Substance Use among Clients of HIV Counseling and Testing Centers in East Gojjam, Ethiopia: Determinants and Its Association with HIV Infection

Introduction: Substance use is a persistent major public health problem worldwide. Alcohol and other substances have been associated with an increased likelihood of various other health risk behaviors. This study aimed to assess factors associated with substance use and whether substance use is associated with increased risk of HIV infection among clients of HIV counseling and testing centers (HCTs) in East Gojjam Ethiopia. Methods: A case control study was conducted among 953 sexually active persons ages 15-49 visiting the HCTs between December 2015 and February 2016. Interviewer-administered questioners and HIV testing were used to obtain the required data. Bivariate and multivariate analysis was used to identify the predictors of substance use as well as the relationship of substance use and HIV infection. Results: 70.1% of the entire sample reported using at least one type of substance studied by present study. The multivariate analysis indicated that substance users had higher odds of being male (AOR: 3.04; 95% CI (1.37, 6.77), living in households with low income (AOR: 2.00; 95% CI (1.36, 2.93), engaging in exchange of sex for money or other gifts (AOR: 3.22; 95% CI (1.57, 6.58) and violence history within relationships (AOR: 3.52; 95% CI (1.30, 9.55). Using both alcohol and khat within the last year was associated with three-fold increased odds of HIV infection (AOR: 3.04, 95% CI (1.37, 6.77). Conclusion: This research underscores that past-year substance use is an important predictor of current HIV status in service-seeking clients of East Gojjam HCTs. Hence, adopting a comprehensive approach that can alter the contextual factors associated with both substance use and HIV focusing on addressing risk behaviors, gender differences as well as differences in socioeconomic and cultural issues is important.