Patterns and correlates of alcohol and other substance use among adults in two communities in Cape Town: a cross-sectional
- 1Department of Psychiatry and Psychotherapy, University of Bern, Switzerland | Institute of Social and Preventive Medicine, University of Bern, Switzerland | Cen
Abstract
BackgroundWe aimed to characterize substance use patterns, and their correlates, among adults with and without HIV at two healthcare facilities in Cape Town, South Africa.
MethodsWe recruited adults with and without HIV from two primary healthcare facilities. We assessed alcohol use with the AUDIT-C and other substance use with the WHO-ASSIST questionnaires. We classified participants with no lifetime drug use and no or low-risk alcohol use as "low risk" and fitted latent class models among remaining participants to identify additional substance use patterns. We used multinomial logistic regression to examine factors associated with substance use patterns.
ResultsAmong 602 participants, 265 (44.0%) were "low risk". Latent class analysis among the remaining 337 identified three patterns: "higher-risk alcohol use" (N=168; 27.9%), "cannabis use" (universal cannabis use with mixed alcohol risk; N=114; 18.9%), and "mixed illicit drug use" (predominantly no or low-risk alcohol use with use of multiple drugs; N=55; 9.1%). Participants younger than 45 years were less likely to be in the low-risk group. Male sex was associated with lower probability of the low-risk group and higher probability of the higher-risk alcohol use and cannabis use classes. HIV was associated with higher probability of higher-risk alcohol use. One facility had a substantially higher probability of mixed illicit drug use.
ConclusionsWe identified distinct higher-risk substance use profiles that varied strongly by age, sex, and facility. These findings support integrating alcohol and substance use screening and management into primary care and tailoring responses to local substance use patterns.
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BibTeX
@misc{haas2026patterns,
title = {{Patterns and correlates of alcohol and other substance use among adults in two communities in Cape Town: a cross-sectional}},
author = {A. D. Haas and M. Tlali and J. Joska and L. L. van den Heuvel and S. Rabie and N. Williams and O. Maniwe and N. Khan and L. Madolo and C. Chinogurei and C. Mothiba and T. Mountford and S. Seedat and C. Orrell and K. Adorjan and M.-A. Davies and L. Johnson and R. Kassanjee},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.12.26365289},
url = {https://www.medrxiv.org/content/10.64898/2026.10.12.26365289v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Patterns and correlates of alcohol and other substance use among adults in two communities in Cape Town: a cross-sectional
AU - A. D. Haas
AU - M. Tlali
AU - J. Joska
AU - L. L. van den Heuvel
AU - S. Rabie
AU - N. Williams
AU - O. Maniwe
AU - N. Khan
AU - L. Madolo
AU - C. Chinogurei
AU - C. Mothiba
AU - T. Mountford
AU - S. Seedat
AU - C. Orrell
AU - K. Adorjan
AU - M.-A. Davies
AU - L. Johnson
AU - R. Kassanjee
PY - 2026
DA - 2026/10/12
PB - medRxiv
DO - 10.64898/2026.10.12.26365289
UR - https://www.medrxiv.org/content/10.64898/2026.10.12.26365289v1
AB - BackgroundWe aimed to characterize substance use patterns, and their correlates, among adults with and without HIV at two healthcare facilities in Cape Town, South Africa. MethodsWe recruited adults with and without HIV from two primary healthcare facilities. We assessed alcohol use with the AUDIT-C and other substance use with the WHO-ASSIST questionnaires. We classified participants with no lifetime drug use and no or low-risk alcohol use as "low risk" and fitted latent class models among remaining participants to identify additional substance use patterns. We used multinomial logistic regression to examine factors associated with substance use patterns. ResultsAmong 602 participants, 265 (44.0%) were "low risk". Latent class analysis among the remaining 337 identified three patterns: "higher-risk alcohol use" (N=168; 27.9%), "cannabis use" (universal cannabis use with mixed alcohol risk; N=114; 18.9%), and "mixed illicit drug use" (predominantly no or low-risk alcohol use with use of multiple drugs; N=55; 9.1%). Participants younger than 45 years were less likely to be in the low-risk group. Male sex was associated with lower probability of the low-risk group and higher probability of the higher-risk alcohol use and cannabis use classes. HIV was associated with higher probability of higher-risk alcohol use. One facility had a substantially higher probability of mixed illicit drug use. ConclusionsWe identified distinct higher-risk substance use profiles that varied strongly by age, sex, and facility. These findings support integrating alcohol and substance use screening and management into primary care and tailoring responses to local substance use patterns.
ER -