Illegal Drug Use, Sleep, and Mental Health Amongst Young Women Living in the Slums of Kampala

INTRODUCTION: This study sought to evaluate correlates of illegal drug use amongst young women living in the slums of Kampala who are at a heightened risk of substance use due to environmental adversities and social inequities. METHODS: Baseline survey and urine drug screen (UDS) data amongst young women living in the slums of Kampala were utilised from the TOPOWA (meaning 'empowerment') cohort study. A composite measure of illegal drug use, consisting of self-reported use or positive UDS, was assessed for associations with sociodemographic characteristics (age, religion, education, parental living status and biological children) and psychosocial variables (post-traumatic stress disorder, mental health quality, sleep quality and transactional sex/sex work). RESULTS: Among 300 total participants, 44 (14.7%) self-reported drug use or had positive UDS results. Khat was the most common drug detected in UDS results (n = 12) and from self-report (n = 33). The distribution of sleep quality differed; those with drug use had a higher reported percentage of fairly bad (20.5%) and very bad (13.6%) sleep quality (p = 0.002). In multivariable models, sleep quality was associated with lower odds of any drug use (OR 0.45; 95% CI 0.26, 0.74) and transactional sex was associated with higher odds of any drug use (OR 2.39; 95% CI 1.18, 4.89). DISCUSSION AND CONCLUSIONS: While the prevalence of illegal drug use in this study is lower than previous research on adolescents in Uganda, targeted prevention programs highlighting the risks associated with poor sleep and transactional sex for young women living in the slums of Kampala are recommended.