Substance use disorders among men in urban and rural communities in South Africa: Culture

Lead Research Organisation: London Sch of Hygiene and Trop Medicine

Abstract

Men of lower socio-economic status in South Africa are more affected by substance use disorders (SUDs), and generally their use of treatment services is very low. Reasons for this are poorly understood but may be due to cultural factors. This study will describe what SUD treatment exists, evaluating barriers which prevent men using treatment services in 2 urban (Khayelitsha, Soshanguve) and 2 rural sites (King Dalindyebo, Madibeng) in South Africa. Specific objectives are to determine the: (1) how SUD treatment services are provided; (2) how demographic, cultural, economic, psychosocial factors and rural-urban migration influence men to seek treatment services; and (3) the burden and severity of SUDs, related common mental health disorders and associated factors.We will conduct a detailed review of all treatment services in 3 study sites (in Khayelitsha an audit is already completed) providing services to men.

Technical Summary

Substance use disorders (SUDs) disproportionately affect men of lower socio-economic status in South Africa, and treatment uptake is low. Reasons for this are poorly understood. This study examines the nature of SUD treatment provision, and obstacles to treatment-seeking among men in 2 urban (Khayelitsha, Soshanguve) and 2 rural sites (King Dalindyebo, Madibeng) in South Africa. Specific objectives are to determine the: (1) availability and nature of SUD treatment provision; (2) role of demographic, cultural, economic, psychosocial factors and rural-urban migration in treatment-seeking; and (3) prevalence and severity of SUDs, common comorbid psychiatric disorders and associated factors.We will conduct an audit of all treatment services catering for men with SUDs in three study sites (in Khayelitsha an audit is already completed). In each service one respondent (manager) will be interviewed about the services provided. The role of culture in men's treatment-seeking will be explored via 32 in-depth interviews (8 per site) and 8 focus groups (2 per site) among men with SUDs, and IDIs with 24 SUDs treatment providers. Thematic analysis will identify cultural and other factors affecting treatment seeking dynamics. The prevalence and severity of SUDs and associated comorbidity and risk factors will be assessed via a household survey in Year 2 (in the Western Cape, Eastern Cape and North West provinces) using random sampling, targeting 547 adult men18 years and above. We will also conduct a community survey in Soshanguve using Respondent Driven Sampling in Year 3 to estimate prevalence of nyaope use. Recruitment will involve multiple waves until the recommended sample of 350 users is reached. Findings will be presented to community stakeholders and key decision makers to propose interventions to improve treatment access, informed by all key cultural, economic and psychosocial factors.

Publications

10 25 50
 
Description Participation in a national task force
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact The research presented helped to reduce morbidity and enhance quality of life among HIV infected patients in Mwanza, northwest Tanzania
 
Title Improvement of online data storage facilities 
Description We have purchased a new computer server allowing for more space to store data from various studies. 
Type Of Material Improvements to research infrastructure 
Year Produced 2020 
Provided To Others? Yes  
Impact This have allowed studies to store data on secure data. Also allows staff to work from home and access files on the server. 
 
Description Collaboration with South African Medical Research Council 
Organisation Medical Research Council of South Africa (MRC)
Country South Africa 
Sector Public 
PI Contribution We applied for research funding as part of the South African and UK Mental Health research scheme
Collaborator Contribution South African MRC contributed funds for this project and we collaborated with senior scientists at this institution in developing the proposal.
Impact No outputs at this point
Start Year 2018
 
Description University of Johannesburg 
Organisation University of Johannesburg
Country South Africa 
Sector Academic/University 
PI Contribution We are working with University of Johannesburg in a new MRC funded project
Collaborator Contribution We have a subcontract for this grant coming through this institution
Impact None at this time
Start Year 2019
 
Description Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a poster presentation at a conference in South Africa
Year(s) Of Engagement Activity 2019
 
Description Interview for national news 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Interview after the workshop
Year(s) Of Engagement Activity 2019