Substance use, self-rated health and HIV status in Brazil

ABSTRACT

We compared the prevalence of of non-injecting drug use (NIDU) and Self-Rated Health (SRH) among individuals self-reporting as HIV-positive (PLWHA), HIV-negative and unknown at the III Brazilian Household Survey on Substance Use. Overall, 16,273 individuals, 12–65 years old, were interviewed in 2015. Prevalence and Standard Error (SE) were estimated considering the complex sample design and weight calibration. Chi-square tests with Rao-Scott adjustment were used to test independence between NIDU, SRH and HIV status. PLWHA presented higher frequencies of 12-month use for most substances than those reporting to be HIV-negative: alcohol use prevalence was 49.5% (SE 12.8) vs. 43.1% (SE 0.7), p = 0.34; tobacco 45.3% (SE 12.7) vs. 15.3% (SE 0.4), p < 0.01; amphetamines 1.7% (SE 1.7) vs. 0.3% (SE 0.1), p = 0.51; cannabis 10.5%(SE 6.7) vs. 2.5%(0.2), p = 0.06; powder cocaine 3.6% (SE 3.0) vs. 0.9% (SE 0.1), p = 0.45; crack-cocaine 5.3% (SE 3.2) vs. 0.3% (SE 0.1), p < 0.01; inhalants 3.6% (SE 3.0) vs. 0.2% (SE 0), p = 0.03; ketamine 1.7%(SE 1.7) vs. 0.1% (SE 0), p = 0.23; and opioids 1.7% (SE 1.7) vs. 1.4% (SE 0.2), p = 0.93. PLWHA also reported worse SRH. Our results and the scarcity of integrated substance use and HIV treatments call for innovative, cost-effective approaches to tackle these public health challenges.

KEYWORDS:

• HIV/AIDS
• probability surveys
• alcohol and drug use
• low and middle-income countries
• Brazil

Acknowledgements

The authors would like to thank the entire team for their effort in data acquisition, especially Luiz Goes Filho and Cassio Pereira de Almeida for national coordination; Ari Nascimento Silva and Luiz Alberto Matzenbacher for data management and imputation; Natalia S.S. Guadalupe and FIOTEC team for administrative support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Brazilian Household Survey on Substance Use–III was primarily funded by the Brazilian National Secretariat for Drug Policies (SENAD), with additional funds from CNPq [grant number # 473157/2012-8] and FAPERJ [grant numbers # E-26/010.001755/2014, E-26/010.002428/2019] (FIB – Principal Investigator). RBDB acknowledges National Council for Scientific and Technological Development (CNPq) [grant number # 310541/2017-4] and Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) [grant number # E-26/203.154/2017]. Its contents are solely the responsibility of the authors and do not necessarily represent the official position of the funding agency.