Substance abuse and adherence to antiretroviral therapy among patients attending clinic at a specialist hospital in Jos, Nigeria

Abstract

Substance abuse does not only increase susceptibility to HIV/AIDS through high risk Sexual behaviors but it also hastens the progression of the disease among infected persons than in those who do not abuse drugs. Furthermore, drug use impairs adherence to antiretroviral therapy (ART) leading to reduction in ART effectiveness and ultimately increased HIV-related mortality. In North Central Nigeria there is a dearth of information concerning the influence of substance abuse on adherence to ART which has substantially altered the fate of HIV-infected people. The objectives of this study therefore, were to determine the type of substances abused by HIV-infected patients attending clinic at Plateau State Specialists Hospital (PSSH) and to determine the effect of substance abuse and sociodemographic factors on adherence to ART among these patients. Ethical approval was obtained before the commencement of the study which was crosssectional in design. The study was carried out at the infectious disease unit of the Plateau State Specialists Hospital, Jos among 160 consecutive patients. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used for the assessment of the types of substance abused and AIDS Clinical Trials Group(ACTG) adherence instrument was used to assess reasons for non- adherence. The results showed that 61.9% of the patients did not use any substance of abuse, 38.1% either abused one substance or a combination of substances. Substance abuse were ( p = 0.0001), alcohol abuse (p = 0.003) and educational status ( p = 0.0001) significantly associated with non-adherence to ART while, age ( p = 0.954), employment status ( p = 0.924) and marital status ( p = 0.466) were not. However, logistic regression revealed that only alcohol abuse (B = -1.383, df = 1, p  = .002) predicted non adherence to ART. We recommend the screening of patients on ART for substance abuse and a multi-disciplinary approach to the treatment of HIV/AIDS. Keywords: HIV, substance abuse, medication adherence