Poverty and Substance Use in South African Tuberculosis Patients

Abstract

To determine whether social support and depressive symptoms mediate the relationship between poverty and substance use in tuberculosis (TB) patients in South Africa. We performed structural equation modeling with the latent constructs socioeconomic status (SES), social support and "substance use" (tobacco smoking, alcohol problem, illicit drug use) in 1005 male TB patients. Higher SES directly (standardized coefficient= -0.27) and indirectly reduced substance use. Indirectly SES provided increased social support (coefficient=0.37), which was associated with reduced substance use (coefficient=-0.15). Higher SES diminished depressive symptoms. Model fit was acceptable. Separate models for tobacco smoking, illicit drug use or alcohol problem produced similar findings. Poverty alleviation and social support-based interventions may benefit male TB patients with substance use.