‘Some mix it with other things to smoke’ : perceived use and misuse of ARV by street thugs in Tshwane District, South Africa

Abstract

The increasing numbers of people living with HIV (Human immunodeficiency virus) and the availability of HIV anti-retroviral therapies (ARVs) have brought attention to the misuse and diversion of ARVs. ARVs are reportedly diverted by street thugs into a new illusive and addictive drug called “Nyaope or “Whoonga”. The purpose of the study was to explore and describe the experiences of Members of HIV and AIDS and Related Malnutrition Communities of Practice (CoPs) regarding the perceived diversion of ARVs in the Tshwane district of South Africa. A qualitative, descriptive study was done. Purposive sampling was used to select the participants, who were members of the CoP working with HIV and AIDS. A total of 26 participants recruited from two Tshwane universities and hospitals were interviewed to explore their experiences regarding the diversion of ARVs in Tshwane. Interviews were transcribed verbatim. Participants reported that most people on ARVs and their families knew about the side effects of ARVs, with emphasis on the hallucinogenic effect of some ARVs which were targeted by street thugs for redesigning into “Nyaope”. The ARV drug said to be used for this purpose was Efivarenz. How the ARVs got into the hands of illegal drug dealers remains unknown. However there were suggestions that HIV positive patients were robbed of their HIV medicines or some sold the medicines. Through these illegal routes, there were concerns that ARVs were becoming available to street thugs who then use them to make a new drug called “Nyaope” or “Whoonga” which is smoked for recreational purposes. Participants recommended that there should be increased efforts to protect the confidentiality of persons living with HIV so they are not targeted by illicit drug dealers. The launch of the fixed-drug-combination (FDC) in South Africa needs to be controlled and monitored.