Prevalence and factors associated with substance use among adolescents and young people on HIV care at Kalisizo Hospital, Kyotera district Uganda

Abstract

Introduction: In sub-Saharan Africa, a significant proportion of adolescents living with HIV consume substances, and these have negative effects on their drug adherence and their quality of life. This study therefore measured the prevalence and factors associated with substance use among adolescents living with HIV at Kalisizo Hospital. Methods: A cross-sectional study utilizing mixed methods was conducted. A sample of 427 randomly selected adolescents living with HIV were interviewed. Twelve in-depth interviews were conducted among adolescents and young people who reported using substances in quantitative questionnaire. Quantitative data were obtained using an interviewer administered questionnaire and qualitative data were collected using an in-depth interview guide. Data were entered in EXCEL and exported to STATA for analysis. Bivariate and multivariable modified Poisson regression analysis was performed, and prevalence ratios reported with their 95% CI and p values. Results: The mean age of participants was 19.2 years (SD=3.5). Of the 427 participants, 52.9% were males, 46.4% had primary education and 38.2% were Catholics. The overall prevalence of substance use in our study was 39.3%. In a multivariable analysis, participants were more likely to use substances if; they practiced Anglican religion (aPR= 1.72, 95% CI: 1.01-2.94) or other religions, which are not Catholicism and Islam (aPR= 2.42, 95% CI: 1.01,5.83), they had history of substance use (aPR= 2.60, 95% CI: 1.68-4.04) and if they had peers who were using any substance (aPR= 1.47, 95% CI: 1.03-2.11). From the qualitative data, four key motives for substance use emerged: social, conformity, enhancement, and coping. Conclusion: Our study reveals a high prevalence of substance use among adolescents and young people living with HIV at Kalisizo Hospital. Key factors such as religion, past use, and peer influence, alongside motives like social acceptance, conformity, enhancement, and coping were associated with substance use.