Khat chewing habit as a possible risk behaviour for HIV infection: a case-control study

Background: The use/abuse of psychoactive drugs such as khat leaves (Catha edulis) are believed to alter one's moods or emotional state either through the sustained release or inhibition of neurotransmitters, thereby enhancing or dampening the response of the individual. Most people whose thinking are warped by continued drug use may not be able to see the harm resulting from their actions. Thus, there has been a strong linkage between drug use and casual or unsafe sexual practice despite the serious concern about HIV infection. Objective: Khat chewing is known to be a widespread habit in Ethiopia. This study is, thus, aimed at investigating whether or not the use of this psychostimulant alone or in conjunction with other behaviors associated with its use constitutes a risk behavior that accelerates the spread of HIV infection. Methods: A case-control study involving 850 human subjects, i.e. 425 HIV positives (cases) and 425 HIV negatives (controls) was conducted using rapid test algorithm and/or western blot method for determination of HIV status. Both groups were interviewed about their probable khat chewing habits, alcohol intake, multiple sexual practice, and the like, using a structured questionnaire. The data were analysed using SPSS/PC + statistical software.Results: Risk behaviors for HIV infection such as khat chewing in conjunction with alcohol intake and casual sex were observed more in people with HIV than in the control group. Khat chewing was significantly associated with multiple sexual practice (OR = 4.03, 95% CI = 3.02, 5.39), which in turn was strongly linked with HIV cases (OR = 3.52, 95% CI = 2.64, 4.69). Thus, more than the non-chewers, khat chewers constituted significantly higher number of HIV cases (OR =2.32, 95% CI = 1.75, 3.07).Conclusion/Recommendations: Khat chewing is a risk behavior for the spread of HIV infection. Mainstreaming of khat control into national development planning initiatives is recommended.The Ethiopian Journal of Health Development Vol. 19(3) 2005: 174-18