{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:02:19Z","timestamp":1777554139981,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>\n                    South Africa has the largest HIV burden and treatment program in the world. Diversion of HIV prevention and treatment medication for recreational use\u2014or nonmedical use for psychoactive effects\u2014is a public health concern globally and in South Africa. Few South African studies examine recreational use of HIV antiretrovirals (ARVs). The objective of this article is to evaluate the prevalence of recreational ARV use and to identify risk and protective factors associated with use. Data are drawn from a cross-sectional household survey of\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u2009=\u20094399 adolescent girls and young women (AGYW) aged 15\u201324 years in six districts across South Africa where an evaluation of a South African combination HIV prevention for girls and young women was implemented. The use of ARVs to \u201cget high\u201d was reported by 8.3% of AGYW across all districts. Logistic regressions showed that those engaging in transactional sex were at two times higher odds of recreational ARV use [adjusted odds ratio (aOR)\u2009=\u20092.01; confidence interval (95% CI): 1.51\u20132.68]. Recreational ARV use was more likely among those who used pre-exposure prophylaxis (PrEP) (aOR\u2009=\u20092.17; 95% CI: 1.36\u20133.48); HIV-positive participants who were not on ARVs for treatment (aOR\u2009=\u20090.36; 95% CI: 0.18\u20130.68); and those who were not virally suppressed (aOR, no vs. yes\u2009=\u20092.84; 95% CI: 1.21\u20136.66). As ARVs become more widely available for prevention and treatment, it will be important to monitor and address the possible emergence of ARVs as a substance for misuse or abuse.\n                  <\/jats:p>","DOI":"10.1089\/apc.2020.0218","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T16:37:29Z","timestamp":1615394249000},"page":"92-101","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["An Emerging Substance Use Epidemic: Recreational Use of HIV Pre-Exposure Prophylaxis and Treatment in South Africa"],"prefix":"10.1177","volume":"35","author":[{"given":"Caroline","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janan","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nevilene","family":"Slingers","sequence":"additional","affiliation":[{"name":"Office of AIDS and TB, UnSouth African Medical Research Council, Cape Town, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxanne","family":"Beauclair","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Lombard","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, UnSouth African Medical Research Council, Cape Town, South Africa."},{"name":"Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Mathews","sequence":"additional","affiliation":[{"name":"Health Systems Research Unit, UnSouth African Medical Research Council, Cape Town, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Simbayi L Zuma K Zungu N et al. South African National HIV Prevalence Incidence and Behaviour and Communication Survey 2017. Cape Town: HSRC Press 2019."},{"key":"e_1_3_5_3_2","volume-title":"Oral Pre-Exposure Prophylaxis (PrEP) and Test and Treat (T&T)","author":"Guidelines for Expanding Combination Prevention and Treatment Options","unstructured":"Guidelines for Expanding Combination Prevention and Treatment Options: Oral Pre-Exposure Prophylaxis (PrEP) and Test and Treat (T&T). 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Tygerberg South Africa: South African Medical Research Council 2020."},{"key":"e_1_3_5_19_2","article-title":"HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study","author":"Mathews C","unstructured":"Mathews C, , Cheyip M, , Beauclair R, et al. HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study. S Afr Med J (in press).","journal-title":"S Afr Med J"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02821-5"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2017.78.88"},{"key":"e_1_3_5_22_2","first-page":"346","article-title":"A preliminary investigation of the AUDIT and DUDIT in comparison to biomarkers for alcohol and drug use among HIV-infected clinic attendees in Cape Town, South Africa","volume":"15","author":"Kader R","year":"2012","unstructured":"Kader R, , Seedat S, , Koch JR, , Parry CD. 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