Substance Use and Violence as Perceived by Men Hospitalized With a Violent Injury in Cape Town, South Africa

In South Africa, men experience the highest rates of homicide and substance use. Substance use has been identified as an important driver of violence against women in South Africa; however, few studies have examined the relationship between substance use and violence among men. The purpose of this study is to describe experiences and perceptions of substance use and violence among men who are hospitalized with a recurrent assault-related injury who live in townships or informal settlements in Cape Town, South Africa. Men aged 18 to 50 years, who reported alcohol or other drug use, were hospitalized for an assault-related injury, and who reported a previous assault-related injury were recruited from Groote Schuur Hospital’s Trauma Centre ( N  = 23). Each participant completed one semi-structured individual interview focused on psychological, developmental, and contextual influences related to substance use and violence. Using inductive content analysis, three themes were identified: (a) Substance use and violence relationship; (b) Childhood exposures to violence and substances; and (c) Structural context of substance use and violence. Participants described complex, multilevel factors that influence substance use, violence, and their relationship. Culturally appropriate multilevel interventions are needed that address trauma exposures, violence prevention, and substance use. Additionally, structural drivers of violence and substance use must be addressed. Future research should further examine the role of structural and social determinants on substance use and violence in the South African context.