Jessica M Perkins1, Bernard Kakuhikire2, Charles Baguma2, Meredith Meadows3, Claire Q Evans3, Jordan Jurinsky3, Justin D Rasmussen4, Emily N Satinsky5, Patience Ayebare2, Viola Kyokunda2, Mercy Juliet2, David R Bangsberg6, Alexander C Tsai7. 1. Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA; Vanderbilt Institute of Global Health, 2525 West End Avenue, Nashville, TN 37203, USA. Electronic address: jessica.m.perkins@vanderbilt.edu. 2. Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda. 3. Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA. 4. Duke University, 417 Chapel Drive, Durham, NC 27708, USA. 5. Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02114, USA. 6. Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda; Oregon Health & Science University-Portland State University School of Public Health, 1880 SW 6th Ave, Portland, OR 97201, USA. 7. Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda; Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Mongan Institute, Massachusetts General Hospital, 100 Cambridge St Suite 1600, Boston, MA 02114, USA.
Abstract
BACKGROUND: Studies from high-income contexts have found evidence that norms about substance use are misperceived. The accuracy of perceived norms about khat and cannabis use in Uganda have not previously been described. METHODS: We conducted a population-based study targeting all resident adults across eight villages in southwestern Uganda. Personal khat and/or cannabis use frequency was based on self-report. We measured perceived norms about substance use by eliciting individuals' perceptions about how often most other adult men and most other adult women in their villages used these substances. We compared perceived norms to aggregated village rates of use to assess the extent to which norms were misperceived. We used multivariable Poisson regression to estimate correlates of misperceived norms. RESULTS: Among 1626 participants (91% response rate), only 29 men (4%) and 9 women (1%) reported any lifetime use of khat and/or cannabis. However, 695 participants (43%) did not think lifetime abstinence was the norm among men in their villages, and 256 participants (16%) did not think lifetime abstinence was the norm among women. Moreover, 219 participants (13%) incorrectly believed most men in their village regularly used khat and/or cannabis (≥4 times per week). Misperceived norms were present across subgroups and were correlated with larger social networks, symptoms of depression, loneliness, and younger age. CONCLUSION: In this study of all adults across 8 villages in rural Uganda, many participants misperceived norms about khat and/or cannabis use. Providing accurate information about prevailing norms in the local population may help prevent initiation of khat and/or cannabis use among adults in this context.
BACKGROUND: Studies from high-income contexts have found evidence that norms about substance use are misperceived. The accuracy of perceived norms about khat and cannabis use in Uganda have not previously been described. METHODS: We conducted a population-based study targeting all resident adults across eight villages in southwestern Uganda. Personal khat and/or cannabis use frequency was based on self-report. We measured perceived norms about substance use by eliciting individuals' perceptions about how often most other adult men and most other adult women in their villages used these substances. We compared perceived norms to aggregated village rates of use to assess the extent to which norms were misperceived. We used multivariable Poisson regression to estimate correlates of misperceived norms. RESULTS: Among 1626 participants (91% response rate), only 29 men (4%) and 9 women (1%) reported any lifetime use of khat and/or cannabis. However, 695 participants (43%) did not think lifetime abstinence was the norm among men in their villages, and 256 participants (16%) did not think lifetime abstinence was the norm among women. Moreover, 219 participants (13%) incorrectly believed most men in their village regularly used khat and/or cannabis (≥4 times per week). Misperceived norms were present across subgroups and were correlated with larger social networks, symptoms of depression, loneliness, and younger age. CONCLUSION: In this study of all adults across 8 villages in rural Uganda, many participants misperceived norms about khat and/or cannabis use. Providing accurate information about prevailing norms in the local population may help prevent initiation of khat and/or cannabis use among adults in this context.
Authors: Jessica M Perkins; Viola N Nyakato; Bernard Kakuhikire; Alexander C Tsai; S V Subramanian; David R Bangsberg; Nicholas A Christakis Journal: Public Health Nutr Date: 2017-10-09 Impact factor: 4.022
Authors: Bernard Kakuhikire; Emily N Satinsky; Charles Baguma; Justin D Rasmussen; Jessica M Perkins; Patrick Gumisiriza; Mercy Juliet; Patience Ayebare; Rumbidzai C Mushavi; Bridget F O Burns; Claire Q Evans; Mark J Siedner; David R Bangsberg; Alexander C Tsai Journal: PLoS Med Date: 2021-07-16 Impact factor: 11.069
Authors: Jessica M Perkins; Bernard Kakuhikire; Charles Baguma; Justin D Rasmussen; Emily N Satinsky; Allen Kiconco; Justus Kananura; Carolyn M Audet; Mark J Siedner; Jessica E Haberer; David R Bangsberg; Alexander C Tsai Journal: AIDS Behav Date: 2022-01-16
Authors: Jessica M Perkins; Bernard Kakuhikire; Charles Baguma; Claire Q Evans; Justin D Rasmussen; Emily N Satinsky; Viola Kyokunda; Mercy Juliet; Immaculate Ninsiima; David R Bangsberg; Alexander C Tsai Journal: Tob Control Date: 2021-12-20 Impact factor: 6.953