Psychoactive substance use among Nigerian cohort with HIV/AIDS: frequency, types and demographic correlates

Introduction: There are good pointers from literature to the detrimental impacts of psychoactive substance use in HIV/AIDS patients. This study aimed at investigating the prevalence, types and demographic correlates of psychoactive substance use among people living with HIV/AIDS.Methods: The study participants consisted of 295 adults with HIV/AIDS and were interviewed with a designed questionnaire that consisted of two parts. The first part contained questions to elicit socio-demographic and treatment related information of the participants, while the second part focused on psychoactive substance use.Results: The mean (SD) age of participants was 37.6 (±8.6) years, and majority (61.0%) of them were made up of females. Most of the subjects were married, 181 (61.4%) and employed 174 (59.0%). Of the total participants, 64 (21.7%) reported use of a form of psychoactive substance, among which the largest proportion (19.3%) reported use of alcohol, 1.4% use cannabis while 1% admitted to use of nicotine. Following regression analyses, being male (Odds Ratio =2.38; 95% Confidence Interval: 95% CI = 1.26 - 4.49; p=0.008) and increasing educational attainment (Odds Ratio = 1.62; 95% CI: 1.07 - 2.45; p=0.02) correlated positively with psychoactive substance use, while being single (Odds Ratio = 0.59; 95% CI: 0.35 - 0.99; p=0.047) correlated negatively.Conclusion: Proactive and targeted intervention strategies against psychoactive substance use among people living with HIV/AIDS using what is known about vulnerability are implied. Further research on the complex relationship between HIV/AIDS and psychoactive substance use is indicated

A four-year review of geriatric mental health services in a Lagos based hospital, Nigeria

Background: There is a growing global concern about the public health implications of the increasing population of the elderly. One main issue of concern is centered on how to address their mental health needs using home-grown interventions and services. We expect that important lessons on geriatric mental health issues would be brought to fore in this report.Methods: This is a four-year (2007-2011) retrospective report on the mental health services rendered to 938 clients aged 60 years and above at a Lagos based mental health treatment facility in Nigeria. Designed questionnaires were filled with socio-demographic and clinical data obtained from patients' case notes based on the objectives of the study.Results: The mean (standard deviation) age of elders was 69.6 (±7.93) years, and 65.5% were females. Majority were married, self-employed and belonged to low socio-economic status (73.1%, 63.1% and 63.2%, respectively). Close to two-thirds (62.4%) commute for at least one hour to get treatment. The commonest diagnosis was psychotic disorders (34.8%), while 5.5% had Alzheimer's dementia. Some 96.5% of the elders were solely on medications. About a quarter had past history of mental illness and 48.5% reported co-morbid medical conditions, with cardiovascular problems (53.0%) being the commonest physical comorbidity. The middle old along with very old elders (aged ≥70years), and those with at least tertiary education, were more likely to present with dementia. Elders with dementia were more likely to present with index episode of mental illness and receive outpatient care.Conclusion: The elders were managed for a wide range of treatable mental illnesses and other comorbidities and commute for hours to access care. Pharmacotherapy was the preponderant sole treatment modality. There is need for sustained development of expertise to enhance multimodal care and scaling up of comprehensive geriatric mental health services. Further research is needed on how to appropriately link and/or integrate geriatric care with services at all-tiers of health care delivery