HIV Prevalence, Estimated Incidence, and Risk Behaviors Among People Who Inject Drugs in Kenya

Abstract

Objective HIV infection in sub-Saharan Africa increasingly occurs among people who inject drugs (PWID). Kenya is one of the first to implement a national needle and syringe program (NSP). Our study undertook a baseline assessment as part of evaluating NSP in a seek, test, treat, and retain approach. Methods Participants enrolled May–December 2012 from 10 sites. Respondent-driven sampling was used to reach n=1,785 PWID for HIV-1 prevalence and viral load determination and survey data. Results Estimated HIV prevalence, adjusted for differential network size and recruitment relationships, was 14.5% in Nairobi (95% CI 10.8–18.2) and 20.5% in the Coast region (95% CI 17.3–23.6). Viral load (log10 transformed) in Nairobi ranged from 1.71 to 6.12 (median 4.41; IQR 3.51–4.94) and in the Coast from 1.71 to 5.88 (median 4.01; IQR 3.44–4.72). Using log10 viral load 2.6 as a threshold for HIV viral suppression, the percentage of HIV-infected participants with viral suppression was 4.2% in Nairobi and 4.6% in the Coast. Heroin was the most commonly injected drug in both regions, used by 93% of participantsin the past month typically injecting 2–3 times/day. Receptive needle/syringe sharing at last injection was more common in Nairobi (23%) than the Coast (4%). Estimated incidence among new injectors was 2.5/100 person-years in Nairobi and 1.6/100 person-years in the Coast. Conclusion The HIV epidemic is well-established among PWID in both Nairobi and Coast regions. Public health scale implementation of combination HIV prevention has the potential to greatly limit the epidemic in this vulnerable and bridging population.

Caracterización de trabajadores sexuales extranjeras del área norte de Santiago

“…Nivel educacional de trabajadoras sexuales extranjeras y chilenas del área norte de Santiago. Otro parámetro considerado en este estudio fue el consumo de alcohol y drogas, cuya relación con un mayor riesgo de contraer ITS está ampliamente descrito [7][8][9] . El 80% de las pacientes (44 de 55) declara consumo regular de alcohol.…”

Heroin shortage in Coastal Kenya: A rapid assessment and qualitative analysis of heroin users’ experiences

“…The Kenyan shortage described here may be the first to be documented in a developing country. Kenya faces an emerging HIV epidemic among injection drug users (Kenya, Ongecha-Owuor, & Oguya, 2011; Kurth et al, 2015). Both heroin smoking and inhaling have been documented in Kenya since the 1980s (Beckerleg, Telfer, & Sadiq, 2006).…”

“…Heroin trafficking from Pakistan and Iran to East Africa is well established and seaports in Mombasa, in coastal Kenya, are vulnerable to drug trafficking (UNODC, 2012). Kenya has been heavily impacted by a generalized heterosexually transmitted HIV epidemic, however while the HIV prevalence among adults in the general population is 5.6%, over 20% of injectors on the coast are infected with HIV (Kurth et al, 2015; Lyerla, Murrill, Ghys, Calleja-Garcia, & DeCock, 2012). Recent estimates indicate a large and growing population of injectors in coastal Kenya reporting high risk behaviors (Kenya et al, 2011).…”

Access to Social Protection Minimum Floors as a tool to end early marriage in Mozambique

“…Table 3 shows unusually robust numbers for northern regions, where practices such as initiation ritesceremonies performed at the occasion of status changes, like puberty and marriage -keep providing the cultural basis for early marriages and perpetuate gender inequality (Osório and Macuácua, 2013;Kurth et al, 2015). The direct link between initiation rites and early marriage is obvious (Osório and Macuácua, 2013), as such rites shape expectations on the role of girls in society and reproductive practice (Singh and Samara, 1996 (Osório and Macuácua, 2013).…”