Substance Use Disorders Among Young People Living with HIV in Sub-Saharan Africa: Insights from a Cohort Study in Ghana
Main Article Content
Abstract
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.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Dayal P, Vishakha V, Thakur N. Review on effect of drug abuse on health. V Pub J Nurs Med Res. 2023:25-26.
3. Stein DJ, Seedat S, Herman A, et al. Lifetime prevalence of psychiatric disorders in South Africa. Br J Psychiatry. 2008;192:112-117.
4. Olawole-Isaac A, Ogundipe O, Amoo EO, Adeloye DO. Substance use among adolescents in sub-Saharan Africa: A systematic review and meta-analysis. South Afr J Child Health. 2018;12:79.
5. Amin P, Douaihy A. Substance use disorders in people living with human immunodeficiency virus/AIDS. Nurs Clin North Am. 2018;53:57-65.
6. World Health Organization. WHO HIV statistics. WHO; 2024. Accessed December 17, 2024. https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/j0482-who-ias-hiv-statistics_aw-1_final_ys.pdf?sfvrsn=61d39578_3
7. Murewanhema G, Musuka G, Moyo P, Moyo E, Dzinamarira T. HIV and adolescent girls and young women in sub‐Saharan Africa: A call for expedited action to reduce new infections. IJID Reg. 2022;5:30-32.
8. Soomar SM, Qamar W, Azizullah Z, Ali TS. Challenges in healthcare access for young people living with HIV: A review. J Glob Health Econ Policy. 2023;3. Accessed December 17, 2024. https://joghep.scholasticahq.com/article/117353-challenges-in-healthcare-access-for-young-people-living-with-hiv-a-review
9. Gamarel KE, Brown L, Kahler CW, et al. Prevalence and correlates of substance use among youth living with HIV in clinical settings. Drug Alcohol Depend. 2016;169:11-18.
10. Nyongesa MK, Mwangi P, Kinuthia M, et al. Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: Prevalence and risk indicators. Subst Abuse Treat Prev Policy. 2021;16:86.
11. Nugent NR, Brown LK, Belzer M, et al. Youth living with HIV and problem substance use: Elevated distress is associated with nonadherence and sexual risk. J Int Assoc Physicians AIDS Care. 2010;9:113-115.
12. Morawej Z, Nyundo A, Kinyaga A, et al. Prevalence and factors associated with substance use among HIV-positive youth attending HIV care and treatment centers in Dodoma, Tanzania. AIDS Res Ther. 2022;19:65.
13. Williams PL, Leister E, Chernoff M, et al. Substance use and its association with psychiatric symptoms in perinatally HIV-infected and HIV-affected adolescents. AIDS Behav. 2010;14:1072-1082.
14. Ikekwere J, Eiger R, Heward B, et al. Opioid use disorder among young people living with HIV: A 10-year trend. Psychiatry Res Commun. 2023;3: 100140.
15. Abedin NFZ, Jaafar Z, Husain S, Abdullah R. The validity of ASSIST as a measurement of learning approach among MDAB students. Procedia Soc Behav Sci. 2013;90:549-557. doi:10.1016/j.sbspro.2 013.07.125
16. Ludwig A, Monico LB, Gryczynski J, et al. Drug and sexual HIV-risk behaviors among adolescents and young adults with opioid use disorder. J Subst Abuse Treat. 2021;130:108477.
17. Rowe CL, Wang W, Greenbaum P, Liddle HA. Predicting HIV/STD risk level and substance use disorders among incarcerated adolescents. J Psychoactive Drugs. 2008;40:503-512.
18. Stephanie S, Stephen MA, Michael TY, Silvia SM. Patterns of drug use and HIV infection among adults in a nationally representative sample. Physiol Behav. 2018;176(1):139-148.
19. Morawej Z, Nyundo A, Kinyaga A, et al. Prevalence and factors associated with substance use among HIV-positive youth attending HIV care and treatment centers in Dodoma, Tanzania. AIDS Res Ther. 2022;19(1):1-9. doi:10.1186/s12981-022-00485-w
20. Cook RL, Comer DM, Wiesenfeld HC, et al. Alcohol and drug use and related disorders: An underrecognized health issue among adolescents and young adults attending sexually transmitted disease clinics. Sex Transm Dis. 2006;33.
21. Necho M, Belete A, Getachew Y. The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: A systematic review and meta-analysis. Subst Abuse Treat Prev Policy. 2020;15:1-15.
22. Kanekar AS. HIV/AIDS counseling skills and strategies: Can testing and counseling curb the epidemic? Int J Prev Med. 2011;2:10-14.
23. Edelman EJ, Dziura J, Esserman D, et al. Working with HIV clinics to adopt addiction treatment using implementation facilitation (WHAT-IF?): Rationale and design for a hybrid type 3 effectiveness-implementation study. Contemp Clin Trials. 2020;98:106156.
24. Starks TJ, MacDonell KK, Pennar AL, et al. Drug use among adolescents and young adults with unsuppressed HIV who use alcohol: Identifying patterns of comorbid drug use and associations with mental health. AIDS Behav. 2020;24:2975-2983.
25. Onaolapo OJ, Olofinnade AT, Ojo FO, et al. Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature. World J Psychiatry. 2022;12 (10):1268-1286. doi:10.5498/wjp.v12.i10.1268
26. Del Boca FK, Darkes J. The validity of self-reports of substance use. J Subst Abuse Treat. 2003; 25(2):137-145.
27. Shadish WR, Cook TD, Campbell DT. Experimental and Quasi-Experimental Designs for Generalized Causal Inference. Boston: Houghton Mifflin; 2002.
28. Gerbi GB, et al. A comparative study of substance use before and after establishing HIV infection status among people living with HIV/AIDS. J Subst Use. 2011.