Pregnant and Nonpregnant Women in Cape Town, South Africa: Drug Use, Sexual Behavior, and the Need for Comprehensive Services

Hendrée E Jones,William A Zule,Tracy L Kline,Bronwyn J Myers,Wendee M Wechsberg,Rachel Middlesteadt Ellerson,Felicia A Browne,Tara Carney,Winona Poulton

doi:10.1155/2011/353410

Hendrée E Jones, William A Zule + Show 7 more

Open Access

https://doi.org/10.1155/2011/353410

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Abstract

The multiple risks associated with methamphetamine use are of serious concern for women. These risks and consequences are magnified during pregnancy. This secondary analysis of a parent study compared 26 pregnant to 356 nonpregnant women in Cape Town, South Africa, on selected demographic, psychosocial, and HIV-risk domains to identify their treatment service needs. Proportionally, more pregnant than nonpregnant women are using methamphetamine, P = .01, although a very high rate of women used methamphetamine. Women reported similar monthly rates of sexual intercourse, but pregnant women were significantly less likely to report condom use, P < .0001, maintaining their risky behavior. Both groups reported elevated Center for Epidemiological Studies Depression Scale CES-D means, suggesting a need for depression treatment. Results demonstrate a pervasive need for women's comprehensive treatment, regardless of pregnancy status. Moreover, findings support the urgent need for women-focused and pregnancy-specific treatment services for methamphetamine use. Finally, a job-skills training/employment component focus is suggested.

Highlights

Is dependence a danger for both pregnant and nonpregnant South African women who use methamphetamine, but use increases risk of exposure to sexual risk behavior, sexual violence, and HIV, which co-occur with methamphetamine use [3,4,5,6,7]
These results are consistent with other reports of high rates of methamphetamine use observed in Cape Town among the general population, its women, and its out-of-school young women between 13 to 20 years old [4, 8]
The high rate of methamphetamine use among pregnant women may be a reflection of the relationship between methamphetamine use and sexual risk behavior, which can result in pregnancy

Summary

Introduction

While methamphetamine use is cause for concern in both sexes, South African social history and structure may provide a context that makes women, especially women of color who live in the township communities, Black (African and Xhosa-speaking) and Coloured (mixed racial ancestry and Afrikaans-speaking), vulnerable to intersecting risks [1,2,3,4]. Similar to the use of other substances, women typically begin using methamphetamine before they become pregnant. Once pregnant, they are often unable to stop using. In South Africa, women who live in poor communities do not usually seek antenatal care, are not very informed about drug treatment, are afraid of stigma from health care providers, and are especially vulnerable to drug-related sexual risk behaviors [7,8,9]. In addition to the maternal vulnerabilities associated with methamphetamine misuse, prenatal stimulant exposure has been associated with fullterm birth but small gestational age [10], a risk factor for later developmental problems [11]

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Results

Discussion

Conclusion