Adolescent female school dropouts who use drugs and engage in risky sex: effects of a brief pilot intervention in Cape Town, South Africa

ABSTRACT

Female adolescents from socioeconomically underserved communities in Cape Town, South Africa, who have dropped out of school, use substances, and engage in risky sex behaviour are at risk of HIV. Tailored gender-focused HIV behavioural interventions for this key population are needed to mitigate these risk factors. A pilot trial of a woman-focused risk-reduction intervention for adolescents was conducted (N = 100), with a one-month follow-up appointment. Participants in the intervention group attended two group workshops. Data were examined for significant differences within and between the groups. At baseline, 94% of participants tested positive for cannabis, 17% were HIV-positive and 11% were pregnant. Ninety-two participants returned for 1-month follow-up. At follow-up, the proportion who tested positive for cannabis use decreased significantly in both the intervention (p = 0.07) and control groups (p = 0.04). Impaired sex with any partner (p = 0.02), or with main partner (p = 0.06) decreased among the intervention group. Impaired sex with a main partner was less likely in the intervention group (p = 0.07) in the regression model. In conclusion, findings indicate a need for HIV prevention interventions among out-of-school female adolescents. Intervention acceptability was high, and there were some decreases in sexual risk behaviour among intervention participants which is promising. Future intervention research with this key population involving larger sample sizes and longer follow-up periods will help to determine intervention efficacy.

Trial registration: Uniform Trial Number identifier: NCT02677025.

KEYWORDS:

• Gender
• alcohol and drug use
• adolescents
• HIV
• brief intervention

Acknowledgements

We wish to thank our project staff, the participants, and our editor, Mr. Jeffrey Novey, for their contribution to this project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This supplement study was supported by the U.S. National Institutes of Health, National Institute on Drug Abuse (NIDA) grant R01DA032061-S1 (PI: Wendee M. Wechsberg, Ph.D.). The views and conclusions are those of the authors and do not necessarily reflect the views of NIDA. The funding agency had no role in the research design; collection, analysis, and interpretation of the data; writing of this article, or the decision to submit the article for publication (ClinicalTrials.gov registration NCT02677025).