The impact of methamphetamine ("tik") on a peri-urban community in Cape Town, South Africa.
Melissa H Watt, Christina S Meade, Stephen Kimani, Jessica C MacFarlane, Karmel W Choi, Donald Skinner, Desiree Pieterse, Seth C Kalichman, Kathleen J Sikkema
Author Information
Melissa H Watt: Duke University, Duke Global Health Institute, Box 90519, Durham, NC 27708, USA. Electronic address: melissa.watt@duke.edu.
Christina S Meade: Duke University, Duke Global Health Institute, Box 90519, Durham, NC 27708, USA; Duke University, Department of Psychiatry and Behavioral Sciences, Box 90519, Durham, NC 27708, USA.
Stephen Kimani: Duke University, Duke Global Health Institute, Box 90519, Durham, NC 27708, USA.
Jessica C MacFarlane: Duke University, Duke Global Health Institute, Box 90519, Durham, NC 27708, USA.
Karmel W Choi: Department of Psychology and Neuroscience, Box 90086, Durham, NC 27708, USA.
Donald Skinner: Stellenbosch University, Unit for Research on Health and Society, PO Box 19063, Tygerberg 7505, South Africa.
Desiree Pieterse: Stellenbosch University, Unit for Research on Health and Society, PO Box 19063, Tygerberg 7505, South Africa.
Seth C Kalichman: University of Connecticut, Department of Psychology, 406 Babbidge Road, Unit 1020, Storrs, CT 06269, USA.
Kathleen J Sikkema: Duke University, Duke Global Health Institute, Box 90519, Durham, NC 27708, USA; Duke University, Department of Psychiatry and Behavioral Sciences, Box 90519, Durham, NC 27708, USA; Department of Psychology and Neuroscience, Box 90086, Durham, NC 27708, USA.
BACKGROUND: Over the last decade, South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("tik") use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. METHODS: We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). RESULTS: Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. CONCLUSIONS: Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels.
