The Association Between Poly-Substance Use, Coping, and Sex Trade Among Black South African Substance Users

Abstract

The current study examined the relationship between poly-substance use and sex trade among 343 black South African substance users recruited from the Pretoria region between 2002 and (57% males; mean age 24 years). The assessment comprised a HIV-risk behavior interview, urinalysis to confirm self-report of drug use, and an HIV test. Logistic regression analyses indicated poly-substance use was positively associated with sex trade among persons using drugs to cope with stress. Results indicate the importance of considering coping strategies as modifiable psychosocial factor related to sexual risk-taking behaviors and substance use. The study's implications and limitations are discussed.

RÉSUMÉ

L’association entre l’utilisation de poly-substance, faire face, et le commerce de sexe parmi les utilisateurs sud-africains noirs de substance

L’étude courante a examiné le rapport entre l’utilisation de poly-substance et le commerce de sexe parmi 343 utilisateurs sud-africains noirs de substance recrutés de la région de Pretoria entre 2002 et (mâle de 57%; âge moyen 24 ans). L’évaluation a été composée d’une entrevue de comportement de HIV-risque, de l’analyse d’urine pour confirmer l’individu-rapport de l’utilisation de drogue, et d’un essai d’HIV. Les analyses logistiques de régression ont indiqué qu’utilisation de poly-substance a été franchement associée au commerce de sexe parmi des personnes employant des drogues pour faire face. Les résultats indiquent l’importance de considérer des stratégies de faire face comme le facteur psychosocial modifiable s’est relié au risque sexuel prenant des comportements et l’utilisation de substance. Les implications et les limitations de l’étude sont discutées.

RESUMEN

La asociación entre el uso de la poly-sustancia, hacer frente, y comercio del sexo entre usuarios negros de la sustancia del africano del sur

El estudio actual examinó la relación entre el uso de la poly-sustancia y el comercio del sexo entre 343 usuarios negros de la sustancia del africano del sur reclutados de la región de Pretoria entre 2002 y (varón del 57%; edad media 24 años). El gravamen fue abarcado de una entrevista del comportamiento del VIH-riesgo, de urinalysis para confirmar el uno mismo-informe del uso de la droga, y de una prueba del VIH. Los análisis logísticos de la regresión indicaron que uso de la poly-sustancia fue asociada positivamente a comercio del sexo entre las personas que usaban las drogas para hacer frente. Los resultados indican la importancia de considerar estrategias que hacen frente como el factor sicosocial modificable se relacionó con el riesgo sexual que tomaba comportamientos y uso de la sustancia. Se discuten las implicaciones y las limitaciones del estudio.

• Keywords: poly-substance use
• coping
• sex trade
• South Africa
• HIV/AIDS
• sex differences
• cocaine
• marijuana
• heroin

THE AUTHORS

Leah J. Floyd, Ph.D., is an assistant scientist in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. Dr. Floyd's research focuses on understanding racial disparities and gender differences in substance use and HIV/AIDS epidemiology and HIV and substance use prevention.

Sarra L. Hedden, Ph.D., is a post-doctoral fellow in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. Dr. Hedden's research is funded by the Drug Dependence Epidemiology Training Program. Her research focuses on drug-using and sexual risk behaviors in vulnerable populations.

April L. Lawson, M.A., is a senior research program coordinator II in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. Ms. Lawson's research interests focus on substance use and HIV/AIDS epidemiology and prevention, specifically among young urban women.

Christina H. Salama, B.A., served as a research project coordinator in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. Ms. Salama is currently pursuing her graduate education in clinical psychology doctoral program at Georgia State University. Her interests include neuropsychological functioning among HIV positive individuals.

Anne Gloria Moleko, M.S., is faculty and senior lecturer in the Department of Psychology at the University of Pretoria. Ms. Moleko's research interests include HIV/AIDS, community and cross-cultural psychology, and drug abuse.

William W. Latimer, Ph.D., M.P.H., is associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. Dr. Latimer's research focuses on epidemiology, prevention, and treatment of infectious disease and drug dependence, with special focus on neurobehavioral risk factors of disease, treatment engagement, and outcome.

Notes

1 The reader is asked to consider that the concepts and processes of “risk” and “protective” factors”, often noted in the literature- need to be delineated in terms of their dimensions (linear, non-linear), its “demands”, the critical necessary conditions (endogenously as well as exogenously; from a micro to a macro level) which are necessary for either of them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically-based, individual and/or systemic stake holder- bound, historically based, based upon “principles of faith” or what. Editor's note.