Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Study protocol

The Young Women’s Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV

Authors: Wendee M. Wechsberg, Felicia A. Browne, Tara Carney, Bronwyn Myers, Alexandra Minnis, Robert MacDonald, Jacqueline W. Ndirangu, Leslie B. Turner, Brittni N. Howard, Nathaniel Rodman

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

South Africa remains the global epicentre of HIV infection, and adolescent women have the highest incidence of HIV in the country. South Africa also has high rates of alcohol and other drug (AOD) use, violence, and gender inequality. Violence converges with AOD use, gender inequities and other disparities, such as poverty, to increase sexual risk and poor educational attainment for adolescent women. This study seeks to test the efficacy of peer recruitment and cofacilitation of the Young Women’s Health CoOp (YWHC), a comprehensive gender-focused intervention to reduce HIV risk behaviours and increase the uptake of HIV counselling and testing (HCT) among out-of-school, adolescent women who use AODs. The YWHC is facilitated by local research staff and supported by peers.

Methods

This cluster-randomised trial is enrolling participants into two arms: a control arm that receives standard HCT, and an intervention arm that receives the YWHC. Participants are enrolled from 24 economically disadvantaged communities in Cape Town, South Africa. These geographically distinct communities serve as clusters that are the units of randomisation. This study uses adolescent peer role models and research field staff to recruit marginalised adolescent women. At baseline, participants complete a questionnaire and biological testing for HIV, recent AOD use, and pregnancy. The core intervention is delivered in the month following enrollment, with linkages to health services and educational programmes available to participants throughout the follow-up period. Follow-up interviews and biological testing are conducted at 6 and 12 months post enrollment.

Discussion

The study findings will increase knowledge of the efficacy of a comprehensive HCT, gender-focused programme in reducing AOD use, victimisation, and sexual risk behaviour and increase uptake services for out-of-school, adolescent women who use AODs. The trial results could lead to wider implementation of the YWHC for vulnerable adolescent women, a key population often neglected in health services.

Trial registration

Trial registration no: NCT02974998, November 29, 2016.
Literature
1.
Joint United Nations Programme on HIV/AIDS (UNAIDS): Ending AIDS: Progress towards 90–90-90 Targets. Geneva, Switzerland; 2017.
2.
Idele P, Gillespie A, Porth T, Suzuki C, Mahy M, Kasedde S, Luo C. Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps. J Acquir Immune Defic Syndr. 2014;66(Suppl 2):S144–53.CrossRefPubMed
3.
Joint United Nations Programme on HIV/AIDS (UNAIDS): AIDS Epidemic Update. Geneva, Switzerland; 2009.
4.
Joint United Nations Programme on HIV/AIDS (UNAIDS): HIV prevention among adolescent girls and young women. Geneva, Switzerland; 2016.
5.
Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D. South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. HSRC: Pretoria, South Africa; 2014.
6.
Reddy SP, James, S, Sewpaul R, Koopman F, Funani NI, Sifunda S, et al. Umthente Uhlaba Usamila-the South African Youth Risk Behaviour Survey 2008. Cape Town: South African Medical Research Council; 2010.
7.
Wechsberg WM, Jones HE, Zule WA, Myers BJ, Browne FA, Kaufman MR, Luseno W, Flisher AJ, Parry CD. Methamphetamine (“tik”) use and its association with condom use among out-of-school females in Cape Town, South Africa. Am J Drug Alcohol Abuse. 2010;36:208–13.
8.
Hobkirk AL, Watt MH, Myers B, Skinner D, Meade CS. A qualitative study of methamphetamine initiation in Cape Town, South Africa. Int J Drug Policy. 2016;30:99–106.
9.
Pluddemann A, Flisher AJ, Mathews C, Carney T, Lombard C. Adolescent methamphetamine use and sexual risk behaviour in secondary school students in Cape Town, South Africa. Drug Alcohol Rev. 2008;27:687–92.
10.
Wechsberg WM, Myers B, Kline TL, Carney T, Browne FA, Novak SP. The relationship of alcohol and other drug use typologies to sex risk behaviors among vulnerable women in Cape Town, South Africa. J AIDS Clin Res. 2012; Suppl 1(15):015.
11.
Kogan SM, Luo Z, Murry VM, Brody GH. Risk and protective factors for substance use among African American high school dropouts. Psychol Addict Behav. 2005;19:382–91.CrossRefPubMed
12.
Weybright EH, Caldwell LL, Xie HJ, Wegner L, Smith EA. Predicting secondary school dropout among South African adolescents: a survival analysis approach. S Afr J Educ. 2017;37:1–11.
13.
Townsend L, Flisher AJ, King G. A systematic review of the relationship between high school dropout and substance use. Clin Child Fam Psychol Rev. 2007;10:295–317.CrossRefPubMed
14.
Sawyer-Kurian KM, Browne FA, Carney T, Petersen P, Wechsberg WM. Exploring the intersecting health risks of substance abuse, sexual risk, and violence for female South African teen dropouts. J Psychol Afr. 2011;21:15–25.
15.
16.
Maphalala MC, Mabunda P. Gangsterism: internal and external factors associated with school violence in selected Western Cape high schools. J Sociol Soc Anth. 2014;5:61–70.
17.
Minnis AM, Doherty IA, Kline TL, Zule WA, Myers B, Carney T, Wechsberg WM. Relationship power, communication, and violence among couples: results of a cluster-randomized HIV prevention study in a South African township. Int J Womens Health. 2015;7:517–25.
18.
Inglis D, Lewis A. Adolescents at risk of dropping out in a high-risk community secondary school. Child Abuse Res South Afric. 2013;14:46–54.
19.
Flisher AJ, Townsend L, Chikobvu P, Lombard CF, King G. Substance use and psychosocial predictors of high school dropout in Cape Town, South Africa. J Res Adolesc. 2010;20:237–55.
20.
Wechsberg WM, Myers B, Reed E, Carney T, Emanuel AN, Browne FA. Substance use, gender inequity, violence and sexual risk among couples in Cape Town. Cult Health Sex. 2013;15:1221–36.
21.
22.
Modisaotsile BM. The failing standards of basic education in South Africa. Policy brief. 2012;72:1–7.
23.
Inglis D. Exploring the dropout phenomenon in a secondary school situated in a high-risk community. Doctoral dissertation, Stellenbosch: University of Stellenbosch. 2009.
24.
25.
Rosenberg M, Pettifor A, Miller WC, Thirumurthy H, Emch M, Afolabi SA, Kahn K, Collinson M, Tollman S. Relationship between school dropout and teen pregnancy among rural South African young women. Int J Epidemiol. 2015;44:928–36.
26.
Carney T, Myers BJ, Louw J, Lombard C, Flisher AJ. The relationship between substance use and delinquency among high-school students in Cape Town, South Africa. J Adolesc. 2013;36:447–55.
27.
Pettifor A, MacPhail C, Anderson AD, Maman S. ‘If I buy the Kellogg's then he should [buy] the milk’: young women's perspectives on relationship dynamics, gender power and HIV risk in Johannesburg, South Africa. Cult Health Sex. 2012;14:477–90.
28.
Howard BN, Van Dorn R, Myers BJ, Zule WA, Browne FA, Carney T, Wechsberg WM. Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services. BMC Health Serv Res. 2017;17:746.
29.
Flisher AJ, Dawes A, Kafaar Z, Lund C, Sorsdahl K, Myers B, Thom R, Seedat S. Child and adolescent mental health in South Africa. J Child Adolesc Ment Health. 2012;24:149–61.CrossRefPubMed
30.
Wechsberg WM, Deren S, Myers B, Kirtadze I, Zule WA, Howard B, El-Bassel N. Gender-specific HIV prevention interventions for women who use alcohol and other drugs: the evolution of the science and future directions. J Acquir Immune Defic Syndr. 2015;69(Suppl 2):S128–39.CrossRefPubMedPubMedCentral
31.
Ramirez-Avila L, Nixon K, Noubary F, Giddy J, Losina E, Walensky RP, Bassett IV. Routine HIV testing in adolescents and young adults presenting to an outpatient clinic in Durban, South Africa. PLoS One. 7(9):e45507.
32.
Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, Hlongwa-Madikizela L, Vermaak K, Padian NS. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005;19:1525–34.CrossRefPubMed
33.
Patten GE, Wilkinson L, Conradie K, Isaakidis P, Harries AD, Edginton ME, De Azevedo V, van Cutsem G. Impact on ART initiation of point-of-care CD4 testing at HIV diagnosis among HIV-positive youth in Khayelitsha, South Africa. J Int AIDS Soc. 2013;16:18518.CrossRefPubMedPubMedCentral
34.
Wechsberg WM, Lam WK, Zule WA, Bobashev G. Efficacy of a woman-focused intervention to reduce HIV risk and increase self-sufficiency among African American crack abusers. Am J Public Health. 2004;94:1165–73.CrossRefPubMedPubMedCentral
35.
Lyles CM, Kay LS, Crepaz N, Herbst JH, Passin WF, Kim AS, Rama SM, Thadiparthi S, DeLuca JB, Mullins MM, HIV/AIDS Prevention Research Synthesis Team. Best-evidence interventions: findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000-2004. Am J Public Health. 2007;97:133–43.CrossRefPubMedPubMedCentral
36.
Wechsberg WM, Luseno WK, Kline TL, Browne FA, Zule WA. Preliminary findings of an adapted evidence-based woman-focused HIV intervention on condom use and negotiation among at-risk women in Pretoria, South Africa. J Prev Interv Commun. 2010;38:132–46.CrossRef
37.
Wechsberg WM, Zule WA, Luseno WK, Kline TL, Browne FA, Novak SP, Ellerson RM. Effectiveness of an adapted evidence-based woman-focused intervention for sex workers and non-sex workers: the Women's Health CoOp in South Africa. J Drug Issues. 2011;41:233–52.
38.
Wechsberg WM, Jewkes R, Novak SP, Kline T, Myers B, Browne FA, Carney T, Lopez AAM, Parry C. A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: a randomised trial of the Women’s Health CoOp. BMJ Open. 2013;3(5): e002622.
39.
Wechsberg WM, Zule WA, Ndirangu J, Kline TL, Rodman NF, Doherty IA, Novak SP, van der Horst CM. The biobehavioral Women's Health CoOp in Pretoria, South Africa: study protocol for a cluster-randomized design. BMC Public Health. 2014;14:1074.
40.
Zule W, Myers B, Carney T, Novak SP, McCormick K, Wechsberg WM. Alcohol and drug use outcomes among vulnerable women living with HIV: results from the Western Cape Women's Health CoOp. AIDS Care. 2014;26:1494–9.
41.
Dennis ML, Titus JC, White MK, Unsicker JI, Hodgkins D. Global appraisal of individual needs: administration guide for the GAIN and related measures. Bloomington, IL: Chestnut Health Systems; 2003.
42.
Wechsberg WM. Revised risk behavior assessment, part I and part II. Research Triangle Park, NC: Research Triangle Institute; 1998.
Metadata
Title
The Young Women’s Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
Authors
Wendee M. Wechsberg
Felicia A. Browne
Tara Carney
Bronwyn Myers
Alexandra Minnis
Robert MacDonald
Jacqueline W. Ndirangu
Leslie B. Turner
Brittni N. Howard
Nathaniel Rodman
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5665-5

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Public knowledge of dehydration and fluid intake practices: variation by participants’ characteristics

Research article

Health-related physical fitness and physical activity in elementary school students

Research article

Interpreting population reach of a large, successful physical activity trial delivered through primary care

Research article

Impact of the use and efficacy of long lasting insecticidal net on malaria infection during the first trimester of pregnancy - a pre-conceptional cohort study in southern Benin

Research article

Effectiveness of workplace social distancing measures in reducing influenza transmission: a systematic review

Research article

Development of a measurement approach to assess time children participate in organized sport, active travel, outdoor active play, and curriculum-based physical activity