Browsing by Author "Myers, Bronwyn J."

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    Brief school-based interventions and behavioural outcomes for substance-using adolescents
    (Cochrane, 2016-01-20) Okwundu, Charles I.; Louw, Johann; Myers, Bronwyn J.; Carney, Tara
    Background: Adolescent substance use is a major problem in and of itself, and because it acts as a risk factor for other problem behaviours. As substance use during adolescence can lead to adverse and often long-term health and social consequences, it is important to intervene early in order to prevent progression to more severe problems. Brief interventions have been shown to reduce problematic substance use among adolescents and are especially useful for individuals who have moderately risky patterns of substance use. Such interventions can be conducted in school settings. This review set out to evaluate the effectiveness of brief school-based interventions for adolescent substance use. Objectives: To evaluate the effectiveness of brief school-based interventions in reducing substance use and other behavioural outcomes among adolescents compared to another intervention or assessment-only conditions.
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    Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes : a randomised controlled trial protocol
    (BioMed Central, 2014-09-12) Parry, Charles D. H.; Morojele, Neo K.; Myers, Bronwyn J.; Kekwaletswe, Connie T.; Manda, Samuel O. M.; Sorsdahl, Katherine; Ramjee, Gita; Hahn, Judith A.; Rehm, Jurgen; Shuper, Paul A.
    Background: Little research has examined whether alcohol reduction interventions improve antiretroviral therapy (ART) adherence and HIV treatment outcomes. This study assesses the efficacy of an intervention for reducing alcohol use among HIV patients on ART who are hazardous/harmful drinkers. Specific aims include adapting a blended Motivational Interviewing (MI) and Problem Solving Therapy (PST) intervention for use with HIV patients; evaluating the efficacy of the intervention for reducing alcohol consumption; and assessing counsellors’ and participants’ perceptions of the intervention. Methods/Design: A randomised controlled trial will evaluate the intervention among ART patients in public hospital-based HIV clinics in Tshwane, South Africa. We will recruit patients who are HIV-positive, on ART for at least 3 months, and classified as harmful/hazardous drinkers using the AUDIT-3. Eligible patients will be randomly assigned to one of three conditions. Patients in the experimental group will receive the MI-PST intervention to reduce harmful/hazardous alcohol use. Patients in the equal-attention wellness intervention group will receive an intervention focused on addressing health risk behaviours. Patients in the control condition will receive treatment as usual. Participants will complete an interviewer-administered questionnaire at baseline and 3, 6 and 12 months post-randomisation to assess alcohol consumption, ART adherence, physical and mental health. We will also collect biological specimens to test for recent alcohol consumption, CD4 counts and HIV RNA viral loads. The primary outcome will be reduction in the volume of alcohol consumed. Secondary outcomes include reduction in harmful/ hazardous use of alcohol, reduction in biological markers of drinking, increase in adherence rates, reductions in viral loads, and increases in CD4 T-cell counts. A process evaluation will ascertain counsellors’ and participants’ perceptions of the acceptability and effectiveness of the interventions. Discussion: We have obtained ethical approval and approval from the study sites and regional and provincial health departments. The study has implications for clinicians, researchers and policy makers as it will provide efficacy data on how to reduce harmful/hazardous alcohol consumption among HIV patients and will shed light on whether reducing alcohol consumption impacts on HIV treatment adherence and other outcomes.
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    Heavy alcohol use in patients on highly active antiretroviral therapy : what responses are needed?
    (Health & Medical Publishing Group, 2016) Parry, Charles David; Kekwaletswe, Connie; Shuper, Paul A.; Nkosi, Sebenzile; Myers, Bronwyn J.; Morojele, Neo K.
    Background. Alcohol has a negative effect on antiretroviral therapy (ART) adherence and HIV treatment outcomes. Method. As part of formative work for a project to test the efficacy of an alcohol-focused intervention to reduce alcohol consumption and improve HIV treatment outcomes, we investigated the extent of problem drinking among patients at ART clinics in Tshwane, South Africa (SA), using the Alcohol Use Disorders Identification Test (AUDIT). Results. The finding that a third of drinkers reported hazardous drinking, roughly 10% reported harmful drinking, and a further 10% were possibly alcohol dependent replicates the findings of similar research in the Western Cape and Gauteng provinces of SA. It also points to the need for more routine screening of ART patients for problematic alcohol use. Conclusion. The 10-item AUDIT may be too time consuming for health workers in busy ART clinics to administer and score, necessitating even briefer screening instruments for assessing hazardous and harmful drinking.
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    Moving beyond access : towards a quality-orientated substance abuse treatment system in South Africa
    (Health and Medical Publishing Group (HMPG), 2012-08) Myers, Bronwyn J.; Petersen, Zaino; Kader, Rehana; Parry, Charles D. H.
    There is growing concern about the increased demand for and limited access to substance abuse treatment in South Africa.1 The government has responded by allocating more money to the delivery of substance abuse treatment, expanding the number of state-funded treatment slots, and training additional health and social workers to deliver these services, particularly in provinces where the prevalence of substance-related problems is high, such as the Western Cape.