HIV prevalence, estimated incidence, and risk behaviors among people who inject drugs in Kenya

Ann E. Kurth, Charles M. Cleland, Don Des Jarlais, Helgar Musyoki, John A. Lizcano, Nok Chhun, Peter Cherutich

Research output: Contribution to journalArticle

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. Our study undertook a baseline assessment as part of evaluating needle and syringe program in a seek, test, treat, and retain approach. Methods: Participants enrolled between May and December 2012 from 10 sites. Respondent-driven sampling was used to reach 1785 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 to 18.2) and 20.5% in the Coast region (95% CI: 17.3 to 23.6). Viral load (log10 transformed) in Nairobi ranged from 1.71 to 6.12 (median: 4.41; interquartile range: 3.51-4.94) and in the Coast from 1.71 to 5.88 (median: 4.01; interquartile range: 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 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 in 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)420-427
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume70
Issue number4
StatePublished - Dec 1 2015

Fingerprint

Kenya
Risk-Taking
HIV
Viral Load
Needle Sharing
Incidence
Pharmaceutical Preparations
Syringes
Needles
Africa South of the Sahara
Heroin
Vulnerable Populations
HIV Infections
HIV-1
Public Health
Injections
Surveys and Questionnaires

Keywords

  • HIV
  • Injection drug use
  • Needle syringe program
  • Sub-Saharan Africa

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Kurth, A. E., Cleland, C. M., Des Jarlais, D., Musyoki, H., Lizcano, J. A., Chhun, N., & Cherutich, P. (2015). HIV prevalence, estimated incidence, and risk behaviors among people who inject drugs in Kenya. Journal of Acquired Immune Deficiency Syndromes, 70(4), 420-427.

HIV prevalence, estimated incidence, and risk behaviors among people who inject drugs in Kenya. / Kurth, Ann E.; Cleland, Charles M.; Des Jarlais, Don; Musyoki, Helgar; Lizcano, John A.; Chhun, Nok; Cherutich, Peter.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 70, No. 4, 01.12.2015, p. 420-427.

Research output: Contribution to journalArticle

Kurth, AE, Cleland, CM, Des Jarlais, D, Musyoki, H, Lizcano, JA, Chhun, N & Cherutich, P 2015, 'HIV prevalence, estimated incidence, and risk behaviors among people who inject drugs in Kenya', Journal of Acquired Immune Deficiency Syndromes, vol. 70, no. 4, pp. 420-427.
Kurth, Ann E. ; Cleland, Charles M. ; Des Jarlais, Don ; Musyoki, Helgar ; Lizcano, John A. ; Chhun, Nok ; Cherutich, Peter. / HIV prevalence, estimated incidence, and risk behaviors among people who inject drugs in Kenya. In: Journal of Acquired Immune Deficiency Syndromes. 2015 ; Vol. 70, No. 4. pp. 420-427.
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