Theme: Models of Care Year: 2024
Background: In South Africa, women who use drugs are underrepresented. They face unique challenges, including elevated HIV infection rates, risky injection behaviors, and exposure to intimate partner violence. The recent introduction of opioid substitution therapy (OST) offers a potential solution to these issues. However, recruitment of women participants in studies remains a challenge, raising concerns about the effectiveness and gender-responsiveness of programmes. This study explored the socio-demographic factors, substance use patterns, and retention rates among women accessing OST services in the Tshwane.
Methods: Data were abstracted from an electronic database and paper-based files pertaining to 199 women (>18 years) who had enrolled for opioid substitution therapy (OST) provided by the Community Orientated Substance Use Programme. A mean total ASSIST score was calculated by averaging the individual ASSIST scores across multiple drugs for each participant before the initiation of OST. Data were analysed descriptively, and inferential analysis using Spearman’s correlation, Kruskal-Wallis and Mann Whitney U tests were used to assess association of variables with retention on OST for six months.
Results: Most (94.6%) participants were unemployed, with 44.3% falling within the 20-29 years age range. During the initiation and course of OST, 39.2% of women experienced intimate partner violence, and 19.0% were pregnant. Retention on OST was significantly associated with increasing age at initiation (p=0.047), knowledge of HIV status (p=0.029), an increase in the ASSIST score (p=0.023), and methadone dose (p<0.001). No other assessed factors were associated with retention on OST (p>0.05).
Conclusion: This study uncovers the distinct challenges and retention factors experienced by women accessing OST, emphasising the need for the integration of interventions to address reproductive health, violence mitigation, infectious disease and polydrug use into care.
Disclosure of Interest Statement:
AS has received honoraria from Gilead to be a guest speaker and sponsored medical training events.