HIV Prevalence, Estimated Incidence, and Risk Behaviors among People who Inject Drugs in Kenya

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.

Estimated HIV prevalence, adjusted for differential network size and recruitment relationships, was 14.5% in Nairobi and 20.5% in the Coast region. Viral load in Nairobi ranged from 1.71 to 6.12 (median 4.41) and in the Coast from 1.71 to 5.88 (median 4.01). 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 participants in 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.

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.

Via: http://ht.ly/S9QrJ 

By:  Kurth AE1, Cleland CM, Des Jarlais DC, Musyoki H, Lizcano JA, Chhun N, Cherutich P.
1*New York University College of Nursing, New York, NY, USA; §The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York, NY, USA; ¶National AIDS & STI Control Programme (NASCOP), Nairobi, Kenya