title: Poverty and substance use in South African tuberculosis patients.
abstract: OBJECTIVE
  To determine whether social support and depressive symptoms mediate the relationship between poverty and substance use in tuberculosis (TB) patients in South Africa.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Poverty alleviation and social support-based interventions may benefit male TB patients with substance use.
authors.affiliation: School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa. goedele.louwagie@up.ac.za.
authors.forename: Goedele M
authors.initials: GM
authors.lastname: Louwagie
authors.affiliation: Department of Sociology and Research Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium; and Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa.
authors.forename: Edwin
authors.initials: E
authors.lastname: Wouters
authors.affiliation: School of Oral Health Sciences, University of Limpopo MEDUNSA campus, South Africa; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
authors.forename: Olalekan A
authors.initials: OA
authors.lastname: Ayo-Yusuf
mesh_terms: D000328:Adult; D044383:Black People; D003863:Depression / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011203:Poverty / Q000706:statistics & numerical data; D012944:Social Support; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000523:psychology