Risk and protective factors for whoonga use among adolescents in South Africa
Background: Antiretroviral therapy (ART) is publicly available in South Africa in response to the urgent need to address HIV and AIDS. Off-label use of ARV medication alone or in combination with other substances is known as “whoonga” and “nyaope” in South Africa. Diversion of ARVs for whoonga use i...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | Addictive Behaviors Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352853219302378 |
| _version_ | 1831728485045895168 |
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| author | Teresa DeAtley Catherine Mathews Dan J. Stein David Grelotti Larry K. Brown Danielle Giovenco Millicent Atujuna William Beardslee Caroline Kuo |
| author_facet | Teresa DeAtley Catherine Mathews Dan J. Stein David Grelotti Larry K. Brown Danielle Giovenco Millicent Atujuna William Beardslee Caroline Kuo |
| author_sort | Teresa DeAtley |
| collection | DOAJ |
| description | Background: Antiretroviral therapy (ART) is publicly available in South Africa in response to the urgent need to address HIV and AIDS. Off-label use of ARV medication alone or in combination with other substances is known as “whoonga” and “nyaope” in South Africa. Diversion of ARVs for whoonga use is not well understood, especially among adolescents. This secondary analysis explores risk and protective factors for adolescent whoonga use in a community-based HIV endemic setting. Methods: Data on whoonga use were derived from a baseline survey of N = 200 adolescents recruited for participation in a randomized controlled trail to reduce adolescent HIV risk behaviors and depression. Risk and protective factors for adolescent whoonga use were explored using an ecological systems framework using one-way ANOVAs, chi-squared tests and hierarchical regression. Results: Individual level factors increased the odds of whoonga use or known use such as child age OR:1.22 (95% CI, 1.03–1.43), hazardous drug use OR:1.62 (95% CI, 1.02–2.59), and hazardous alcohol OR:1.80 (95% CI, 1.05–3.09). Food insecurity appears to have a slightly protective effect on the odds of whoonga use or reports of use among people adolescents knew OR:0.649 (95% CI, 0.541–0.779). Conclusions: Larger epidemiological studies should expand the surveillance of hazardous alcohol use and illicit drug use, specifically for recreational use of prescription medication. Granular data is warranted to characterize the patters of use, especially among highly vulnerable populations. Future surveillance studies that explore these multi-level relationships are warranted to further understand this phenomenon among teens in South Africa. |
| first_indexed | 2024-12-21T06:50:09Z |
| format | Article |
| id | doaj.art-fd55ad850bf54ff0803bb38e47806af6 |
| institution | Directory Open Access Journal |
| issn | 2352-8532 |
| language | English |
| last_indexed | 2024-12-21T06:50:09Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Addictive Behaviors Reports |
| spelling | doaj.art-fd55ad850bf54ff0803bb38e47806af62022-12-21T19:12:30ZengElsevierAddictive Behaviors Reports2352-85322020-06-0111Risk and protective factors for whoonga use among adolescents in South AfricaTeresa DeAtley0Catherine Mathews1Dan J. Stein2David Grelotti3Larry K. Brown4Danielle Giovenco5Millicent Atujuna6William Beardslee7Caroline Kuo8Brown University School of Public Health, Department of Behavioral and Social Sciences Brown University School of Public Health, 121 S Main St, Providence, Rhode Island 02903, USA; Corresponding author at: Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island 02912, USA.University of Cape Town, Department of Psychiatry and Mental Health & South African Medical Research Council, Unit on Risk & Resilience in Mental Disorders, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town 7925, South AfricaUniversity of Cape Town, Department of Psychiatry and Mental Health & South African Medical Research Council, Unit on Risk & Resilience in Mental Disorders, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town 7925, South AfricaUniversity of California San Diego, Department of Psychiatry, 220 Dickinson Street, Suite B, San Diego, CA 92103, USAAlpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, Rhode Island 02903, USA; Providence/Boston Center for AIDS Research, 164 Summit Avenue CFAR Building, Room 134, Providence, Rhode Island 02906, USAUniversity of North Carolina at Chapel Hill, Department of Epidemiology, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USADesmond Tutu HIV Foundation, P.O. Box 13801, Mowbray, 7705 Cape Town, South AfricaBoston Children’s Hospital & Judge Baker Children’s Center & Harvard Medical School, Department of Psychiatry, 53 Parker Hill Ave, Roxbury Crossing, MA 02120, USABrown University School of Public Health, Department of Behavioral and Social Sciences Brown University School of Public Health, 121 S Main St, Providence, Rhode Island 02903, USA; University of Cape Town, Department of Psychiatry and Mental Health & South African Medical Research Council, Unit on Risk & Resilience in Mental Disorders, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town 7925, South Africa; Providence/Boston Center for AIDS Research, 164 Summit Avenue CFAR Building, Room 134, Providence, Rhode Island 02906, USABackground: Antiretroviral therapy (ART) is publicly available in South Africa in response to the urgent need to address HIV and AIDS. Off-label use of ARV medication alone or in combination with other substances is known as “whoonga” and “nyaope” in South Africa. Diversion of ARVs for whoonga use is not well understood, especially among adolescents. This secondary analysis explores risk and protective factors for adolescent whoonga use in a community-based HIV endemic setting. Methods: Data on whoonga use were derived from a baseline survey of N = 200 adolescents recruited for participation in a randomized controlled trail to reduce adolescent HIV risk behaviors and depression. Risk and protective factors for adolescent whoonga use were explored using an ecological systems framework using one-way ANOVAs, chi-squared tests and hierarchical regression. Results: Individual level factors increased the odds of whoonga use or known use such as child age OR:1.22 (95% CI, 1.03–1.43), hazardous drug use OR:1.62 (95% CI, 1.02–2.59), and hazardous alcohol OR:1.80 (95% CI, 1.05–3.09). Food insecurity appears to have a slightly protective effect on the odds of whoonga use or reports of use among people adolescents knew OR:0.649 (95% CI, 0.541–0.779). Conclusions: Larger epidemiological studies should expand the surveillance of hazardous alcohol use and illicit drug use, specifically for recreational use of prescription medication. Granular data is warranted to characterize the patters of use, especially among highly vulnerable populations. Future surveillance studies that explore these multi-level relationships are warranted to further understand this phenomenon among teens in South Africa.http://www.sciencedirect.com/science/article/pii/S2352853219302378 |
| spellingShingle | Teresa DeAtley Catherine Mathews Dan J. Stein David Grelotti Larry K. Brown Danielle Giovenco Millicent Atujuna William Beardslee Caroline Kuo Risk and protective factors for whoonga use among adolescents in South Africa Addictive Behaviors Reports |
| title | Risk and protective factors for whoonga use among adolescents in South Africa |
| title_full | Risk and protective factors for whoonga use among adolescents in South Africa |
| title_fullStr | Risk and protective factors for whoonga use among adolescents in South Africa |
| title_full_unstemmed | Risk and protective factors for whoonga use among adolescents in South Africa |
| title_short | Risk and protective factors for whoonga use among adolescents in South Africa |
| title_sort | risk and protective factors for whoonga use among adolescents in south africa |
| url | http://www.sciencedirect.com/science/article/pii/S2352853219302378 |
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