Getting high on treatment – a cause for concern

Whoonga and the abuse and diversion of antiretrovirals in Soweto, South Africa.

Rough K, Dietrich J, Essien T, Grelotti DJ, Bansberg DR, Gray G, Katz IT AIDS Behavior. 2014 Jul;18(7):1378-80. doi: 10.1007/s10461-013-0683-x.

Media reports have described recreational use of HIV antiretroviral medication in South Africa, but little has been written about this phenomenon in the scientific literature. We present original, qualitative data from eight semi-structured interviews that characterize recreational antiretroviral use in Soweto, South Africa. Participants reported that antiretrovirals, likely efavirenz, are crushed, mixed with illicit drugs (in a mixture known as whoonga), and smoked. They described medications being stolen from patients and expressed concern that antiretroviral abuse jeopardized the safety of both patients and users. Further studies are needed to understand the prevalence, patterns, and consequences of antiretroviral abuse and diversion.

Abstract access 

Editor’s notes: This short report is based on information provided by eight out of 43 participants of a study on decision making linked to HIV-treatment refusal.  The team did not, therefore, set out to gather data on the misuse of anti-retroviral drugs.  However, eight people volunteered information on the use of efavirenz to `get high’ by people in their communities.  The authors’ call for further research is timely with the move to `test and treat’. With more people who may not perceive themselves to be ill taking antiretroviral therapy, there may be an increased risk of drugs being sold on the black market for illicit use.

South Africa
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