Substance abuse and its associated factors among HIV/AIDS patients at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia, 2025
DOI:
https://doi.org/10.18203/issn.2454-2156.IntJSciRep20261489Keywords:
HIV, Substance abuse, Alcohol, Prevalence, KhatAbstract
Background: Substance use refers to the consumption of psychoactive substances such as alcohol, tobacco, illicit drugs. Substance use among individuals living with HIV AIDS is a significant public health issue. The World Health Organization (WHO) estimates that globally about 25- 90% of HIV AIDS patients engage in substance use. In Ethiopia, magnitude of HIV AIDS was 3.69% in 2022/2023. Therefore, this study was to identify the magnitude of substance use and associated factor among HIV/AIDS patients at Dessie Comprehensive Specialized Hospital, Ethiopia.
Methods: A cross-sectional study was conducted from November to December 2025, involving 422 participants selected through stratified random sampling. Data were collected via structured face-to-face interviews and analyzed using statistical package for the social sciences (SPSS). Logistic regression identified factors associated with substance use.
Result: this study showed that 20.8% of HIV-positive individuals reported substance use, with khat (64.2%) and alcohol (29.8%) being the most common substances. Males were four times more likely to use substances than females. Substance use history, peer substance use, and depression were significantly associated with increased substance use.
Conclusion: These findings emphasize the need for integrated care approaches that combine HIV treatment with substance use interventions. It recommends routine screening for substance use and mental health disorders, gender-sensitive and peer-based interventions, and policy changes to improve access to comprehensive care for individuals living with HIV.
References
CDC. Epidemiology NCfHSDoAa. Substance use. 2023. Available at: /https://wwwcdcgov/nchs/hus /sources-definitions/substance-usehtm#print. Accessed on 10 February 2026.
Parthasarathy SMJ, Moore C, Weisner C. Utilization and cost impact of integrating substance abuse treatment and primary care. Med Care. 2003;41(3):357-67.
Roba HSBA, Irenso AA, Gebremichael B. Prevalence of lifetime substances use among students in Ethiopia: a systematic review and meta-analysis. System Rev. 2019;2019;8:1-16.
Duko B, Ayalew M, Ayano G. The prevalence of alcohol use disorders among people living with HIV/AIDS: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy. 2019;14:52.
WHO GHP. HIV data and statistics. 2025. Available at: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics. Accessed on 10 February 2026.
Degenhardt L, Stockings E, Patton G, Hall WD, Lynskey M. The increasing global health priority of substance use in young people. The Lancet Psychiatr. 2016;3(3):251-64.
Deren SCT, Dickson VV, Guilamo-Ramos V, Han BH, Karpiak S, Naegle M, et al. Substance Use Among Older People Living With HIV: Challenges for Health Care Providers. Front Public Health. 2019;7:94.
Chander G, Himelhoch S, Moore RD. Substance abuse and psychiatric disorders in HIV-positive patients: epidemiology and impact on antiretroviral therapy. Drugs. 2006;66:769-89.
Przybyla S, Ashare RL, Cioffi L, Plotnik I, Shuter J, Seng EK, et al. Substance Use and Adherence to Antiretroviral Therapy among People Living with HIV in the United States. Trop Med Infect Dis. 2022;7(11):349.
Morawej Z NA, Kinyaga A, Kirway V, Kagoye S, Turiho A, Nakasujja N. Prevalence and factors associated with substance use among HIV positive youth attending HIV care and treatment centers in Dodoma, Tanzania. AIDS Res Ther. 2022;19(1):65.
Kassew TTG, Alamneh TS, Kassa SF, Liyew B, Terefe B. The prevalence and determinant factors of substance use among the youth in Ethiopia: A multilevel analysis of Ethiopian Demographic and Health Survey. Front Psychiatry. 2023;14:1096863.
Galvan FH, Bing EG, Fleishman JA, London AS, Caetano R, Burnam MA, et al. The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. J Stud Alcohol. 2002;63(2):179-86.
Hirpa SFA, Addissie A, Bauld L, Frese T, Unverzagt S, et al. An emerging problem of shisha smoking among high school students in Ethiopia. J Environ Res Public Health. 2021;18.
Johnson OAE, Okonna. E, Adeboye. S, Udoh. A. The Prevalence and Factors affecting Psychoactive Substance Use among Undergraduate Students in University of Uyo, Nigeria. J Community Med Prim Health Care. 2017;29:11-22.
Ebrahim JAJ, Demant D. Substance use among young people in sub-Saharan Africa: a systematic review and meta-analysis. Front Psychiatry. 2024;15:1328318.
Siziya SMA, Besa C, Babaniyi O, Songolo P, Kankiza N, et al. Cannabis use and its socio-demographic correlates among in-school adolescents in Zambia. Italy J Pediatr. 2013;39:13.
Osborne AAR, Olorunsaiye CZ, James PB, Bangura C, Seidu A-A, et al. Alcohol use among in-school adolescents in Sierra Leone. BMJ Open. 2024;14:e080222.
Olawole-Isaac AOO, Amoo EO, Adeloye D. Substance use among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. South African J Child Health. 2018;12(SPE):s79-84.
Necho M, Belete A, Getachew Y. The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy. 2020;15:63.
Duko B, Toma A, Abraham Y. Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross-sectional study. Substance Abuse Treat Prevent Policy. 2019;14:1-6.
Seme A, Mariam DH, Worku A. The association between substance abuse and HIV infection among people visiting HIV counselling and testing centres in Addis Ababa, Ethiopia. Ethiopia J Health Develop. 2005;19(2):116-25.
Goar SG, Audu MD, Agbir MT, Dochalson E. Prevalence and socio-demographic correlates of alcohol use disorders among HIV patients. African J Drug Alcohol Stud. 2011;10(1):41-7.
Kassaw AT, Sendekie AK, Wubetu GA, Adugna BY. Prevalence and Associated Factors of Substance Use Disorder in Bahir Dar City Residents, Northwest Ethiopia. Health Social Care Commun. 2026;5563946:12.
Goar SG, Audu MD, Agbir MT, Dochalson E. Prevalence and socio-demographic correlates of alcohol use disorders among HIV patients. Africa J Drug Alcohol Studies. 2011;10(1).
Lifson AR, Workneh S, Shenie T, Ayana DA, Melaku Z, Bezabih L, et al. Frequent use of khat, an amphetamine-like substance, as a risk factor for poor adherence and lost to follow-up among patients new to HIV Care in Ethiopia. Aids Res Human Retroviruses. 2017;33(10):995-8.
Onohuean H OF, Omara C, Saleem H. Prevalence and epidemiological distribution of substance use among people living with HIV in the East African region: a meta-analysis. Front Psychiatr. 2025;16:1494469.
Tsuyuki KPE, Levi-Minzi MA, Urada LA, Kurtz SP, Stockman JK, Surratt HL. Substance Use Disorders, Violence, Mental Health, and HIV: Differentiating a Syndemic Factor by Gender and Sexuality. AIDS Behav. 2017;21(8):2270-82.
Abate SM CY, Minaye SY. Prevalence and risk factors of psychoactive substance abuse among students in Ethiopia: A systematic review and meta-analysis. Ann Med Surg (Lond). 2021;70:102790.
Duko B, Toma A, Abraham Y. Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross- sectional study. Subst Abuse Treat Prev Policy. 2019;14:22.
Pokhrel KNGPK, Neupane SR, Sharma VD. Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life. Glob Health Act. 2018;11(1):1441783.
Whitesell MBA, Peel J, Brown M. Familial, social, and individual factors contributing to risk for adolescent substance use. J Addict. 2013;2013:579310.
Shifa JEAJ, Demant D. Substance use among young people in the West Arsi Zone, Ethiopia: A cross-sectional study. PLoS One. 2025;20(3):e0319432.
Brooke-Sumner C, Marchionatti LE, Mneimneh Z, Harker N, Egbe CO, Jenkins D, et al. Systematic Review and Meta-Analysis of the Prevalence of Substance Use Among Adolescents in South Africa. Drug Alcohol Rev. 2026;45(4):e70143.
Magidson JF, Skeer MR, Mayer KH, Safren SA. Prevalence of psychiatric and substance abuse symptomatology among HIV-infected gay and bisexual men in HIV primary care. Psychosomatics. 2015;56(5):470-8.
Deep PD, Ghosh N, Gaither C, Rahaman MS. The Factors Affecting Substance Use and the Most Effective Mental Health Interventions in Adolescents and Young Adults. Psychoactives. 2024;3(4):461-75.
Watts LL, Hamza EA, Bedewy D, Ahmed M. A meta-analysis study on peer influence and adolescent substance use. Curr Psychol. 2023;43:1-16.
Brennan MM, Doyle A, Millar SR, Cavallaro M, Zgaga L, Smyth BP, et al. Early and risky adolescent alcohol use independently predict alcohol, tobacco, cannabis and other drug use in early adulthood in Ireland: a longitudinal analysis of a nationally representative cohort. BMC Public Health. 2025;25(1):1129.