Socio-demographic and sexual practices associated with HIV infection in Kenyan injection and non-injection drug users

Valentine Budambula,Michael F Otieno,Aabid A Ahmed,James Ouma,Charles Matoka,Tom Were

doi:10.1186/s12889-018-5100-y

Abstract

BackgroundSubstance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection. Although socio-demographic factors influence substance consumption and risk of HIV infection, the association of these factors with HIV infection is poorly understood among substance users on the African continent. The objective of the study was to assess socio-demographic and sexual practices that are associated with HIV infection among injection drug users (IDUs), non-IDUs, and non-drug users (DUs) at an urban setting of coastal Kenya.MethodsA cross-sectional descriptive study was conducted among 451 adults comprising HIV-infected and -uninfected IDUs (n = 157 and 39); non-IDUs (n = 17 and 48); and non-DUs (n = 55 and 135); respectively at coastal, Kenya. Respondent driven sampling, snowball and makeshift methods were used to enroll IDUs and non-IDUs. Convenience and purposive sampling were used to enroll non-DUs from the hospital’s voluntary HIV testing unit. Participant assisted questionnaire was used in collecting socio-demographic data and sexual practices.ResultsBinary logistic regression analysis indicated that higher likelihood of HIV infection was associated with sex for police protection (OR, 9.526; 95% CI, 1.156-78.528; P = 0.036) and history of sexually transmitted infection (OR, 5.117; 95% CI, 1.924-13.485; P = 0.001) in IDUs; divorced, separated or widowed marital status (OR, 6.315; 95% CI, 1.334-29.898; P = 0.020) in non-IDUs; and unemployment (OR, 2.724; 95% CI, 1.049-7.070; P = 0.040) in non-drug users. However, never married (single) marital status (OR, 0.140; 95% CI, 0.030-0.649; P = 0.012) was associated with lower odds for HIV infection in non-drug users.ConclusionAltogether, these results suggest that socio-demographic and sexual risk factors for HIV transmission differ with drug use status, suggesting targeted preventive measures for drug users.

Highlights

Substance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection
Sexual practices The proportions of participants reporting early age sexual debut, > 1 sexual partners, unprotected sex and history of sexually transmitted infections was significantly higher in HIV-infected injection drug users than in non-injection drug users and non-drug users (Table 2)
The frequency of bisexuality, homosexuality, sex for police protection as well as sex for drugs was higher in HIV-infected injection drug users as compared to non-injection drug users and non-drug users (Table 2)

Summary

Introduction

Substance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection. Like other countries in Africa, is experiencing an alarming increase in the burden of drug use with about 37.1% of the population reporting having used a substance in their life time [6] Social demographic factors such as the level of education, gender, income and marital status are primary determinants of the health status of drug users [7]. These factors indirectly influence individual drug-use behavior including sharing of needles and soliciting for Budambula et al BMC Public Health (2018) 18:193 sex in exchange for drugs or police protection [8, 9]. Drugrelated activity has been associated with age, low level of education, familial dysfunction, unemployment, poverty, drug-related violence and gang activity [13, 14]

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