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

There is a scarcity of research on drug use patterns among HIV-positive young individuals in Sub-Saharan Africa (YLWH). To fill the gap, the following was set out:

1. compare the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH to their HIV-uninfected peers;
2. look into the independent relationship between HIV infection status and substance use among these young people;
3. look into 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.

Prevalence estimates for hazardous drug use among young people in this environment in the previous year were usually low (less than 10%), with no significant group differences found. Being HIV-positive was associated with a decreased likelihood of current drug use but not of hazardous substance use. Some risk factors for current drug use were shared by HIV-positive and HIV-negative young people, such as male sex, khat usage, and a history of many negative life events, although risk markers specific to each group were also observed. None of the HIV-related indicators were shown to be substantially linked to current drug use among YLWH.

Substance abuse is common among young people on the Kenyan coast. In comparison to their HIV-uninfected friends, YLWH appear to utilize the drug less often. In this scenario, drug use prevention activities aimed at young people, regardless of HIV status, are necessary to reduce their risk of developing substance use disorders, including dependence. As part of drug use awareness and prevention campaigns, the multiple intrapersonal and interpersonal variables that put young people at risk of substance use must be addressed.