{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:30:42Z","timestamp":1769560242279,"version":"3.49.0"},"reference-count":38,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,17]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Sexual and physical trauma and substance use are intersecting risks for HIV among young women. This study assesses the feasibility, acceptability and preliminary effects of a novel trauma-informed substance use and sexual risk reduction intervention for young South African women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A single arm feasibility test and qualitative interviews of participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Sixty women, between 18 and 25 years of age, who reported trauma exposure, substance use and recent condom-less sex were recruited. Twenty participants were randomly selected for qualitative interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>A six-session group-based intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>We examined the proportion of women who provided consent, completed counselling and were retained in the study. Qualitative interviews explored intervention acceptability. Preliminary effects of the intervention on substance use, mental health (depression, psychological distress and trauma symptoms) and sexual risk outcomes (STI symptoms, number of partners and condomless sex) were explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 66 eligible women, 91% were enrolled. Intervention completion rates were low; 35% attended all sessions. On average, participants attended four sessions (M=3.8, SD=1.3). A 93% follow-up rate was achieved at the 3-month endpoint. In this single group design, reductions in the proportion of participants who tested positive for methamphetamine, cannabis and methaqualone were observed at the 3-month endpoint. Symptoms of depression, psychological distress and trauma; number of STI symptoms; and number of sexual partners also decreased. Outcomes were similar for participants who completed up to four and those who completed five or more sessions. Participants thought the intervention was highly beneficial and proposed modifications to enhance acceptability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This novel intervention seems acceptable and holds potential benefits for trauma-exposed women who use substances. Truncating the intervention may enhance the likelihood of its implementation. The efficacy of the intervention for improving substance use, sexual risk and mental health outcomes requires testing in a controlled design.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024776","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T09:24:20Z","timestamp":1549272260000},"page":"e024776","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["A trauma-informed substance use and sexual risk reduction intervention for young South African women: a mixed-methods feasibility study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0235-6716","authenticated-orcid":false,"given":"Bronwyn","family":"Myers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Carney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia A","family":"Browne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendee M","family":"Wechsberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,3]]},"reference":[{"key":"2024051714490856000_9.2.e024776.1","first-page":"339","article-title":"The South African Stress and Health (SASH) study: 12-month and lifetime prevalence of common mental disorders","volume":"99","author":"Herman","year":"2009","journal-title":"S Afr Med J"},{"key":"2024051714490856000_9.2.e024776.2","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1016\/j.socscimed.2008.07.023","article-title":"Risk for post-traumatic stress disorder associated with different forms of interpersonal violence in South Africa","volume":"67","author":"Kaminer","year":"2008","journal-title":"Soc Sci Med"},{"key":"2024051714490856000_9.2.e024776.3","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/j.socscimed.2012.06.020","article-title":"Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town","volume":"75","author":"Pitpitan","year":"2012","journal-title":"Soc Sci Med"},{"key":"2024051714490856000_9.2.e024776.4","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1037\/tra0000207","article-title":"The role of substance use coping in the relation between childhood sexual abuse and depression among methamphetamine users in South Africa","volume":"9","author":"Berg","year":"2017","journal-title":"Psychol Trauma"},{"key":"2024051714490856000_9.2.e024776.5","first-page":"47","article-title":"The self-medication hypothesis revisited: The dually diagnosed patient","volume":"10","author":"Khantzian","year":"2003","journal-title":"Primary Psychiatry"},{"key":"2024051714490856000_9.2.e024776.6","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3109\/00952990.2010.493592","article-title":"Methamphetamine (\u201ctik\u201d) use and its association with condom use among out-of-school females in Cape Town, South Africa","volume":"36","author":"Wechsberg","year":"2010","journal-title":"Am J Drug Alcohol Abuse"},{"key":"2024051714490856000_9.2.e024776.7","doi-asserted-by":"publisher","DOI":"10.1891\/vivi.21.2.247"},{"key":"2024051714490856000_9.2.e024776.8","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2013.815366"},{"key":"2024051714490856000_9.2.e024776.9","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1007\/s10461-014-0820-1","article-title":"Experiences of violence and association with decreased drug abstinence among women in Cape Town, South Africa","volume":"19","author":"Reed","year":"2015","journal-title":"AIDS Behav"},{"key":"2024051714490856000_9.2.e024776.10","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0140-6736(10)60548-X","article-title":"Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study","volume":"376","author":"Jewkes","year":"2010","journal-title":"The Lancet"},{"key":"2024051714490856000_9.2.e024776.11","unstructured":"Shisana O , Rehle T , Simbayi LC , et al . 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