Combination Prevention for Vulnerable Women in South Africa

An effective woman-focused solution for reducing risk for HIV, violence, and substance use

National Institute on Drug Abuse

South Africa is home to more people living with HIV than anywhere else in the world. HIV disproportionally affects women and girls, who constitute more than half of all people living with the disease.

In South Africa, young women have an HIV prevalence nearly four times greater than young men the same age. However, few gender-specific approaches targeting HIV prevention among women and girls exist.

RTI researchers found that by addressing substance use and sexual risk behaviors, we can reduce the risk of experiencing violence, and further the risk for acquiring HIV among women in vulnerable settings. These findings are especially significant in South Africa, where substance use, violence, and HIV are highly prevalent, particularly among women of reproductive age.

The study, conducted in Pretoria, South Africa, combined a seek, test, treat, and retain approach with an adapted version of the Women’s Health CoOp (WHC). The WHC, which was developed by Dr. Wendee Wechsberg, is a woman-focused, enhanced HIV prevention strategy that has been adapted for use with various key populations around the world and was found to be a “best-evidence” HIV behavioral intervention by the Centers for Disease Control and Prevention.

This combination approach is designed to improve the quality of life and reduce HIV infectiousness among women who are HIV positive and reduce HIV risk behaviors among women regardless of their HIV status.

Going forward, RTI is implementing an evidence-informed women’s intervention with support from the U.S. National Institute on Alcohol Abuse and Alcoholism and will assess its adoption, cost-effectiveness, and sustainability as an HIV prevention intervention for women.