School of Medicine, Deakin University, 75 Pigdons St, Waurn Ponds, Geelong, VIC, 3216, Australia.
College of Population Health, Thomas Jefferson University, Philadelphia, USA.
AIDS Behav. 2023 Feb;27(2):558-577. doi: 10.1007/s10461-022-03791-6. Epub 2022 Jul 27.
South Africa currently has the highest number of cases of HIV in the world. HIV antiretrovirals (ARVs) are publicly available across the country to address this crisis. However, a consequence of widely available ARVs has been the diversion of these drugs for recreational usage in a drug cocktail commonly known as "nyaope" or "whoonga," which poses a significant public health concern. To better understand nyaope, we conducted a systematic review investigating the risks and consequences associated with its usage. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searches were conducted in eight different databases and screened thereafter. Articles were eligible for inclusion if they included analysis of least one nyaope user and considered either demographics, risk factors, or consequences of usage. Data extracted included study characteristics and limitations, as well as demographic factors, risk factors for usage in the general population, and consequences. Quality assessments were performed using the Joanna Briggs Institute's tools. Searches produced a total of 228 articles and, after screening, a total of 19 articles were eligible for inclusion. There was a pooled total of 807 nyaope users, all in South Africa. Major risk factors for usage were being male, unemployed, not completing secondary education, pressure from peer groups, having HIV, prior use of cannabis, and to a lesser extent, usage of other substances such as alcohol and tobacco. While young adults tend to be at high-risk, evidence indicates that adolescents are also at-risk. Consequences of usage include high rates of infection, cortical atrophy, depression, and addiction. Addiction was shown to lead to individuals stealing from friends and family to pay for the drugs. HIV-positive nyaope users were more likely to partake in risk behaviours and tended to have high viral loads. Nyaope's rise has been linked to many health and social issues. Considering that this may also disrupt HIV control efforts in South Africa, there is an urgent need to address the rise of nyaope.
南非目前是世界上艾滋病毒病例最多的国家。为了解决这一危机，全国各地都可以获得艾滋病毒抗逆转录病毒药物（ARV）。然而，广泛提供 ARV 的一个后果是，这些药物被转移用于娱乐用途，制成一种俗称“nyaope”或“whoonga”的药物混合物，这对公共健康构成了重大威胁。为了更好地了解 nyaope，我们进行了一项系统评价，调查其使用相关的风险和后果。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，在八个不同的数据库中进行了搜索，然后进行了筛选。如果文章分析了至少一个 nyaope 用户，并考虑了人口统计学、风险因素或使用后果，则符合纳入标准。提取的数据包括研究特征和局限性，以及人口统计学因素、普通人群使用的风险因素以及后果。使用 Joanna Briggs 研究所的工具进行质量评估。搜索共产生了 228 篇文章，经过筛选，共有 19 篇文章符合纳入标准。总共共有 807 名 nyaope 用户，全部来自南非。使用的主要风险因素包括男性、失业、未完成中学教育、来自同龄人的压力、感染艾滋病毒、以前使用大麻，以及在较小程度上使用其他物质如酒精和烟草。虽然年轻人风险较高，但有证据表明青少年也有风险。使用的后果包括感染率高、皮质萎缩、抑郁和成瘾。成瘾导致个人从朋友和家人那里偷钱来支付毒品费用。艾滋病毒阳性 nyaope 用户更有可能参与危险行为，并且病毒载量往往较高。nyaope 的兴起与许多健康和社会问题有关。考虑到这也可能破坏南非的艾滋病毒控制工作，迫切需要解决 nyaope 的兴起。
