Prevalence, patterns, and associated factors of psychoactive substance use among people living with HIV in Lomé (Togo)

Background 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. Methods A cross-sectional survey was conducted between August and October 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). Multivariable logistic regression analysis was used to determine factors associated with substance use. Results 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, and 38.4% had reported the consumption of any PAS. In the multivariable analysis, the age of PLHIV (40 and 49 years old: aOR = 0.57; p = 0.043; ref = “Less than 40 years old”); the female sex (aOR = 0.36; p < 0.001); level of education (primary level of education: aOR = 0.63; p = 0.041; ref = “secondary or higher level”); religion (Christian: aOR = 0.44; p = 0.020; Muslim: aOR = 0.17; p < 0.001; ref= “none or practicing a traditional religion”); adherence to ARV treatment (aOR = 0.49; p = 0.008) and being sexually active at the time (aOR = 1.69; p = 0.012) were the factors associated with the consumption of any PAS. Conclusion 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.