Gender as a predictor of relapse risk after adolescent drug and substance rehabilitation in Zimbabwe: a survival analysis approach

This study aimed to assess how gender predict time-to-relapse among adolescents recovering from substance abuse, applying survival analysis to capture time-sensitive relapse patterns. In this study, relapse was defined and measured as the time (in months) from discharge to the first documented readmission for substance use, based on retrospective hospital records, with multiple relapses consolidated into the first relapse event. A retrospective dataset of 1,061 adolescents (aged 12–19) was drawn from two public Zimbabwean rehabilitation hospitals (2022–2024). Time-to-first relapse was analyzed using Kaplan-Meier survival curves and log-rank tests to assess gender differences. Ethical clearance was obtained, and data were anonymized. Females had a longer mean time-to-relapse (13.28 months) than males (8.94 months). Median survival was 11.0 months for females and 7.0 months for males. The log-rank test showed a significant difference (χ² = 72.496, <i>p</i> &lt; .001). Males exhibited higher and earlier hazard rates, especially within the first 3–6 months. Gender significantly impacts relapse timing. Males are more vulnerable to early relapse due to socio-cultural pressures, while females face prolonged reintegration challenges. Gender-responsive, time-targeted interventions are essential for effective relapse prevention.