The SCoOp

The community newsletter of RTI International’s Substance Use, Gender, and Applied Research (SUGAR) Program and the CoOp Studies

Dear Friends and Colleagues,

What a year it has been so far, with many of you still being affected by COVID and the new Delta variant. I sincerely hope you all are able to stay safe and get access to vaccinations. Some places are doing better than others as challenges and barriers remain for certain communities and populations. Many of our projects are getting back online, and some have actually worked almost through this whole year. We also have some new awards to celebrate that reflect our commitment for impact with underserved and underrepresented populations. We will share more about this next time.

Jackie Ndirangu, Erin Cox and Brittni Howard packing up intervention materials to be sent to South Africa for our recently finished Implementation Science project!
Jackie Ndirangu, Erin Cox and Brittni Howard packing up intervention materials to be sent to South Africa for our recently finished Implementation Science project!


We also have learned new methods by conducting appointments virtually. And in June, we welcomed our summer MPH Practicum Students, Suzanne Singer and Ayanna Smith from the Department of Maternal, Child and Family Health at UNC Gillings School of Global Public Health.


Just last month we held our 13th InWomen's Conference, with almost 20 countries addressing issues of gender and addiction virtually for the last time and we look forward to seeing everyone in person again next year. We are excited to share more updates about the conference inside!


Finally, we sent the Women’s Health CoOp package and curriculum to continue implementation in Cape Town. This was an exciting milestone after 20 years of work in South Africa!


Mpho/Dr. Wendee


To reduce alcohol and other drug misuse, risk behavior, health disparities, and gender inequality


We develop and test the efficacy, effectiveness, and impact of interventions for people who misuse alcohol and other drugs and other key populations for HIV and other health outcomes in community-based and real-world settings.


Under the direction of Dr. Wendee Wechsberg, the SUGAR Program maintains projects in South Africa and North Carolina, Delaware, and Georgia, USA, where we partner RTI’s scientific expertise with community agencies and community collaborative boards of citizens and professionals to improve the lives of people who use alcohol and other drugs.


To learn more about the SUGAR Program or the CoOp Studies, please contact Dr. Wendee Wechsberg at

Research Updates from the SUGAR Team

Ongoing Projects

South Africa Projects

Couples Health CoOp Plus (CHC+)

(MPIs: Drs. Wendee Wechsberg, Felicia Browne, RTI International; Dr. Tara Carney, South African Medical Research Council)

CHC+ Delft field site.
CHC+ Delft field site.


This study proposes to use a status-neutral approach to increase pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) initiation, adherence, and retention, while also addressing stigma toward young couples who use substances. A Peer Advisory Board was established, and we also conducted a virtual Community Collaborative Board meeting in April and received feedback on the proposed community stigma training. We are currently conducting formative activities with couples, having completed interviews with stakeholders.

This study is funded by National Institute on Drug Abuse grant R01 DA049612.


PrEPARE Pretoria: Prevention Empowering and PRotEcting Young Women in South Africa

(PI: Dr. Wendee Wechsberg; PD: Jacqueline Ndirangu)

Intervention staff in Pretoria
Intervention staff in Pretoria

This project aims to increase uptake of PrEP and sexual reproductive health services among young women aged 16 to 24. We have enrolled more than 80% of the expected sample, and have completed study activities in half of the clinics. We held a Youth Advisory Board meeting in March. All study staff have been vaccinated against COVID-19 and activities are being conducted under strict COVID prevention measures.

This study is funded by Eunice Kennedy Shriver National Institute of Child Health and Human Development grant R01 HD094629.

Cape Town Young Women’s Health CoOp

(PI: Dr. Wendee Wechsberg; Co-PD: Dr. Felicia Browne, RTI International; Co-PD: Dr. Tara Carney, South African Medical Research Council)

Study findings regarding mental health and substance use were recently published in the South African Medical Journal. This analysis found that frequency of depressive symptoms were positively related to methaqualone (Mandrax) use, which has important implications in South Africa for youth. Other study findings are forthcoming over the next several months.

This study is funded by National Institute on Drug Abuse grant R01 DA041227.

USA Projects

Carolina CoOp (Mecklenburg County, NC and surrounding NC and SC counties)

(Supplement PD: Dr. Felicia Browne; Implementation Partner: Mecklenburg County Public Health)

SUGAR staff Isa van der Drift  conducting outreach in Mecklenburg County
SUGAR staff Isa van der Drift conducting outreach in Mecklenburg County

Study activities have resumed for this implementation project. Findings from virtual focus group discussions conducted to date indicate that social and structural determinants, such as housing instability and stigma, play a role in why African American adults are not engaged or retained in HIV services. These and other findings will be used to adapt and refine the tailored intervention for the upcoming implementation stage.

This study is funded by UNC Center for AIDS Research grant P30 AI050410.

Mitigating the Outcomes Associated with the Injection Drug Use Epidemic in Southern Appalachia

(PI: Dr. William Zule)

We have suspended field work because of COVID-19. As COVID-19 cases continued to surge in the Appalachian region, we were forced to completely redesign the study to conduct all activities virtually. We are excited to have received IRB approval for the redesigned protocol in May 2021, and we have just restarted recruitment.

This study is funded by National Institute on Drug Abuse grant UG3 DA044823.

Young Women-Focused HIV Prevention: Seek & Test in NC Clinics (NC Young Women’s CoOp) (Durham, Guilford, and Wake Counties, NC)

(MPI [contact]: Dr. Wendee Wechsberg; MPI: Dr. Felicia Browne)

Having met our primary goals for this randomized trial, we conducted a brief telephone survey with a subset of participants, and the findings were presented recently. Currently, we are analyzing data and plan to disseminate the study findings via manuscripts, local meetings, and conference presentations. We thank our collaborators—the Durham County Department of Public Health, Wake County Human Services, and Guilford County Department of Public Health.

This study is funded by National Institute on Drug Abuse grant R01 DA041009.

IMPROV (Atlanta, GA)

(PI: Dr. Courtney Peasant Bonner; Implementing Partners: SisterLove, Inc., and Positive Impact Healthcare Clinics)

This study is adapting a stigma-reduction training, developing a prescribing platform to help providers offer pharmacotherapy for mental health disorders and/or alcohol use disorder, and testing the feasibility of these tools in Ryan White clinics. We conducted the first meeting with our Community Collaborative Board, completed formative work with providers, and are continuing to recruit for our in-depth interviews.

This study is funded by National Institute of Mental Health grant R34 MH124628.

Individual Breastfeeding Support with Contingent Incentives among Low-income Mothers (Philadelphia, PA and Newark, DE)

(PI: Dr. Yukiko Washio)

This project uses an established behavioral approach to incentivize breastfeeding on a monthly basis for 6- and 12-month follow-ups among postpartum mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children. We are tracking medical incidents, infant weights, and the costs associated with the intervention. We will be recruiting almost 200 African American and Puerto Rican mothers by early 2022.

This study is funded by Eunice Kennedy Shriver National Institute of Child Health and Human Development grant R01 HD094877.


Safe4both Integration of Mobile Technologies with Case Management (Newark, DE)

(PI: Tony Ma, Benten Technologies; Co-I: Dr. Yukiko Washio, RTI International)

The goal of this study is to improve the efficiency and timeliness of collaborative care management for the case manager and the postpartum mother with a substance use disorder by providing an electronic Plan of Safe Care (ePOSC) accessible via mobile phone or tablet. We are currently completing pilot testing to prepare for our Phase II application.

The study is funded by National Institute on Drug Abuse grant R43 DA048673.

EMPOW-HER (Atlanta, GA)

(Supplement PD: Dr. Courtney Peasant Bonner, Implementing Partner: SisterLove, Inc.)

Marketing flyers used for the EMPOW-HER Intervention.
Marketing flyers used for the EMPOW-HER Intervention.

This supplemental project aims to increase providers’ PrEP knowledge and self-efficacy to increase PrEP access among African American women. We will adapt a PrEP training to promote PrEP prescribing among reproductive healthcare providers who serve African American women. The training will be delivered online to allow for individualization of content and will be pretested with providers in the Atlanta area.

This study is funded by UNC Center for AIDS Research grant P30 AI050410.

NEW: Strategies To Reduce Intersectional Drug usE Stigma (STRIDES) (Durham, NC)

(PI: Dr. Felicia Browne)

We were recently awarded a new project to address drug stigma and other forms of stigma among African American adults who use alcohol and other drugs in Durham. This project will use mixed methods to examine how drug-related stigma impacts engagement and retention in HIV services, and findings will be used for an evidence-informed intervention to address drug use stigma and other intersecting forms. We will begin our formative stage, which includes journey mapping with African American adults who use drugs; in-depth interviews with health providers; and a brief survey.

This study is funded by National Institute on Drug Abuse grant R21 DA053694.

Come see members of our team present at the upcoming....

2021 Annual APHA Meeting and Expo

October 24-27, 2021

Out and About

The InWomen's Conference

The 13th InWomen's Conference, chaired by Dr. Wendee Wechsberg, was held virtually on June 18, 2021. We had a great lineup of speakers, breakout rooms, and over 100 attendees representing nearly 20 countries! Stay tuned about details for next year's conference.

Participants gathered before the conference for networking and reconnecting.
Participants gathered before the conference for networking and reconnecting.

Several of our projects were presented at InWomen's by:

  • Dr. Courtney P. Bonner
  • Erin Cox
  • Isa van der Drift
  • Dr. Tara Carney
  • Dr. Yukiko Washio
  • Jackie Ndirangu
  • Dr. Waru Gichane

UNWomen’s 65th Virtual Session on the Commission on the Status of Women (CSW)

Several SUGAR team members participated in WomenNC's panel for UNWomen's 65th Session on CSW, “Building Feminist Leaders: WomenNC’s Youth Leadership Training Program." The panel, co-hosted by Dr. Wechsberg and moderated by Dr. Browne, featured several previous WomenNC scholars as panelists, including Isa van der Drift.


Dr. Courtney Bonner was a plenary speaker during a webinar hosted by AIDSImpact. Her presentation was titled "Understanding the Strengths and Vulnerabilities of Those Most Impacted by HIV: Implications of Vaccines and Vaccination Campaigns."

Dr. Courtney Bonner presenting !
Dr. Courtney Bonner presenting !

New Publications from SUGAR Staff


Washio, Y., Browne, F.A., Ndirangu, J., Kline, T.L., Wechsberg, W.M. (2021). Antiretroviral Therapy (ART) adherence and prenatal alcohol use among women who are pregnant with HIV in South Africa. Int J Environ Res Public Health, 18(14), 7446.


Wechsberg, W.M., Browne, F.A., Ndirangu, J., Bonner, C.P., Kline, T. L., Gichane, M., & Zule, W.A. (2021). Outcomes of implementing in the real world the Women's Health CoOp Intervention in Cape Town, South Africa. AIDS Behav. 1-4.


Wechsberg, W.M., Browne, F.A., Bonner, C.P., Washio, Y., Howard, B.N., & van der Drift, I. (2021). Current interventions for people living with HIV who use alcohol: why gender matters. Curr HIV/AIDS Rep. 18(4), 351–364.


Packel, L.J., de Walque, D., Feeney, K.C., Balampama, M.P., Cooper, J.E., Kalolella, A., Wechsberg, W.M., & Dow, W. H. (2021). A randomized trial of cash incentives for sexual behavior change among female sex workers in Dar es Salaam. Soc Sci Med. 272, 111655.


Washio, Y., Novack Wright, E., Davis-Vogel, A., Chittams, J., Anagnostopulos, C., Kilby, L. M., & Teitelman, A. M. (2021). Prior exposure to intimate partner violence associated with less HIV testing among young women. J Interpers Violence, 36(5-6), NP2848–NP2867.


Short, V.L., Bellad, R.M., Kelly, P.J., Washio, Y., Ma, T., Chang, K., Majantashetti, N.S., Charantimath, U.S., Jaeger, F.J., Lalakia, P., Goudar, S.S., & Derman, R. (2021). Feasibility, acceptability, and preliminary impact of an mHealth supported breastfeeding peer counselor intervention in rural India. Int J of Gynaecol and Obstet.


Washio, Y., Atreyapurapu, S., Hayashi, Y., Taylor, S., Chang, K., Ma, T., & Isaacs, K. (2021). Systematic review on use of health incentives in U.S. to change maternal health behavior. Pre Med, 145, 106442.


Kranzler, H. R., Washio, Y., Zindel, L. R., Wileyto, E. P., Srinivas, S., Hand, D. J., Hoffman, M., Oncken, C., & Schnoll, R. A. (2021). Placebo-controlled trial of bupropion for smoking cessation in pregnant women. AM J Obstet Gynecol, 100315.

How to reach us or to join our Community Collaborative Boards (CCBs) or Youth Advisory Board (YAB)

North Carolina Community Collaborative Board, USA

Dr. Felicia Browne

Dr. Wendee Wechsberg

Atlanta Community Collaborative Board, USA

Dr. Courtney Peasant Bonner

Pretoria Community Collaborative Board and Youth Advisory Board, South Africa

Ms. Jacqueline Ndirangu

Cape Town Community Collaborative Board, South Africa

Dr. Tara Carney



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