News Article
July 28, 2011
Poor Mental Health Increases HIV Risk Among South African Bar Goers
A new publication by Kathleen Sikkema in the Department of Psychology and Neuroscience suggests that alcohol-serving venues in South Africa may be strategic locations for targeting HIV prevention interventions and awareness programs. The research findings published in the July issue of the Journal of Acquired Immune Deficiency Syndromes found that individuals who frequent bars in one South African township have high levels of traumatic experiences, which is associated with increased depression and PTSD. These mental health problems, in turn, lead to greater sexual risk behavior, putting people at increased risk of contracting HIV.
In surveys of 738 men and women who frequent bars and taverns in one township in Cape Town, half of those surveyed screened positive for depression and a third screened positive for Post Traumatic Stress Disorder or PTSD. Individuals who had experienced physical abuse by a sex partner, been raped, or were abused as a child were much more likely to exhibit mental health distress. Women with depression, and both men and women with PTSD, reported more unprotected sex, compared with people without mental health distress. The influence of mental health was above and beyond the influence of drug and alcohol consumption on sexual behavior.
“South Africa has one of the largest HIV epidemics in the world,” said Sikkema, highlighting that these findings are important for addressing mental health as part of HIV prevention in South Africa. “Our response to the epidemic must address the synergy of co-occurring risk factors, which includes past traumas, poor mental health, and drug and alcohol use. Only when we address the larger context that pre-disposes people to HIV risk will we begin to curb the spread of the HIV epidemic.”
Sikkema, along with a team of researchers from Duke, University of Connecticut and the University of Stellenbosch in South Africa, led the study to examine HIV risk behaviors in informal bars and taverns in a township in Cape Town, which is funded by the National Institute of Alcohol Abuse and Alcoholism (NIAAA).
The Duke research team working on this study includes DGHI Research Scholar Melissa Watt, DGHI faculty Christina Meade, postdoctoral scholar Krista Ranby, and DGHI Research Assistant Frances Aunon. The research team is currently working on several other publications that will provide greater context for HIV risk behavior in this setting, which includes topics such as the dynamics of transactional sex, gender-based violence and methamphetamine use.