Open Access Research article

Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions

Bronwyn Myers12*, Tracy L Kline3, Felicia A Browne4, Tara Carney1, Charles Parry15, Kim Johnson1 and Wendee M Wechsberg3678

Author Affiliations

1 Alcohol and Drug Abuse Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg 7505, South Africa

2 Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

3 RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA

4 Harvard School of Public Health, Harvard University, 677 Huntington Ave., Boston, MA, USA

5 Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa

6 Health, Policy and Administration, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA

7 Psychology in the Public Interest, North Carolina State University, Raleigh, NC, USA

8 Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA

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BMC Public Health 2013, 13:174  doi:10.1186/1471-2458-13-174

Published: 26 February 2013



Alcohol and other drug (AOD) use among poor Black African and Coloured women in South Africa compounds their sexual risk for HIV. Given South Africa’s history of ethnic disparities, ethnic differences in sex risk profiles may exist that should be taken into account when planning HIV risk reduction interventions. This paper aims to describe ethnic differences in AOD use and AOD-related sexual risks for HIV among vulnerable women from Cape Town, South Africa.


Cross-sectional data on 720 AOD-using women (324 Black African; 396 Coloured) recruited from poor communities in Cape Town were examined for ethnic differences in AOD use and AOD-related sexual risk behavior.


Ethnic differences in patterns of AOD use were found; with self-reported drug problems, heavy episodic drinking and methamphetamine use being most prevalent among Coloured women and cannabis use being most likely among Black African women. However, more than half of Black African women reported drug-related problems and more than a third tested positive for recent methamphetamine use. More than a third of women reported being AOD-impaired and having unprotected sex during their last sexual encounter. Coloured women had four-fold greater odds of reporting that their last sexual episode was AOD-impaired and unprotected than Black African women. In addition, close to one in two women reported that their sexual partner was AOD-impaired at last sex, with Coloured women having three-fold greater odds of reporting that their partner was AOD-impaired at last sex than Black African women.


Findings support the need to develop and test AOD risk reduction interventions for women from both ethnic groups. In addition, findings point to the need for tailored interventions that target the distinct profiles of AOD use and AOD-related sex risks for HIV among Black African and Coloured women.

Ethnic differences; Alcohol and other drugs; Sexual risks; Women; South Africa