Substance use literacy, adherence to HIV medication and addiction severity among adult substance users in Naivasha district hospital (Kenya)
Abstract
Substance use knowledge has been found to be low among substance users despite numerous
substance awareness campaigns. This presents a worrying trend considering that substance use is
a major impediment to HIV medication adherence. Studies done on the association between
health literacy and HIV medication adherence have given mixed results. However, the impact of
substance use literacy on HIV medication adherence is yet to be known. This study embarked on
finding out if there is a significant relationship between substance use literacy and adherence to
HIV medication and whether severity of addiction modified this relationship. A cross-sectional
study among 179 HIV infected substance users was carried out whereby Questionnaire
Assessment of Literacy in Mental Health, Addiction Severity Test and 8-item Morisky
Medication Adherence Scale psychometric tests were administered. Data was coded and
analyzed using SPSS version 20. Descriptive statistics were used to calculate frequencies and
chi-square was used to calculate significant correlations. Data was presented in the form of
tables, pie charts and narratives. Results showed 50.3% of the respondents wrongly identified the
alcohol use vignette problem as stress. Not recognizing that there was a problem was
significantly correlated to moderate adherence (P = 0.003). Among the severely addicted, there
was a clear association between low adherence and not recognizing substance use as vignette
problem. Preference was given to informal sources of help like a close friend (83.2%, P = 0.050)
and psychosocial management like physical exercise (79.9%, P = 0.007) other than professionals
like psychiatrists (58.1%) leading to moderate adherence and addiction severity. Though 81% of
the severely addicted recognized a psychiatrist could help, 61.9% of them had low adherence.
The same inverse relationship was exhibited in recognizing effective medication like
antidepressants. Poor substance use literacy was found to lead to poor adherence with severe
addiction modifying this relationship.
Publisher
University of Nairobi
Description
Thesis