Substance Use Disorders Among Young People Living with HIV in Sub-Saharan Africa: Insights from a Cohort Study in Ghana

Background: Substance use disorders are a growing public health concern, especially among adolescents and young people, as they are disproportionately affected. In sub-Saharan Africa, the estimated overall prevalence of substance use disorders is 41.6%. Substance use disorders lead to challenges among young people living with HIV, including reduced adherence to antiretroviral therapy, worsened health outcomes, and increased risk of HIV transmission. Hence, understanding the patterns and prevalence of substance use disorders among this population is essential for effective mitigative strategies and interventions. This study aims to evaluate the patterns and prevalence of substance use disorders among young people living with HIV and their HIV-negative close relatives in Ghana. 

Method: A cohort study was conducted among young people living with HIV receiving treatment at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, and their HIV-negative close relatives who are aware of the HIV status of the young people living with HIV. 196 participants aged between 12-24 years were recruited and organized into two groups in equal distribution: young people living with HIV (Case) and HIV-negative close relative (Control). Data was collected between October 22, 2021, and November 14, 2021, using the World Health Organization (WHO)-validated Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) version 3.0. Inferential and descriptive analyses were done using IBM SPSS 27.0, where significance was set as p < 0.05. 

Results: Females accounted for 53.57% of the total sample (n = 105) and were between 12 and 24 years old (n = 77; 39.29%). Alcohol was the most reported substance used (n = 46; 23.47%), with 24 controls and 22 cases. Participants in the case group showed high adherence to ART but reported few instances where substance use has impacted their responsibilities. Substance use disorders were found to be generally higher among controls, as they were generally more engaged in substance use.

Conclusion: The prevalence of substance use disorders was higher in the HIV-negative close relatives of young people living with HIV. This could be a result of regular counselling received by the young people living with HIV. Efforts should be made to integrate substance use prevention counselling for both young people living with HIV and their close contacts to reduce the burden of substance use disorders.