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Drug Alcohol Depend. 2015 Jun 1;151:262-6. doi: 10.1016/j.drugalcdep.2015.02.037. Epub 2015 Mar 14.

Evidence of injection drug use in Kisumu, Kenya: Implications for HIV prevention.

Author information

1
Department of Anthropology, The Ohio State University, 4046 Smith Laboratory 174W. 18th Ave., Columbus, OH 43210-1106, USA. Electronic address: Syvertsen.1@osu.edu.
2
Impact Research and Development Organization, P.O. Box 9171-40141, Kisumu, Kenya.
3
Division of Global Public Health, University of California, San Diego, Central Research Services Facility (CRSF), La Jolla, CA 92093-0507, USA.
4
Department of Obstetrics, Gynecology & Reproductive Sciences and Center for AIDS Prevention Studies, University of California at San Francisco, 550 16th St., 3rd Floor [UCSF Mailcode 1224], San Francisco, CA 94158-2549 USA.
5
Kenya Medical Research Institute, P.O. Box 614-40100, Kisumu, Kenya.
6
Center for Biostatistics, The Ohio State University, 2012 Kenny Road, Columbus, OH 43221 USA.
7
School of Community Health Sciences, University of Nevada, Reno, 1664N. Virginia St. MS 0274, Reno, NV 89557, USA.

Abstract

BACKGROUND:

Injection drug use is increasingly contributing to the HIV epidemic across sub-Saharan Africa. This paper provides the first descriptive analysis of injection drug use in western Kenya, where HIV prevalence is already highest in the nation at 15.1%.

METHODS:

We draw on quantitative data from a study of injection drug use in Kisumu, Kenya. We generated descriptive statistics on socio-demographics, sexual characteristics, and drug-related behaviors. Logistic regression models were adjusted for sex to identify correlates of self-reported HIV positive status.

RESULTS:

Of 151 participants, mean age was 28.8 years, 84% (n = 127) were male, and overall self-reported HIV prevalence reached 19.4%. Women had greater than four times the odds of being HIV positive relative to men (Odds Ratio [OR] 4.5, CI: 1.7, 11.8, p = .003). Controlling for sex, ever experiencing STI symptoms (Adjusted Odds ratio [AOR] 4.6, 95% CI 1.7, 12.0, p = .002) and sharing needles or syringes due to lack of access (AOR 3.6, 95% CI 1.2, 10.5, p = .02) were significantly associated with HIV positive status. Lower education (AOR 2.3, 95% CI 0.9, 5.6, p=.08), trading sex for drugs (AOR 2.8, 95% CI 0.9, 8.8, p = .08), being injected by a peddler (AOR 2.9, 95% CI 1.0, 8.5, p = .05), and injecting heroin (AOR 2.3, 95% CI 1.0, 5.7, p = .06), were marginally associated with HIV.

CONCLUSIONS:

This exploratory study identified patterns of unsafe drug injection and concurrent sexual risk in western Kenya, yet few resources are currently available to address addiction or injection-related harm. Expanded research, surveillance, and gender sensitive programming are needed.

KEYWORDS:

Gender; HIV interventions; Harm reduction; Heroin; Sexual risk; sub-Saharan Africa

PMID:
25861945
PMCID:
PMC4447587
DOI:
10.1016/j.drugalcdep.2015.02.037
[Indexed for MEDLINE]
Free PMC Article

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