Methamphetamine (tik) use, sexual risk, aggression and mental health among school going adolescents in Cape Town

Includes bibliographical references.Methamphetamine use has become a growing problem in many regions of the world.Cape Town has shown a particularly sharp increase in use over the past six years. The aim of this thesis is to establish the extent of methamphetamine use among adolescents in Cape Town, and to investigate mental health problems and sexual risk behaviour related to methamphetamine use among adolescents. In addition the study aimed to establish whether methamphetamine use is associated with not continuing to attend high school. The results of the thesis are presented through five journal articles, which address the above aims. The articles are based on two quantitative high school surveys and an ongoing surveillance of substance abuse counselling and rehabilitation centres in Cape Town. Findings in the first paper in Chapter 3 indicate that the proportion of individuals seeking substance abuse treatment for methamphetamine related problems increased steadily from 2004 to 2006 and that in 2006 73% of adolescents in treatment for substance abuse reported methamphetamine as their primary or secondary drug. Findings of the high school surveys in Chapters 4-7 indicated that between 9% and 12% of high school students (mean age = 15) reported life-time use of methamphetamine. The second and fourth papers in Chapters 4 and 6 indicated associations between methamphetamine use and sexual risk behaviour, particularly for students who reported recent use of methamphetamine. The third paper in Chapter 5 indicated associations between methamphetamine use in the past year and mental health problems among adolescents, including aggressive behaviour, depression and higher scores on a composite measure of mental health. The fifth paper in Chapter 7 showed that life-time methamphetamine use in addition to other substances was significantly associated with high school nonattendance when other non-substance use factors (repeating a year at school and being older than the norm for current grade) were taken into account. This thesis clearly demonstrates that methamphetamine use is a significant problem in Cape Town, and that developing strategies to curb and address this problem should be given priority. The thesis presents among the first and most comprehensive studies on adolescent methamphetamine use and associated problems internationally, and to our knowledge the first publications on this problem among adolescents in Africa. For South Africa, and Cape Town in particular, the greatest concern remains the associations between methamphetamine use and sexual risk behaviour, leading to an increased exposure to HIV. Further prevention efforts targeting both methamphetamine use and sexual risk behaviour should be a high priority for government and community based prevention efforts