Risk and protective factors associated with substance use among orphaned and non-orphaned youth in South Africa

Background: Substance use among South Africa youth is growing at a time when many are concerned about the vulnerability of millions of orphaned youth in the region. Substance use morbidity comes both through injected drug use and by association with risky sexual behaviors, contributing to HIV. The purpose of this study was to identify factors associated with substance use among South African youth and to determine any increased risk to orphaned youth.

Methods: Data collected in a national household survey of South African youth ages 15 to 24 (n=11,904) was analyzed. Factors associated with a) alcohol use, b) experience of drunkenness, and c) drug use, and differences between orphaned and non-orphaned youth, were assessed.

Results: Fifty four percent of youth reported having consumed alcohol, 67% of those who drank had been drunk in the previous month, and 11% of youth reported illegal drug use. Regression analyses indicate that paternally orphaned males were significantly more likely to consume alcohol as were males who were white, non-Christian, older, and living in urban regions (p<.05). Female orphans were not at increased risk of alcohol use but paternally orphaned females were significantly more likely to use drugs (p<.05). Using a conceptual framework based on primary socialization and social cognitive theories, the influence of individual, family, peer and environmental factors were also explored.

Conclusion: Increasing substance use among all South African youth is concerning, especially given the region's HIV crisis. As prevention and treatment programs are planned, sub-groups of orphaned youth may require particular attention.