Stress, Substance Use and Sexual Risk Behaviors Among Primary Care Patients in Cape Town, South Africa
Open accessAbstract
We assessed the relationship between stress, substance use and sexual risk behaviors in a primary care population in Cape Town, South Africa. A random sample of participants (and over-sampled 18-24-year-olds) from 14 of the 49 clinics in Cape Town's public health sector using stratified random sampling (n = 2,618), was selected. We evaluated current hazardous drug and alcohol use and three domains of stressors (Personal Threats, Lacking Basic Needs, and Interpersonal Problems). Several personal threat stressors and an interpersonal problem stressor were related to sexual risk behaviors. With stressors included in the model, hazardous alcohol use, but not hazardous drug use, was related to higher rates of sexual risk behaviors. Our findings suggest a positive screening for hazardous alcohol use should alert providers about possible sexual risk behaviors and vice versa. Additionally, it is important to address a broad scope of social problems and incorporate stress and substance use in HIV prevention campaigns.
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Rates of non-use of condoms and unplanned pregnancies in South Africa public-sector primary care patients are high.
“because rates of non-use of condoms and unplanned pregnancies in South Africa public-sector primary care patients are high (Avalos et al., 2009)”
From Effectiveness of Nurse-Practitioner-Delivered Brief Motivational Intervention for Young Adult Alcohol and Drug Use in Primary Care in South Africa: A Randomized Clinical Trial (2014) · cites this paper as Avalos et al., 2009
The Results report that 12.6% of the Cape Town public-sector primary care sample did not use a condom at last intercourse, making it one of the two most prevalent sexual risk behaviors measured. The Methods > Stressors section calls teenage pregnancy rates in South Africa very high, but gives no rate of unplanned pregnancy among these patients; teenage pregnancy is not equivalent to unplanned pregnancy. (LLM, conf=0.87)
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Cites
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BackgroundStimulant-induced enhanced sexual desire as a potential contributing factor in HIV transmission
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Prevalence and Correlates of Substance Use Among South African Primary Care Clinic Patients
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Self-citation
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Cited by
Sorted by citations
Mertens, J. R., Ward, C. L., Bresick, G. F., Broder, T., & Weisner, C. M. (2014) · Alcohol and Alcoholism · doi:10.1093/alcalc/agu030 · Cited by 64 · see citing works
Self-citationWard, C. L., Mertens, J. R., Bresick, G. F., Little, F., & Weisner, C. M. (2015) · Alcohol and Alcoholism · doi:10.1093/alcalc/agv007 · Cited by 17 · see citing works
Self-citation
- Authors
- Avalos, L. A., Mertens, J. R., Ward, C. L., Flisher, A. J., Bresick, G. F., & Weisner, C. M.
- Affiliations
- Alcohol Research Group (US)
- Kaiser Permanente (US)
- Human Sciences Research Council (ZA)
- University of Cape Town (ZA)
- Corresponding author
- Avalos, Lyndsay Ammon
- Venue
- AIDS and Behavior
- Published
- 2009-02-10
- Volume
- 14
- Issue
- 2
- Pages
- 359-370
- ISSN
- 1090-7165 (ISSN-L)
- 1573-3254
- PMC
- PMC2835823
- OpenAlex
- W1985146111
- Cited by
- 18
- References
- 3
- Citations by year
- 2025: 3 · 2019: 1 · 2018: 1 · 2015: 2 · 2014: 2 · 2012: 3
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- AIDS and Behavior (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Medical Research Council
- National Institute on Drug Abuse (R37DA010572)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- stress, substance use, sexual risk behavior, hazardous drinking, personal threat, basic needs, interpersonal problems, HIV prevention, primary care patients, young adults, Cape Town
- MeSH terms
- Adolescent, Alcohol Drinking, Ambulatory Care Facilities, Female, Humans, Male, Primary Health Care, Surveys and Questionnaires, Risk-Taking, Sexual Behavior, South Africa, Stress, Psychological, Substance-Related Disorders, Young Adult
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