Prevalence, patterns, and associated factors of psychoactive substance use among people living with HIV in Lomé, Togo : a cross-sectional study

Psychoactive substance (PAS) use among people living with HIV (PLHIV) can adversely affect treatment adherence, disease progression, and mental health. Despite growing concern, there is limited data on the prevalence and correlates of substance use in this population in Togo. This study aimed to assess the prevalence, patterns, and associated factors of PAS use among PLHIV in Lomé. A cross-sectional survey was conducted between August and October 2023 among PLHIV attending HIV clinic of the infectious and tropical diseases department of the CHU Sylvanus Olympio in Lomé. Data were collected using a structured, pre-tested questionnaire administered through face-to-face interviews. Information was gathered on sociodemographic characteristics, ART adherence, and use of PAS (alcohol, tobacco, cannabis, others) in the past 12 months. Using STATA version 15.1, multivariate logistic regression analysis was used to determine factors associated with substance use. A total of 510 PLHIV were included in this study, of which 71.6% were women. Their average age was 48.0 ± 9.5 years. The prevalence of PAS use was 38.4% (95% CI: 34.3–42.7%). In the multivariable analysis, age between 40 and 49 years (aOR = 0.57; 95% CI:0.33–0.98; p = 0.043); the female sex (aOR = 0.36; 95% CI:0.23 ;0.56; p < 0.001); secondary or higher level of education (aOR = 0.63; 95% CI:0.41–0.98; p = 0.041); Christianity (aOR = 0.44; 95% CI:0.22–0.88; p = 0.020) or Islam religion (aOR = 0.17; 95% CI:0.04–0.44; p < 0.001); adherence to ARV treatment (aOR = 0.49; 95% CI:0.29–0.82; p = 0.008) and being sexually active (aOR = 1.69; 95% CI:1.12–2.55; p = 0.012) were the factors associated with the consumption of any PAS. The high prevalence of psychoactive substance use among PLHIV in Lomé calls for urgent policy and programmatic action. Routine screening, counseling, and integrated interventions should be prioritized to address both substance use and HIV care outcomes.