Abstract
There is a dearth of evidence on injection drug use and associated HIV infections in Kenya. To generate population-based estimates of characteristics and HIV/STI prevalence among people who inject drugs (PWID) in Nairobi, a cross-sectional study was conducted with 269 PWID using respondent-driven sampling. PWID were predominantly male (92.5 %). An estimated 67.3 % engaged in at least one risky injection practice in a typical month. HIV prevalence was 18.7 % (95 % CI 12.3–26.7), while STI prevalence was lower [syphilis: 1.7 % (95 % CI 0.2–6.0); gonorrhea: 1.5 % (95 % CI 0.1–4.9); and Chlamydia: 4.2 % (95 % CI 1.2–7.8)]. HIV infection was associated with being female (aOR, 3.5; p = 0.048), having first injected drugs 5 or more years ago (aOR, 4.3; p = 0.002), and ever having practiced receptive syringe sharing (aOR, 6.2; p = 0.001). Comprehensive harm reduction programs tailored toward PWID and their sex partners must be fully implemented as part of Kenya’s national HIV prevention strategy.
Highlights
Injection drug behaviors have been recognized as key facilitators of HIV transmission since the beginning of the epidemic [1,2,3]
Comprehensive harm reduction programs tailored toward people who inject drugs (PWID) and their sex partners must be fully implemented as part of Kenya’s national HIV prevention strategy
While Southeast and East Asia have the largest number of PWID [4], recent evidence shows an increase in injection drug use and associated HIV infections in sub-Saharan Africa, where the burden of HIV is already the highest in the world [5,6,7,8,9,10,11,12,13,14,15,16]
Summary
Injection drug behaviors have been recognized as key facilitators of HIV transmission since the beginning of the epidemic [1,2,3]. While Southeast and East Asia have the largest number of PWID [4], recent evidence shows an increase in injection drug use and associated HIV infections in sub-Saharan Africa, where the burden of HIV is already the highest in the world [5,6,7,8,9,10,11,12,13,14,15,16]. Despite a lack of comprehensive evidence, it is clear that PWID in subSaharan Africa are at great risk for acquiring and. M. Sheehy Population Council, New York, NY, USA. D. Broz HHS-Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Center for Global Health, Atlanta, GA, USA
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