Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators

Moses K. Nyongesa*, Paul Mwangi, Michael Kinuthia, Amin S. Hassan, Hans M. Koot, Pim Cuijpers, Charles R.J.C. Newton, Amina Abubakar

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people’s HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people. Methods: Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18–24 years (407 HIV-positive). Alcohol and drug use disorders identification tests (AUDIT and DUDIT) were administered via audio computer-assisted self-interview alongside other measures. Logistic regression was used to determine substance use risk indicators. Results: The point prevalence of current substance use was significantly lower among YLWH than HIV-uninfected youths: current alcohol use, 13% vs. 24%, p < 0.01; current illicit drug use, 7% vs. 15%, p < 0.01; current alcohol and illicit drug use comorbidity, 4 vs. 11%, p < 0.01. Past-year prevalence estimates for hazardous substance use were generally low among young people in this setting (< 10%) with no significant group differences observed. Being HIV-positive independently predicted lower odds of current substance use, but not hazardous substance use. There was overlap of some risk indicators for current substance use between young people with and without HIV including male sex, khat use and an experience of multiple negative life events, but risk indicators unique to either group were also identified. Among YLWH, none of the HIV-related factors was significantly associated with current substance use. Conclusions: At the Kenyan coast, substance use is a reality among young people. The frequency of use generally appears to be low among YLWH compared to the HIV-uninfected peers. Substance use prevention initiatives targeting young people, regardless of HIV infection status, are warranted in this setting to avert their potential risk for developing substance use disorders, including dependence. The multifaceted intrapersonal and interpersonal factors that place young people at risk of substance use need to be addressed as part of the substance use awareness and prevention initiatives.

Original languageEnglish
Article number86
Pages (from-to)1-17
Number of pages17
JournalSubstance Abuse: Treatment, Prevention, and Policy
Volume16
DOIs
Publication statusPublished - 24 Nov 2021

Bibliographical note

Funding Information:
This work was funded by the Wellcome Trust International Master’s Fellowship to MKN (Grant number 201310/Z/16/Z). Further funding supporting this work was from: 1) the Medical Research Council (Grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union; 2) DELTAS Africa Initiative [DEL-15-003]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [107769/Z/10/Z] and the UK government. The funders did not have a role in the design and conduct of the study or interpretation of study findings. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK government.

Funding Information:
We thank all the young people who chose to voluntarily participate in this study. We appreciate the overwhelming support from the peer educators and staff at the HIV clinics we recruited from. Special thanks go out to the following for their immense commitment during the data collection period: Carophine Nasambu, Collins Kipkoech, Haprity Nyadzua, Irene Kasichana, Maureen Sikubali, Isaac Menza, Richard Karisa, Sadaka Charo, Victor Mwalewa and Vincent Amukumbi. The authors would also like to acknowledge the permission from the Director, Kenya Medical Research Institute (KEMRI) to publish this work.

Publisher Copyright:
© 2021, The Author(s).

Keywords

  • HIV infections
  • Kenya
  • Prevalence
  • Risk indicators
  • Substance use
  • Young people

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