Association of Khat and alcohol use with HIV infection and age at first sexual initiation among youths visiting HIV testing and counseling centers in Gamo-Gofa Zone, South West Ethiopia

Abstract

BackgroundHIV/AIDS is the major problem and an obstacle to both the health and development of people in Ethiopia today. It is also indicated that the use of substances have dramatically increased despite the serious concern about HIV infection.MethodsUnmatched case control study was conducted in South West Ethiopia using a sample of 105 cases and 305 controls. Multivariate logistic regression was used to assess the degree of association between dependent and independent variables.ResultHIV infection was positively associated with being in the age of 20 – 24 years [OR & (95% CI) = 2.892 (1.266, 6.607)], being female [OR & (95% CI) = 2.013 (1.061, 3.822)], alcohol use [OR & (95% CI) = 5.883 (3.034, 11.408)], having no education [OR & (95% CI) = 3.193 (1.523, 6.695)] and primary education level [OR & (95% CI) = 3.160 (1.351, 7.388)]. Early sexual initiation was also positively associated with being not employed Adj. HR & (95% CI) = 7.372 (1.455, 37.357)], not having comprehensive knowledge on HIV/AIDS [Adj. HR & (95% CI) = 8.247 (2.121, 32.067)], alcohol use [Adj. HR & (95% CI) = 3.815 (1.315, 11.070)] and khat use [Adj. HR & (95% CI) = 7.241 (1.871, 28.016)].ConclusionStrategies should be designed to control the use of alcohol and khat which were found to be predictors of HIV infection and early sexual initiation in this study.

The Psychostimulant Khat (Catha edulis) Inhibits CYP2D6 Enzyme Activity in Humans

“…A high prevalence of HIV in khat users is well documented, and HIV patients on antiretroviral therapy also chew khat concomitantly. 5,15,18 Ethiopia is a malariaendemic country. Plasmodium vivax malaria is responsible for 40% of total malaria cases in Ethiopia, and the only remedies are chloroquine and primaquine, which are metabolized by CYP2D6.…”

“…14 The increasing daily use of khat in East Africa and Arabia is a major concern for public health. 6,15 There is evidence that herbdrug interactions represent a potential risk to patients taking conventional medicines, resulting in serious clinical consequences. 16 Cytochrome P450 3A4 and CYP2D6 are the 2 most important liver enzymes, metabolizing approximately more than 75% of all medications, 17 including antiretroviral, antimalarial, and antituberculosis drugs.…”

“…In khat belt countries, including Ethiopia, it is not uncommon to take medications along with khat, and even a high prevalence of HIV/acquired immunodeficiency syndrome and risky sexual behaviors among khat users in Ethiopia is well documented. 5,15,18 The likelihood of herb-drug interactions could be higher than drug-drug interactions because drugs usually contain single chemical entities, whereas almost all herbs contain mixtures of pharmacologically active constituents. 16,19 To date, there are little or no data available regarding the effect of concurrent khat use on the metabolism of commonly used essential medications.…”

Determinants of alcohol use and khat chewing among Hawassa University students, Ethiopia: A cross sectional study

“…Its effects are increased self esteem, increased levels of energy, increased libido and excitement [9][10][11] . Different studies revealed that frequent khat chewing has been associated with risky sexual behavior, predisposition to HIV, unwanted pregnancy, reduced school performance, adverse pregnancy outcome, and cardiovascular disorders [12][13][14][15][16] .…”

Prevalence and risk factors for khat use among youth students in Ethiopia: systematic review and meta-analysis, 2018

“…The World Health Organization report has shown that khat use causes dependency [15][16][17][18][19], predisposes the individual to myocardial infarction [20], ischemic heart disease [21], psychosis [22,23], distress [24], premature ejaculation [25], unprotected sex [26], manic episodes [27,28], oesophageal cancer [29], low birth weight and lactation problems [30], structural and functional brain changes [31,32], and criminal activity [33].…”