Open Access Pub publishes peer-reviewed, free-to-read open-access articles. Showing
articles matching Substance abuse — open any to read the full text,
or download the PDF or XML.
Jul 2026 DOI 10.14302/issn.2324-7339.jcrhap-26-6137
Austin Lee J.Corresponding author
Introduction Contemporaneous substance abuse, violence and HIV/AIDS risks (SAVA) result in synergistic negative impacts (syndemic effects). Presence of and risks for syndemic SAVA conditions are common among emergency department (ED) patients, however research on these inter-related processes is limited in sub-Saharan Africa. This study utilizes structural equation modeling to examine the relationships of syndemic SAVA conditions among persons seeking emergency injury care in Nairobi, Kenya. Methods This secondary analysis of a prospective observational study examined SAVA syndemic conditions among non-pregnant, adult ED injury patients able to provide consent at Kenyatta National Hospital. Structural equation modeling using diagonally weighted least squares (DWLS), was used to quantify associations between three latent variables (substance use, HIV risks, violence exposure). HIV risk included partner HIV status, men who have sex with men (MSM), and gay identities; violence exposure covered emotional, physical or sexual violence in the past six months; substance use encompassed positive screening for alcohol use disorder, poly-substance use, injection drug use and injury-related substance use. Model fitness was assessed using the Bentler-Bonett Normalized Fit Index (BB NFI), Goodness of Fit Index (GFI) (>0.9) and standardized root mean square residual (SRMSR) (< 0.05). Covariance between the latent factors was estimated. Results Among 2,368 screened ED patients, 665 were enrolled. Males were 83% of the sample; median age was 30 years (IQR: 24-38). Fit indices using DWLS showed a close fitting model (GFI=0.99, BB NFI=0.95, SRMSR=0.04). The indicator variables had significant loadings on two of the three syndemic factors (substance use and violence exposure, β range 0.10-0.95); in the SEM only MSM status had a significant loading on HIV risk, which was insufficient to confirm the identification of the latent factor. Violence exposure and substance use risk had significant positive covariance (0.30, p<0.001). Discussion and Conclusion This study provides the first available data from ED patients in sub-Saharan Africa on SAVA conditions, showing a co-relationship of violence exposure and substance use but no significant associations with HIV risk. These results can be used to inform programmatic interventions for higher-risk persons addressing synergistic conditions during emergency care.
Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5613
de Dieu Harerimana JeanCorresponding author
Background Domestic violence among HIV discordant couples poses significant public health challenges, affecting treatment adherence and HIV transmission risks. This study examined factors contributing to domestic violence among HIV discordant couples in Kicukiro District, Rwanda. Methods A cross-sectional study was conducted among 384 HIV discordant couples from eleven health centers using stratified systematic sampling. Data were collected through structured face-to-face interviews and analyzed using descriptive statistics and bivariate analysis. Results Domestic violence prevalence was 41.1% physical violence, 34.2% sexual coercion, and 52.3% emotional abuse. Key socio-demographic risk factors included female gender (56% vs. 29% males, p<0.001), older age (61% in ≥55 years vs. 32% in 18-24 years, p=0.004), unemployment (55% vs. 34% formal employment, p=0.014), and financial hardship (63% vs. 25% comfortable situations, p=0.002). Behavioral factors included alcohol use (58% vs. 38%, p=0.021), substance abuse (62% vs. 35%, p<0.001), and poor conflict resolution (72% vs. 25%, p<0.001). Contextual factors like hostile HIV disclosure reactions (68% vs. 34%, p<0.001) and HIV-related stigma (60% vs. 35%, p<0.001) significantly increased violence risk. Conclusions Domestic violence among HIV discordant couples is multifactorial, driven by socio-economic, behavioral, and HIV-related factors. Integrated interventions addressing economic empowerment, conflict resolution skills, stigma reduction, and couple-centered counseling are urgently needed.
Aug 2017 DOI 10.14302/issn.2324-7339.jcrhap-16-1316
Gebreyohannes Selamu LiransoCorresponding author
Scholar in Medical and Psychiatry Social Work, Mangalore, India
The socio-cultural context of illness has become a major research area, and it has made significant contributions to our understanding of the socio-cultural dimensions of illness. In this article, we briefly trace the roots of a socio-cultural approach to illness, and we present some of the key findings of socio-cultural organized under main themes. Adherence to antiretroviral therapy drugs in the treatment of HIV infection is complicated because of many psychosocial factors. The aim of the study was to investigate the psychosocial factors involved in non-compliance with ART among people infected with HIV in Alert Hospital in Ethiopia. To achieve its objective, the study utilized a qualitative method to gather direct, inductive and wealthy information from the participants. The study covered interviews with twenty participants. The participants were selected using purposive sampling technique. The collected data was categorized and analyzed thematically based on the research objective. The results of the study indicated that the major psychological and social factors such as stigma and discrimination, social support, substance abuse, subjective norms, belief system and perceived behavioral control, and various cultural factors may uniquely contribute to deeper and potential barriers to ART adherence. Evaluating changes in the level of knowledge health workers trained in adherence measurements and concerned bodies work for providing relevant and updated information about ART issues for the followers in a convincing way. Therefore, the study has concluded that health workers in all facilities that provide ART would be trained in adherence counseling through formal training.