Perceived need for substance use treatment among young women from disadvantaged communities in Cape Town, South Africa

Bronwyn Myers,Wendee M Wechsberg,Irene A Doherty,Tara Carney,Tracy L Kline

doi:10.1186/1471-244x-14-100

Abstract

BackgroundInitiation of treatment for substance use disorders is low among young women from disadvantaged communities in Cape Town, South Africa. Yet little is known about the factors that influence perceived need for treatment (a determinant of treatment entry) within this population.MethodsBaseline data on 720 young, drug-using women, collected as part of a randomized field experiment were analyzed to identify predisposing, enabling and health need factors associated with perceived need for treatment.ResultsOverall, 46.0% of our sample perceived a need for treatment. Of these participants, 92.4% wanted treatment for their substance use problems but only 50.1% knew where to access services. In multivariable logistic regression analyses, we found significant main effects for ethnicity (AOR = 1.54, 95% CI = 1.05-1.65), income (AOR = 0.96, 95% CI = 0.93-0.99), anxiety (AOR = 1.22, 95% CI = 1.05-1.45), and not having family members with drug problems (AOR = 1.45, 95% CI = 1.05-2.04) on perceived need for treatment. When the sample was stratified by methamphetamine use, income (AOR = 0.87, 95% CI = 0.79-0.96), awareness of treatment services (AOR =1.84, 95% CI = 1.03-3.27), anxiety (AOR =1.41, 95% CI = 1.06-1.87) and physical health status (AOR = 6.29, 95% CI = 1.56-25.64) were significantly associated with perceived need for treatment among those who were methamphetamine-negative. No variables were significantly associated with perceived need for treatment among participants who were methamphetamine-positive.ConclusionsA sizeable proportion of young women who could benefit from substance use treatment do not believe they need treatment, highlighting the need for interventions that enhance perceived need for treatment in this population. Findings also show that interventions that link women who perceive a need for treatment to service providers are needed. Such interventions should address barriers that limit young women’s use of services for substance use disorders.

Highlights

Initiation of treatment for substance use disorders is low among young women from disadvantaged communities in Cape Town, South Africa
Women who tested positive for methamphetamine were somewhat older, had higher monthly incomes (R304.2 versus R211.4, p = 0.009) than women who tested negative for methamphetamine (Table 1)
The mean Center for Epidemiological Studies Depression (CES-D) (p

Summary

Introduction

Initiation of treatment for substance use disorders is low among young women from disadvantaged communities in Cape Town, South Africa. In South Africa, the prevalence of substance use disorders is high [1,2], with the lifetime and past year prevalence of substance use disorders among adults being 13.3% and 5.8%, respectively [1]. Failure to perceive a need for treatment, a key determinant of health services use [13] and a necessary step in the process of changing addictive behaviors [14], may contribute to the poor uptake of treatment for substance use disorders by vulnerable women. As people who perceive a need for treatment are more likely to initiate treatment and have better substance use outcomes than those who do not think treatment is necessary [15,18,19,20], helping substance-using women recognize a need for treatment may be an important focus for interventions directed at improving treatment initiation among disadvantaged women

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