Substance Use and Sexual Risk Prevention in Cape Town, South Africa: An Evaluation of the HealthWise Program
Abstract
Sexual behavior and substance use represent major threats to the health and well-being of South African adolescents, especially in light of the high prevalence of HIV infection in this population. However, there is currently a lack of evidence-based school programs designed to address health risk behaviors. The current study details the evaluation of HealthWise South Africa, a leisure, life skills, and sexuality education intervention for eighth and ninth grade students. We hypothesized that, compared to controls, HealthWise participants would have delayed sexual initiation, reduced rates of current sexual activity, increased use of and perceived access to condoms, and lower rates of lifetime and past use of multiple substances. Longitudinal data were analyzed using logistic regression of multiply imputed data. Results indicate that HealthWise was effective in increasing the perception of condom availability for both genders (OR = 1.6). As compared to HealthWise participants, control participants also had steeper increases in recent and heavy use of alcohol (OR = 1.4 [95% C.I. = 1.1-1.8], 1.6 [1.2-2.2], respectively) and recent and heavy cigarette use (OR = 1.4 [1.1-1.7], 1.4 [1.1-1.8], respectively). There were also several significant gender by treatment interactions, which are discussed. These results suggest that HealthWise is a promising approach to reducing multiple health risk behaviors among the population of school-going South African adolescents.
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HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence-based program for preventing substance use and sexual risk that emphasizes positive use of leisure time.
“HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence-based substance use and sexual risk prevention program that emphasizes the positive use of leisure time.”
From Translational research in South Africa: evaluating implementation quality using a factorial design (2012) · cites this paper as Smith et al. 2008
In HWStudy1 intervention schools, cigarette and alcohol use were significantly lower.
“Cigarette and alcohol use, for example, were significantly lower among those students in the HWStudy1 intervention schools.”
From Translational research in South Africa: evaluating implementation quality using a factorial design (2012) · cites this paper as Smith et al. 2008
HWStudy1 results indicated that HW reduced both substance use and sexual risk.
“Results from HWStudy1 suggest that HW was effective in reducing both substance use and sexual risk (Smith et al. 2008).”
From Translational research in South Africa: evaluating implementation quality using a factorial design (2012) · cites this paper as Smith et al. 2008
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- Authors
- Smith, E. A., Palen, L.-A., Caldwell, L. L., Flisher, A. J., Graham, J. W., Mathews, C., Wegner, L., & Vergnani, T.
- Affiliations
- Pennsylvania State University (US)
- University of Cape Town (ZA)
- University of the Western Cape (ZA)
- Corresponding author
- Smith, Edward A.
- Venue
- Prevention Science
- Published
- 2008-10-07
- Volume
- 9
- Issue
- 4
- Pages
- 311-321
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- OpenAlex
- W2167173676
- Cited by
- 77
- References
- 48
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 9 · 2015: 6 · 2014: 7 · 2013: 3 · 2012: 4
- FWCI
- 11.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Healthwise
- National Institutes of Health
- National Institute on Drug Abuse (R01 DA01749, T32DA017629)
- Topics
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Adolescent Health and Behaviors
- Keywords
- adolescent substance use, sexual risk behavior, HIV prevention, school-based intervention, condom use, sexual initiation, alcohol consumption, cigarette smoking, multiple substance use, life skills education, sex education, gender differences, South African adolescents
- MeSH terms
- Adolescent, Adolescent Behavior, Female, Health Promotion, Humans, Male, School Health Services, South Africa, Condoms, Substance-Related Disorders, Social Marketing, Unsafe Sex
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