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

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.

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Cardiovascular risk factors and illicit drug use may have a more profound effect on coronary atherosclerosis progression in people living with HIV

European Radiology ◽

10.1007/s00330-021-07755-7 ◽

2021 ◽

Author(s):

Márton Kolossváry ◽

Elliot K. Fishman ◽

Gary Gerstenblith ◽

David A Bluemke ◽

Raul N. Mandler ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Drug Use ◽

Cardiovascular Risk Factors ◽

Coronary Atherosclerosis ◽

Illicit Drug ◽

Illicit Drug Use ◽

People Living With Hiv ◽

Atherosclerosis Progression ◽

Living With Hiv

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High prevalence of recreational and illicit drug use in German people living with HIV with a potential for drug–drug interactions with antiretroviral therapy

International Journal of STD & AIDS ◽

10.1177/0956462420959169 ◽

2020 ◽

pp. 095646242095916

Author(s):

B Funke ◽

CD Spinner ◽

S Esser ◽

HJ Stellbrink ◽

A Stoehr ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Drug Use ◽

Drug Interactions ◽

Illicit Drug ◽

Illicit Drug Use ◽

People Living With Hiv ◽

Recreational Drug ◽

Recreational Drug Use ◽

Potential Risks ◽

Living With Hiv

Recreational drug use is higher in people living with HIV (PLHIV) than in the general population in Europe. This use increases the risk for drug-drug interactions (DDIs) and adverse events. We assessed the prevalence and clinical consequences of substance abuse among PLHIV. BESIDE was a cross-sectional, multi-center study in 2016/18, evaluating comorbidities, polypharmacy and recreational/illicit drug use in PLHIV on antiretroviral therapy (ART) in Germany. Legal and illicit drug use was recorded using two anonymous patient questionnaires one year apart (Q1 and Q2). The BESIDE study population consisted of 453 PLHIV (22% female, median age 46 years). Recreational drug use was reported by the majority (Q1: ever used 73%, within previous 6 months 56%): nitrite inhalants (“poppers”), cannabis and PDE-5 inhibitors were common across all age groups; ecstasy, (meth-)amphetamine and gamma-hydroxybutyrate/gamma-butyrolactone were predominantly reported by younger PLHIV. Based on Q2, two-thirds of PLHIV (67%) had been informed about potential risks of drug abuse by their doctors, whereas one-third (33%) had talked to their doctors on their own initiative with only 7% considering drug use in combination with ART a problem. Strikingly, 44% and 42% had undergone medical treatment or had been hospitalized due to drug use. These data emphasize the high clinical relevance of recreational drug use in PLHIV and the need for treating physicians to pro-actively communicate the potential risks.

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Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0211252 ◽

2019 ◽

Vol 14 (6) ◽

pp. e0211252 ◽

Cited By ~ 2

Author(s):

Maria Jose Fuster-RuizdeApodaca ◽

Vanessa Castro-Granell ◽

Noé Garin ◽

Ana Laguía ◽

Ángeles Jaén ◽

...

Keyword(s):

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Sectional Study ◽

Cross Sectional ◽

Living With Hiv

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Substance Use and Dependence Following Initiation of Alcohol or Illicit Drug Use

PsycEXTRA Dataset ◽

10.1037/e429732008-001 ◽

2008 ◽

Keyword(s):

Substance Use ◽

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use

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Trajectories of drug use among French young people: Prototypical stages of involvement in illicit drug use

Journal of Substance Use ◽

10.3109/14659891.2015.1063720 ◽

2016 ◽

Vol 21 (5) ◽

pp. 485-490 ◽

Cited By ~ 2

Author(s):

Stéphanie Baggio ◽

Stanislas Spilka ◽

Joseph Studer ◽

Katia Iglesias ◽

Gerhard Gmel

Keyword(s):

Young People ◽

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use

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Peer and Community Influences on Adolescent Substance Use in the Context of Adverse Childhood Experiences

Sociological Perspectives ◽

10.1177/07311214211018718 ◽

2021 ◽

pp. 073112142110187

Author(s):

Haley Stritzel

Keyword(s):

Substance Use ◽

Drug Use ◽

Adverse Childhood Experiences ◽

Illicit Drug ◽

Illicit Drug Use ◽

Peer Influences ◽

Childhood Experiences ◽

Community Influences ◽

Adverse Childhood ◽

Peer Substance Use

Both adverse childhood experiences (ACEs) and peer influences consistently predict early tobacco, alcohol, and illicit drug use. However, less research considers how peer and community influences contribute to or modify the association between ACEs and early substance use. This study addresses these gaps in the literature by analyzing multilevel, longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN; N = 1,912). Unstructured socializing and peer substance use largely explained the association between ACEs and drinking, smoking cigarettes, and illicit drug use in the past month. A history of ACEs magnified the association between peer substance use and the number of cigarettes smoked. Collective efficacy also shaped the associations between peer influences, ACEs, and substance use, but in different ways depending on the substance use outcome analyzed.

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Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load

Clinical Infectious Diseases ◽

10.1093/cid/ciz299 ◽

2019 ◽

Vol 70 (5) ◽

pp. 867-874 ◽

Cited By ~ 3

Author(s):

Robin M Nance ◽

Maria Esther Perez Trejo ◽

Bridget M Whitney ◽

Joseph A C Delaney ◽

Fredrick L Altice ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Substance Use ◽

Viral Load ◽

Drug Use ◽

Viral Suppression ◽

Illicit Drug ◽

Illicit Drug Use ◽

Hiv Viral Load ◽

Immunodeficiency Virus ◽

The Impact

Abstract Background Substance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved. Methods This was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies. We used joint longitudinal and survival models to examine the impact of decreasing drug use and of abstinence for each drug on viral suppression. We repeated analyses using linear mixed models to examine associations between change in frequency of drug use and VL. Results The number of PLWH who were using each drug at baseline ranged from n = 568 (illicit opioids) to n = 4272 (marijuana). Abstinence was associated with higher odds of viral suppression (odds ratio [OR], 1.4–2.2) and lower relative VL (ranging from 21% to 42% by drug) for all 4 drug categories. Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with VL suppression (OR, 2.2, 1.6, respectively). Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with lower relative VL (47%, 38%, respectively). Conclusions Abstinence was associated with viral suppression. In addition, reducing use of illicit opioids or methamphetamine/crystal, even without abstinence, was also associated with viral suppression. Our findings highlight the impact of reducing substance use, even when abstinence is not achieved, and the potential benefits of medications, behavioral interventions, and harm-reduction interventions.

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Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072401 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2401 ◽

Cited By ~ 3

Author(s):

Monica O. Kuteesa ◽

Helen A. Weiss ◽

Sarah Cook ◽

Janet Seeley ◽

Josephine N. Ssentongo ◽

...

Keyword(s):

Alcohol Use ◽

Young People ◽

Drug Use ◽

Illicit Drugs ◽

Alcohol Misuse ◽

Illicit Drug ◽

Illicit Drug Use ◽

Older Age ◽

Fishing Communities ◽

Low Education

Background: We determined the prevalence of and risk factors for alcohol misuse and illicit drug use among young Ugandans in fishing communities, a recognised “key population” for human immunodeficiency virus (HIV) infection. Methods: We conducted a cross-sectional survey among young people (15–24 years) in fishing communities in Koome, Uganda, in December 2017–July 2018. Using Audio-Assisted Self-Interviewing, we collected data on socio-demographic characteristics and alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT) and timeline follow-back calendar (TLFB). Blood samples were analysed for HIV, herpes simplex virus 2 (HSV2), and Phosphatidyl ethanol (PEth 16:0/18:1). Urine samples were analysed for illicit drugs. Results: Among 1281 participants (52.7% male, mean age 20 years), 659 (51.4%) reported ever drinking alcohol, 248 (19.4%) had 12-month-AUDIT ≥ 8, and 261 (20.5%) had whole-blood PEth 16:0/18:1 concentration ≥ 20 ng/mL, indicating significant consumption. In multivariable analyses, PEth 16:0/18:1 ≥ 20ng/mL, AUDIT ≥ 8 and binge drinking (≥6 standard drinks per drinking occasion in the previous month from TLFB) were all strongly associated with older age, low education, smoking, and HSV2. Illicit drug use prevalence was 5.2% and was associated with older age, low education, being single, and smoking. Conclusion: Levels of alcohol misuse were high among young people in fishing communities and associated with HSV2, a proxy for risky sexual behaviour. Alcohol and illicit drug harm reduction services and HIV prevention programs in Uganda should prioritise young fisherfolk.

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