Author/Authors :
Lifson, Alan R. Division of Epidemiology and Community Health - University of Minnesota, Minneapolis, USA , Workneh, Sale Ethiopian Office - National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia , Shenie, Tibebe Ethiopian Office - National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia , Admassu Ayana, Desalegn College of Health and Medical Sciences - Haramaya University, Dire Dawa, Ethiopia , Melaku, Zenebe International Center for AIDS Care and Treatment Program, Addis Ababa, Ethiopia , Bezabih, Lemlem Ethiopian Office - National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia , Waktola, Hiwot Tekle Ethiopian Office - National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia , Dagne, Behailu Ethiopian Office - National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia , Hilk, Rose Division of Epidemiology and Community Health - University of Minnesota, Minneapolis, USA , Winters, Ken C. Oregon Research Institute, Eugene, or USA , Slater, Lucy Global Program - National Alliance of State and Territorial AIDS Directors, Washington, DC USA
Abstract :
Background: Khat, a plant native to East Africa, has psychoactive constituents similar to amphetamine. Chronic khat
use can lead to psychological dependence with multiple physical and mental health harms, complicating clinical
management of people living with HIV. In two Ethiopian cities where khat is common, we evaluated prevalence and
correlates of khat use among patients new to HIV care.
Methods: During 2013–2014, we surveyed 322 patients recently enrolled in HIV clinics in Dire Dawa and Harar about
khat use, demographics, smoking and alcohol use, clinical illness, food insecurity, and social support. We analyzed fac-
tors associated with khat use in the past year, as well as heaviest use of khat (based on greatest number of hours used
in a typical month).
Results: 242 (75%) respondents reported lifetime khat use; 209 (65%) reported khat use during the previous year.
54% of khat users started before age 19 years. Although 84% believed that using khat every day is dangerous for
health if you have HIV, khat was used in the previous year a median of 5 h/days and 30 days/month; 21% said they felt
a need to cut down or control their khat use but had difficulty doing so. Those using khat were more likely to report
smoking (46%) and alcohol use (49%) compared to non-khat users (1 and 31% respectively). Those reporting heavi-
est khat use (≥180 h/typical month) were more likely to rate their health status as poor, have an underweight BMI
(≤18.5 kg/m2), report more symptoms of chronic illness, and agree with more statements indicating a negative physi-
cal quality of life. In multivariate analysis, heavy users were more likely to be male, Muslim, and non-married.
Conclusions: Khat use was common among HIV patients entering care, and associated with symptoms of poorer
physical health. Over half started khat use when they were young. Although most believed khat is harmful for HIV
patients, a number of respondents reported some difficulty controlling their drug use. In settings where khat is legal
and widely utilized, developing interventions for responsible use represent an important health priority as part of
comprehensive care for people living with HIV.
Keywords :
HIV , Khat , Amphetamine , Sub-Saharan Africa , Ethiopia
