Assessment of Association between Perceived Stigma, Social Support and Substance Abuse among Clients at the Comprehensive Care Centre at the Coast Province General Hospital.

Abstract

Introduction: Clients in Comprehensive Care Centres (CCC) usually face stigma and have poor social support which results in poor coping mechanisms including substance (alcohol and illicit drugs) abuse. The prevalence of substance abuse among patients infected with the Human Immunodeficiency Virus (HIV) is higher than that in the general population. HIV infected patients abusing substances are not easily contracted into treatment which delays initiation of Highly Active Antiretroviral Therapy (HAART). Substance abuse also poses a great challenge in adherence to management and prevention of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome contributing to high morbidity and mortality. Aim/objectives: This descriptive cross-sectional study was to explore the association between perceived stigma, social support and substance abuse among Comprehensive Care Centre clients at the Coast Province General Hospital – Mombasa. Method: The CAGE – AID (acronym for cut down, annoyed, guilty, eye opener – adapted to include drug use) tool was used to screen patients for substance abuse and a score of ≥2 was considered significant. A sample of 235 patients was selected by convenience sampling method. Patients with a CAGE-AID score of ≥2 who consented were subjected to a socio-demographic questionnaire, the multidimensional scale of perceived social support and the HIV stigma instrument for People Living With HIV/AIDS (PLWHA). Data analysis: Data analysis was done using Statistical Package for Social Sciences version 21.0. Descriptive statistics were used to examine demographic characteristics while the Pearson’s Chi square test was used to test the significance of association between perceived stigma, social support and substance abuse in HIV. Multivariate analysis was further done to test for association between the variables. The confidence interval was set at 95%, p value at ≤0.05.The findings of the study demonstrate a significant statistical association between lack of social support, stigma and substance abuse among people infected with HIV/AIDS. Conclusion: An assessment of perceived stigma and social support is instrumental in identifying HIV infected patients at risk of substance abuse. A reduction in perceived stigma among PLWHA and adequate social support would come in handy in dealing with substance abuse in HIV/AIDS which would see a reduction in HIV related morbidity and mortality. HIV/AIDS patients with substance abuse disorders should be linked with further counselling and probably psychiatric follow up. HIV/AIDS support groups should be established and membership encouraged.