Prevalence and Correlates of Substance Use Among Youth Living with HIV in Fishing Communities in Uganda

• Published in: AIDS and behavior Vol. 28; no. 7; pp. 2414 - 2426
• Main Authors: Brathwaite, Rachel, Mutumba, Massy, Nannono, Sylvia, Ssewamala, Fred M., Filiatreau, Lindsey M., Namatovu, Phionah
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-07-2024; Springer Nature B.V
• Subjects: Adolescents; Advertising; Alcohol; Alcohols; Benzodiazepines; Cannabis; Childhood factors; Children; Community; Community involvement; Community participation; Confidence intervals; Demographics; Drug abuse; Drug use; Drugs; Fishing; Fishing communities; Health education; Health Psychology; HIV; Human immunodeficiency virus; Infectious Diseases; Interpersonal relations; Intervention; Marijuana; Medicine; Medicine & Public Health; Mental health; Multilayers; Original Paper; Poverty; Public Health; Regression analysis; Social support; Statistical analysis; Substance abuse; Substance use; Treatment outcomes; Infectious disease; Adolescents; Epidemiology; Drug use; Vulnerable communities
• ISSN: 1090-7165; 1573-3254; 1573-3254
• DOI: 10.1007/s10461-024-04339-6

Alcohol and drug use (ADU) poses a significant barrier to optimal HIV treatment outcomes for adolescents and youths living with HIV (AYLHIV). We aimed to investigate the prevalence and correlates of ADU among ALHIV in Ugandan fishing communities, areas characterized by high HIV and poverty rates. AYLHIV aged 18–24, who knew they were HIV-positive, were selected from six HIV clinics. Substance use was determined through self-report in the last 12 months and urine tests for illicit substances. Utilizing a socioecological framework, the study structured variables into a hierarchical logistic regression analysis to understand the multi-layered factors influencing ADU. Self-reported past 12 months substance use was 42%, and 18.5% of participants had a positive urine test for one or more substances, with alcohol, benzodiazepines, and marijuana being the most commonly used. With the addition of individual-level socio-demographics, indicators of mental health functioning, interpersonal relationships, and community factors, the logistic regression analysis revealed greater exposure to adverse childhood experiences increased the odds of substance use (Odds Ratio [OR] = 1.24; 95% Confidence Interval [CI]: 1.03–1.55). Additionally, exposure to alcohol advertisements at community events significantly raised the odds of substance use (OR = 3.55; 95% CI: 1.43–8.83). The results underscore the high prevalence among AYLHIV and emphasize the need for comprehensive interventions targeting individual (e.g., life skills education and mental health supports), interpersonal (e.g., peer support and family-based interventions), community (e.g., community engagement programs, restricted alcohol advertisements and illicit drug access), and policies (e.g., integrated care models and a national drug use strategy), to address ADU.