Prevalence of substance use amongst people living with human immunodeficiency virus who attend primary healthcare services in Mthatha, South Africa

Background: About 13.3% of the South African population use some kind of substance during their lifetime. The incidence of substance use disorders is twice the global average. The use of various substances amongst people living with human immunodeficiency virus (PLWH) has increased tremendously in recent years. The growing culture of substance use amongst PLWH is a serious threat adding to the human immunodeficiency virus (HIV) epidemic and is likely to compromise the continuity of HIV care. Methods: A cross-sectional descriptive survey recruited adult PLWH who attended primary healthcare (PHC) services in Mthatha between 15 March and 15 April 2018. The Alcohol, Smoking and Substance Involvement Screening Test questionnaire (ASSIST), a tool validated by the World Health Organization, was used for data collection. Results: Out of a total 347 participants, 53% reported lifetime substance use and 32% admitted current use of a substance. Alcohol was the most common substance reported, followed by tobacco and cannabis. The majority of participants were female (75.2%), unemployed (70.8%), had secondary school-level education (85.2%) and a per capita household income below the national food poverty line (75%). The mean age of the participants was 37.9 years (standard deviation [SD] +/- 10.33); this was marginally higher for male (39.9 years; SD +/- 10.92) than female (37.2 years; SD +/- 10.06) participants. Conclusion: This study has shown that there is a high prevalence of lifetime and current alcohol abuse amongst PLWH who make use of PHC services in the Mthatha area of South Africa. Of particular concern are the strong pointers towards younger people and males.