knowledge about risk reduction strategies. • Describes strategies for reducing drug and sexual harm among men who have sex with men.
Keywords	HIV risk ; HIV intervention ; alcohol ; drugs ; Science ; Q ; Science (General) ; Q1-390 ; Social Sciences ; H ; Social sciences (General) ; H1-99
Subject code	360
Language	English
Publishing date	2016-09-01T00:00:00Z
Publisher	Academy of Science of South Africa
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Aggressive behaviour among drug-using women from Cape Town, South Africa

Tara Carney / Bronwyn Myers / Tracy L. Kline / Kim Johnson / Wendee M. Wechsberg

BMC Women's Health, Vol 17, Iss 1, Pp 1-

ethnicity, heavy alcohol use, methamphetamine and intimate partner violence

2017 Volume 7

Abstract: Abstract Background Women have generally been found to be the victims of violence, but scant attention has been paid to the characteristics of women who perpetrate aggression and violence. In South Africa, violence is a prevalent societal issue, ... ...

Abstract	Abstract Background Women have generally been found to be the victims of violence, but scant attention has been paid to the characteristics of women who perpetrate aggression and violence. In South Africa, violence is a prevalent societal issue, especially in the Western Cape. Method This study aimed at identifying factors that were associated with aggression among a sample of 720 substance-using women. We conducted multivariate logistic regression to identify factors that are significantly associated with these behaviours. Results Ethnicity (Wald Χ2 = 17.07(2), p < 0.01) and heavy drinking (Wald Χ2 = 6.60 (2), p = 0.01) were significantly related to verbal aggression, methamphetamine use was significantly related to physical (Wald Χ2 = 2.73 (2), p = 0.01) and weapon aggression (Wald Χ2 = 7.94 (2), p < 0.01) and intimate partner violence was significantly related to verbal (Wald Χ2 = 12.43 (2), p < 0.01) and physical aggression (Wald Χ2 = 25.92 (2), p < 0.01). Conclusions The findings show high levels of aggression among this sample, and highlight the need for interventions that address methamphetamine, heavy drinking and intimate partner violence among vulnerable substance-using women.
Keywords	Substance use ; Aggression ; Violence ; Women ; South Africa ; Gynecology and obstetrics ; RG1-991 ; Public aspects of medicine ; RA1-1270
Subject code	390
Language	English
Publishing date	2017-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Alcohol and Tobacco Use in a Tuberculosis Treatment Cohort during South Africa’s COVID-19 Sales Bans

Bronwyn Myers / Tara Carney / Jennifer Rooney / Samantha Malatesta / Laura F. White / Charles D. H. Parry / Tara C. Bouton / Elizabeth J. Ragan / Charles Robert Horsburgh / Robin M. Warren / Karen R. Jacobson

International Journal of Environmental Research and Public Health, Vol 18, Iss 5449, p

A Case Series

2021 Volume 5449

Abstract: Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants ...

Abstract	Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The timeline follow-back procedure and Fägerstrom test for nicotine dependence was used to collect monthly alcohol and tobacco use information. We report changes in heavy drinking days (HDD), average amount of absolute alcohol (AA) consumed per drinking day, and cigarettes smoked daily during the alcohol and tobacco ban compared to use prior to the ban. Results: Of the 61 participants for whom we have pre-ban and within-ban alcohol use information, 17 (27.9%) reported within-ban alcohol use. On average, participants reported one less HDD per fortnight (interquartile range (IQR): −4, 1), but their amount of AA consumed increased by 37.4 g per drinking occasion (IQR: −65.9 g, 71.0 g). Of 53 participants who reported pre-ban tobacco use, 17 (32.1%) stopped smoking during the ban. The number of participants smoking >10 cigarettes per day decreased from 8 to 1. Conclusions: From these observations, we hypothesize that policies restricting alcohol and tobacco availability seem to enable some individuals to reduce their consumption. However, these appear to have little effect on the volume of AA consumed among individuals with more harmful patterns of drinking in the absence of additional behavior change interventions.
Keywords	COVID ; alcohol sales ban ; South Africa ; heavy drinking ; alcohol policy ; Medicine ; R
Subject code	150
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL)

Tara Carney / Jennifer A. Rooney / Nandi Niemand / Bronwyn Myers / Danie Theron / Robin Wood / Laura F. White / Christina S. Meade / Novel N. Chegou / Elizabeth Ragan / Gerhard Walzl / Robert Horsburgh / Robin M. Warren / Karen R. Jacobson

PLoS ONE, Vol 17, Iss

A cross-sectional observational study protocol using respondent driven sampling

2022 Volume 2

Abstract: People who use illicit drugs (PWUDs) have been identified as a key at-risk group for tuberculosis (TB). Examination of illicit drug use networks has potential to assess the risk of TB exposure and disease progression. Research also is needed to assess ... ...

Abstract	People who use illicit drugs (PWUDs) have been identified as a key at-risk group for tuberculosis (TB). Examination of illicit drug use networks has potential to assess the risk of TB exposure and disease progression. Research also is needed to assess mechanisms for accelerated TB transmission in this population. This study aims to 1) assess the rate of TB exposure, risk of disease progression, and disease burden among PWUD; 2) estimate the proportion of active TB cases resulting from recent transmission within this network; and 3) evaluate whether PWUD with TB disease have physiologic characteristics associated with more efficient TB transmission. Our cross-sectional, observational study aims to assess TB transmission through illicit drug use networks, focusing on methamphetamine and Mandrax (methaqualone) use, in a high TB burden setting and identify mechanisms underlying accelerated transmission. We will recruit and enroll 750 PWUD (living with and without HIV) through respondent driven sampling in Worcester, South Africa. Drug use will be measured through self-report and biological measures, with sputum specimens collected to identify TB disease by Xpert Ultra (Cepheid) and mycobacterial culture. We will co-enroll those with microbiologic evidence of TB disease in Aim 2 for molecular and social network study. Whole genome sequencing of Mycobacteria tuberculosis (Mtb) specimens and social contact surveys will be done for those diagnosed with TB. For Aim 3, aerosolized Mtb will be compared in individuals with newly diagnosed TB who do and do not smoke illicit drug. Knowledge from this study will provide the basis for a strategy to interrupt TB transmission in PWUD and provide insight into how this fuels overall community transmission. Results have potential for informing interventions to reduce TB spread applicable to high TB and HIV burden settings. Trial registration: Clinicaltrials.gov Registration Number: NCT041515602. Date of Registration: 5 November 2019.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The prevalence of religiosity and association between religiosity and alcohol use, other drug use, and risky sexual behaviours among grade 8-10 learners in Western Cape, South Africa.

Joel Msafiri Francis / Bronwyn Myers / Sebenzile Nkosi / Petal Petersen Williams / Tara Carney / Carl Lombard / Elmarie Nel / Neo Morojele

PLoS ONE, Vol 14, Iss 2, p e

2019 Volume 0211322

Abstract: Background Alcohol and other drug use (AOD) and risky sexual behaviours remain high among adolescents in South Africa and globally. Religiosity influences, mitigates and provides resilience against engaging in risky behaviours among young people but few ... ...

Abstract	Background Alcohol and other drug use (AOD) and risky sexual behaviours remain high among adolescents in South Africa and globally. Religiosity influences, mitigates and provides resilience against engaging in risky behaviours among young people but few South African studies have explored potential associations between religiosity, AOD use and risky sex. We report the prevalence of religiosity and association between religiosity and AOD use and risky sexual behaviours among learners in the Western Cape Province, South Africa. Methods Between May and August 2011, a cross sectional survey was conducted among 20 227 learners from 240 public schools randomly selected through a stratified multistage sampling design to determine the prevalence of AOD use and sexual risk behaviours. We performed univariate and multivariate logistic regression analyses to assess the association between religiosity, AOD use and risky sexual behaviours. Results The learners were aged 10-23 years. Almost three quarters (74%) of learners reported high religiosity (defined as attending religious services or activities at least 1-2 times a month). More female than male learners had high religiosity. The prevalence of past 30 day reported alcohol, tobacco and cannabis use was 23%, 19% and 8% respectively. Compared to learners with low religiosity, those with high religiosity were less likely to engage in AOD use: specifically alcohol use, (AOR = 0.86, 95%CI: 0.76-0.97), tobacco use (AOR = 0.76, 95%CI: 0.67-0.87), cannabis use (AOR = 0.57, 95%CI: 0.48-0.68) in the last 30 days. They were also less likely to engage in risky sexual behaviours (AOR = 0.90, 95%CI: 0.81-0.99). Conclusion Religiosity was associated with lower odds of reported AOD use and risky sexual behaviours among learners in the Western Cape. This calls for further exploration on how to incorporate religiosity into AOD use and risky sexual behaviour interventions.
Keywords	Medicine ; R ; Science ; Q
Subject code	380
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL)

Tara Carney / Jennifer A Rooney / Nandi Niemand / Bronwyn Myers / Danie Theron / Robin Wood / Laura F White / Christina S Meade / Novel N Chegou / Elizabeth Ragan / Gerhard Walzl / Robert Horsburgh / Robin M Warren / Karen R Jacobson

PLoS ONE, Vol 17, Iss 2, p e

A cross-sectional observational study protocol using respondent driven sampling.

2022 Volume 0262440

Abstract	People who use illicit drugs (PWUDs) have been identified as a key at-risk group for tuberculosis (TB). Examination of illicit drug use networks has potential to assess the risk of TB exposure and disease progression. Research also is needed to assess mechanisms for accelerated TB transmission in this population. This study aims to 1) assess the rate of TB exposure, risk of disease progression, and disease burden among PWUD; 2) estimate the proportion of active TB cases resulting from recent transmission within this network; and 3) evaluate whether PWUD with TB disease have physiologic characteristics associated with more efficient TB transmission. Our cross-sectional, observational study aims to assess TB transmission through illicit drug use networks, focusing on methamphetamine and Mandrax (methaqualone) use, in a high TB burden setting and identify mechanisms underlying accelerated transmission. We will recruit and enroll 750 PWUD (living with and without HIV) through respondent driven sampling in Worcester, South Africa. Drug use will be measured through self-report and biological measures, with sputum specimens collected to identify TB disease by Xpert Ultra (Cepheid) and mycobacterial culture. We will co-enroll those with microbiologic evidence of TB disease in Aim 2 for molecular and social network study. Whole genome sequencing of Mycobacteria tuberculosis (Mtb) specimens and social contact surveys will be done for those diagnosed with TB. For Aim 3, aerosolized Mtb will be compared in individuals with newly diagnosed TB who do and do not smoke illicit drug. Knowledge from this study will provide the basis for a strategy to interrupt TB transmission in PWUD and provide insight into how this fuels overall community transmission. Results have potential for informing interventions to reduce TB spread applicable to high TB and HIV burden settings. Trial registration: Clinicaltrials.gov Registration Number: NCT041515602. Date of Registration: 5 November 2019.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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