Clients in Comprehensive Care Centres (CCC) usually face stigma and have poor social
support which results in poor coping mechanisms including substance (alcohol and illicit
drugs) abuse. The prevalence of substance abuse among patients infected with the Human
Immunodeficiency Virus (HIV) is higher than that in the general population. HIV infected
patients abusing substances are not easily contracted into treatment which delays initiation of
Highly Active Antiretroviral Therapy (HAART). Substance abuse also poses a great
challenge in adherence to management and prevention of Human Immunodeficiency
Virus/Acquired Immune Deficiency Syndrome contributing to high morbidity and mortality.
The aim of this descriptive cross-sectional study was to explore the association between
perceived stigma, social support and substance abuse among Comprehensive Care Centre
clients at the Coast Province General Hospital – Mombasa. The CAGE – AID (acronym for
cut down, annoyed, guilty, eye opener – adapted to include drug use) tool was used to screen
patients for substance abuse and a score of ≥2 was considered significant. A sample of 235
patients was selected by convenience sampling method. Patients with a CAGE-AID score of
≥2 who consented were subjected to a socio-demographic questionnaire, the
multidimensional scale of perceived social support and the HIV stigma instrument for People
Living With HIV/AIDS (PLWHA). Data analysis was done using Statistical Package for
Social Sciences version 21.0. Descriptive statistics were used to examine demographic
characteristics while the Pearson‟s Chi square test was used to test the significance of
association between perceived stigma, social support and substance abuse in HIV.
Multivariate analysis was further done to test for association between the variables. The
confidence interval was set at 95%, p value at ≤0.05.The findings of the study demonstrate a
significant statistical association between lack of social support, stigma and substance abuse
among people infected with HIV/AIDS. In conclusion, an assessment of perceived stigma
and social support is instrumental in identifying HIV infected patients at risk of substance
abuse. A reduction in perceived stigma among PLWHA and adequate social support would
come in handy in dealing with substance abuse in HIV/AIDS which would see a reduction in
HIV related morbidity and mortality. HIV/AIDS patients with substance abuse disorders
should be linked with further counselling and probably psychiatric follow up. HIV/AIDS
support groups should be established and membership encouraged.