The frequency of positive urine multi-drug tests among outpatients with both HIV and psychiatric illnesses at Luthando Clinic, Chris Hani Baragwanath academic hospital, Soweto, South Africa
Khabisi, Moeketsi Elliot
here is evidence from both local and international studies on the high levels of substance use in patients with mental illnesses or those diagnosed with HIV (Human Immunodeficiency Virus). However, there is limited data in South Africa (SA) on the level of substance use, particularly cannabis, in patients who have been diagnosed with both HIV and psychiatric illness. The aim of the study is to describe the frequency of positive multi-drug urine tests for a duration of 6 months (1st January-30th June 2014) among outpatients with both psychiatric illness and HIV at the Luthando Neuropsychiatric clinic. Methods: This was a retrospective record review of all patients who attended Luthando clinic within the 6 month study period. A record sheet with demographics, multi-drug urine test (MDUT) results and clinical variables were completed for each patient and was thereafter subsequently entered into a statistical software programme SAS version 9.4 Windows database. For categorical data, a descriptive analysis was used, while Chi square and Fisher exact tests were used for evaluating associations between MDUT results and clinical variables. Cramer’s V and Phi coefficient were employed to measure the association’s strengths respectively. A 5% precision and 95% confidence level were used. Results: A total of 337 file records were reviewed. The prevalence of positive MDUTs was 36.4% (n=118). The most common substance used was cannabis at 94.9%. There was a significant association between positive MDUTs and young, male participants (p=0.030 and p=0.0001, respectively). There was a significant association between a positive MDUT and poor viral suppression (p=0.010), as well as the patient’s duration on antiretroviral treatment (ART), with a shorter duration on ART being related to use of substances (p=0.036). There was also a significant association between MDUT outcome and psychiatric diagnoses, specifically bipolar disorder due to HIV and substance use disorder (p=0.0001 and p=0.0006, respectively). Conclusion: This study demonstrated a high prevalence of substance use with a lower rate of viral suppression among patients attending Luthando Neuropsychiatric clinic. This is of great concern to personal and public health implications, hence such patients must be promptly identified in the course of their illnesses so that they can be effectively managed.
A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, in partial fulfilment of the requirements for the degree of Masters of Science in Medicine in Psychiatry
Khabisi, Moeketsi Elliot (2019) The frequency of positive urine multi-drug test among outpatients with both HIV and psychiatric illnesses at Chris Hani Baragwanath Academic Hospital, Soweto,South Africa, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/29871>