KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya.
Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Subst Abuse Treat Prev Policy. 2021 Nov 24;16(1):86. doi: 10.1186/s13011-021-00422-6.
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.
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.
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.
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.
在撒哈拉以南非洲地区，针对 HIV 感染者青少年（YLWH）的物质使用模式研究较为匮乏。为填补这一空白，我们旨在：i）确定 YLWH 与未感染 HIV 的同龄人相比，物质使用（特别是酒精和非法药物使用）的流行率；ii）调查年轻人 HIV 感染状况与物质使用之间的独立关联；iii）调查这些年轻人物质使用的风险指标。
2018 年 11 月至 2019 年 9 月，在肯尼亚沿海地区开展了一项横断面研究，招募了 819 名 18-24 岁的年轻人（407 名 HIV 阳性）。通过音频计算机辅助自我访谈以及其他措施，对酒精和药物使用障碍识别测试（AUDIT 和 DUDIT）进行了评估。使用逻辑回归确定物质使用的风险指标。
YLWH 中当前物质使用者的比例显著低于未感染 HIV 的年轻人：当前酒精使用，13%比 24%，p<0.01；当前非法药物使用，7%比 15%，p<0.01；当前酒精和非法药物使用共病，4%比 11%，p<0.01。在这一环境中，年轻人过去一年危险物质使用的流行率估计普遍较低（<10%），且组间无显著差异。HIV 阳性独立预测当前物质使用的可能性降低，但不预测危险物质使用。YLWH 与非 HIV 人群中当前物质使用的一些风险指标存在重叠，包括男性、使用阿拉伯茶和经历多种负面生活事件，但也确定了各自群体特有的风险指标。在 YLWH 中，与当前物质使用相关的 HIV 相关因素均无显著相关性。
在肯尼亚沿海地区，年轻人存在物质使用问题。与未感染 HIV 的同龄人相比，YLWH 的使用频率似乎较低。在这种情况下，针对年轻人开展物质使用预防计划是必要的，以避免他们因潜在的物质使用障碍风险（包括依赖）而陷入困境。需要解决使年轻人面临物质使用风险的多方面的内在和人际因素，作为物质使用意识和预防计划的一部分。
