Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 1/2015

Open Access 01-02-2015 | Original Paper

HIV and STI Prevalence and Injection Behaviors Among People Who Inject Drugs in Nairobi: Results from a 2011 Bio-behavioral Study Using Respondent-Driven Sampling

Authors: Waimar Tun, Meredith Sheehy, Dita Broz, Jerry Okal, Nicholas Muraguri, H. Fisher Raymond, Helgar Musyoki, Andrea A. Kim, Mercy Muthui, Scott Geibel

Published in: AIDS and Behavior | Special Issue 1/2015

Login to get access

Abstract

There is a dearth of evidence on injection drug use and associated HIV infections in Kenya. To generate population-based estimates of characteristics and HIV/STI prevalence among people who inject drugs (PWID) in Nairobi, a cross-sectional study was conducted with 269 PWID using respondent-driven sampling. PWID were predominantly male (92.5 %). An estimated 67.3 % engaged in at least one risky injection practice in a typical month. HIV prevalence was 18.7 % (95 % CI 12.3–26.7), while STI prevalence was lower [syphilis: 1.7 % (95 % CI 0.2–6.0); gonorrhea: 1.5 % (95 % CI 0.1–4.9); and Chlamydia: 4.2 % (95 % CI 1.2–7.8)]. HIV infection was associated with being female (aOR, 3.5; p = 0.048), having first injected drugs 5 or more years ago (aOR, 4.3; p = 0.002), and ever having practiced receptive syringe sharing (aOR, 6.2; p = 0.001). Comprehensive harm reduction programs tailored toward PWID and their sex partners must be fully implemented as part of Kenya’s national HIV prevention strategy.
Literature
1.
Aceijas C, Stimson GV, Hickman M, Rhodes T, United Nations Reference Group on HIV/AIDS Prevention and Care among IDU in Developing and Transitional Countries. Global overview of injecting drug use and HIV infection among injecting drug users. AIDS. 2004;18(17):2295–303.CrossRefPubMed
2.
Mathers BM, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick RP, Myers B, Ambekar A, Strathdee SA, Reference Group to the UNoHIV. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet. 2010;375(9719):1014–28.CrossRefPubMed
3.
Stimson G, Choopanya K. Global perspectives on drug injecting. London: UCL Press; 1998.
4.
Dutta A, Wirtz A, Stanciole A, Oelrichs R, Semini I, Baral S, Pretorius C, Haworth C, Hader S, Beyrer C et al. The global HIV epidemics among people who inject drugs. In. Washington, DC: World Bank; 2013.
5.
Global Report: UNAIDS report on the global AIDS epidemic 2010.
6.
Gelmon L, Kenya P, Oguya F, Cheluget B, Haile G. Kenya HIV prevention response and modes of transmission analysis. Nairobi: Kenya National AIDS Control Council; 2009.
7.
Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, Wodak A, Panda S, Tyndall M, Toufik A, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008;372(9651):1733–45.CrossRefPubMed
8.
9.
Brodish P, Singh K, Rinyuri A, Njeru C, Kingola N, Mureithi P, Sambisa W, Weir S. Evidence of high-risk sexual behaviors among injection drug users in the Kenya PLACE study. Drug Alcohol Depend. 2011;119(1–2):138–41.CrossRefPubMedCentralPubMed
10.
McCurdy S, Kilonzo GP, Williams M, Kaaya S. Harm reduction in Tanzania: an urgent need for multisectoral intervention. Int J Drug Policy. 2007;18(3):155–9.CrossRefPubMed
11.
McCurdy SA, Williams ML, Kilonzo GP, Ross MW, Leshabari MT. Heroin and HIV risk in Dar es Salaam, Tanzania: youth hangouts, mageto and injecting practices. AIDS Care. 2005;17(Suppl 1):S65–76.CrossRefPubMed
12.
McCurdy SA, Williams ML, Ross MW, Kilonzo GP, Leshabari MT. A theme issue by, for, and about Africa: new injecting practice increases HIV risk among drug users in Tanzania. BMJ. 2005;331(7519):778.CrossRefPubMedCentralPubMed
13.
Tun W, Vu L, Adebajo SB, Abiodun L, Sheehy M, Karlyn A, Njab J, Ahonsi B, Issa BK, Idogho O. Population-based prevalence of hepatitis B and C virus, HIV, syphilis, gonorrhoea and chlamydia in male injection drug users in Lagos, Nigeria. Int J STD AIDS. 2013;24(8):619–25.CrossRefPubMed
14.
Williams ML, McCurdy SA, Atkinson JS, Kilonzo GP, Leshabari MT, Ross MW. Differences in HIV risk behaviors by gender in a sample of Tanzanian injection drug users. AIDS Behav. 2007;11(1):137–44.CrossRefPubMed
15.
Williams ML, McCurdy SA, Bowen AM, Kilonzo GP, Atkinson JS, Ross MW, Leshabari MT. HIV seroprevalence in a sample of Tanzanian intravenous drug users. AIDS Educ Prev. 2009;21(5):474–83.CrossRefPubMedCentralPubMed
16.
Eluwa GI, Strathdee SA, Adebayo SB, Ahonsi B, Adebajo SB. A profile on HIV prevalence and risk behaviors among injecting drug users in Nigeria: Should we be alarmed? Drug Alcohol Depend. 2012;127(1):65–71.PubMed
17.
National AIDS and STI Control Programme (NASCOP), Ministry of Health (Kenya): Kenya AIDS Indicator Survey 2012: Preliminary Report. In. Nairobi, Kenya; 2013.
18.
Beckerleg S, Telfer M, Sadiq A. A rapid assessment of heroin use in Mombasa, Kenya. Subst Use Misuse. 2006;41(6–7):1029–44.CrossRefPubMed
19.
Okal J, Geibel S, Muraguri N, Musyoki H, Tun W, Broz D, Kuria D, Kim A, Oluoch T, Raymond HF. Estimates of the size of key populations at risk for HIV infection: men who have sex with men, female sex workers and injecting drug users in Nairobi. Sex Transm Infect: Kenya; 2013.
20.
National AIDS and STI Control Programme (NASCOP), Ministry of Health (Kenya): Kenya Most-At-Risk-Populations Size Estimate Consensus Report. In. Nairobi, Kenya; 2013.
21.
UNODC/ICHIRA: Rapid Situational Assessment of HIV Prevalence and Risky Behaviours among Injecting Drug Users in Kenya. In. Nairobi, Kenya 2012.
22.
Needle RH, Zhao L. HIV prevention among injection drug users: Strengthening U.S. support for core interventions. In. Washington, DC: Center for Strategic and International Studies; 2010.
23.
Gouws E, White PJ, Stover J, Brown T. Short term estimates of adult HIV incidence by mode of transmission: Kenya and Thailand as examples. Sex. Transm. Infect. 2006;82 Suppl 3:iii51–55.
24.
Alter MJ, Moyer LA. The importance of preventing hepatitis C virus infection among injection drug users in the United States. J Acquir Immune Defic Syndr Human Retrovirol. 1998;18(Suppl 1):S6–10.CrossRef
25.
Des Jarlais DC, Friedman SR. HIV infection among intravenous drug users: epidemiology and risk reduction. AIDS. 1987;1(2):67–76.PubMed
26.
Levine OS, Vlahov D, Koehler J, Cohn S, Spronk AM, Nelson KE. Seroepidemiology of hepatitis B virus in a population of injecting drug users. Association with drug injection patterns. Am J Epidemiol. 1995;142(3):331–41.PubMed
27.
Schoenbaum EE, Hartel D, Selwyn PA, Klein RS, Davenny K, Rogers M, Feiner C, Friedland G. Risk factors for human immunodeficiency virus infection in intravenous drug users. N Engl J Med. 1989;321(13):874–9.CrossRefPubMed
28.
Bacon O, Lum P, Hahn J, Evans J, Davidson P, Moss A, Page-Shafer K. Commercial sex work and risk of HIV infection among young drug-injecting men who have sex with men in San Francisco. Sex Transm Dis. 2006;33(4):228–34.CrossRefPubMed
29.
Des Jarlais DC, Arasteh K, McKnight C, Hagan H, Perlman DC, Semaan S. : Associations between herpes simplex virus type 2 and HCV With HIV among injecting drug users in New York City: the current importance of sexual transmission of HIV. Am J Public Health. 2011;101(7):1277–83.CrossRefPubMedCentralPubMed
30.
Doherty MC, Garfein RS, Monterroso E, Brown D, Vlahov D. Correlates of HIV infection among young adult short-term injection drug users. AIDS. 2000;14(6):717–26.CrossRefPubMed
31.
Hahn JA, Page-Shafer K, Lum PJ, Bourgois P, Stein E, Evans JL, Busch MP, Tobler LH, Phelps B, Moss AR. Hepatitis C virus seroconversion among young injection drug users: relationships and risks. J Infect Dis. 2002;186(11):1558–64.CrossRefPubMed
32.
Neaigus A, Gyarmathy VA, Miller M, Frajzyngier V, Zhao M, Friedman SR, Des Jarlais DC. Injecting and sexual risk correlates of HBV and HCV seroprevalence among new drug injectors. Drug Alcohol Depend. 2007;89(2–3):234–43.CrossRefPubMedCentralPubMed
33.
Strathdee SA, Sherman SG. The role of sexual transmission of HIV infection among injection and non-injection drug users. J Urban Health 2003;80(4 Suppl 3):iii7–14.
34.
Rachlis B, Brouwer KC, Mills EJ, Hayes M, Kerr T, Hogg RS. Migration and transmission of blood-borne infections among injection drug users: understanding the epidemiologic bridge. Drug Alcohol Depend. 2007;90(2–3):107–19.CrossRefPubMed
35.
Deveau C, Levine B, Beckerleg S. Heroin use in Kenya and findings from a community based outreach programme to reduce the spread of HIV/AIDS. Afr J Drug Alcohol Stud. 2006;5(2):95–107.
36.
Ndetei D: Linkages between drug use, injecting drug use and HIV/AIDS in Kenya. In: World Drug Report. Vienna: University of Nairobi; 2004.
37.
Odek-Ogunde M, Okoth FA, Lore W, Owiti FR: Seroprevalence of HIV, HBC and HCV in injecting drug users in Nairobi, Kenya: World Health Organization drug injecting study phase II findings. In: In XV International Conference on AIDS, Bangkok. 2004.
38.
Heckathorn D. Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44(2):174–99.CrossRef
39.
Heckathorn DD. Respondent driven sampling II: deriving valid populations estimates from chain referral samples of hidden populations. Soc Probl. 2002;49(1):11–34.CrossRef
40.
Gile KJ. Improved inference for respondent-driven sampling data with application to HIV prevalence estimation. J Am Stat Assoc. 2011;106(493):135–46.CrossRef
41.
Heckathorn DD. Extensions of respondent-driven sampling: analyzing continuous variables and controlling for differential recruitment. Sociol Methodol. 2007;37(1):151–207.CrossRef
42.
National AIDS and STI Control Programme (NASCOP), Ministry of Health, Kenya: National Guidelines for HIV Testing and Counseling in Kenya, 2nd Edition. In. Nairobi, Kenya; 2010.
43.
Volz E, Wejnert C, Cameron C, Spiller M, Barash V, Degani I, Heckathorn DD. Respondent-Driven Sampling Analysis Tool (RDSAT) In. Ithaca, NY: Cornell University; 2012.
44.
Broz D, Kim AA, Kim EJ, Holman A, Khatib A, Othman A, Mussa M, Johnston LG, Kangolle A, Dahoma M. Correlates of HIV Infection among Injection Drug Users—Unguja, Zanzibar, 2007. In: XVIII Intl AIDS Conference. Vienna, Austria.; 2010.
45.
Odek-Ogunde M, Okoth FA, Lore W, Owiti FR: Seroprevalence of HIV, HBC and HCV in injecting drug users in Nairobi, Kenya: World Health Organization Drug Injecting Study Phase II findings. In: The XV International AIDS Conference. Bangkok, Thailand; 2004.
46.
Johnston L, Saumtally A, Corceal S, Mahadoo I, Oodally F. High HIV and hepatitis C prevalence amongst injecting drug users in Mauritius: findings from a population size estimation and respondent driven sampling survey. Int J Drug Policy. 2011;22(4):252–8.CrossRefPubMed
47.
Timpson S, McCurdy SA, Leshabari MT, Kilonzo GP, Atkinson J, Msami A, Williams ML. Substance abuse, HIV risk and HIV/AIDS in Tanzania. Afr J Drugs Alcohol Stud. 2006;5(2):158–69.
48.
Dahoma MJU, Salim AA, Abdool R, Othman AA, Makame H, Ali AS, Abdalla A, Juma S, Yahya B, Shaka SH, et al. HIV and substance abuse: the dual epidemics challenging Zanzibar. Afr J Drugs Alcohol Stud. 2006;5(2):130–9.
49.
Aceijas C, Friedman SR, Cooper HL, Wiessing L, Stimson GV, Hickman M: Estimates of injecting drug users at the national and local level in developing and transitional countries, and gender and age distribution. Sex Transm Infect 2006;82 Suppl 3:iii10–17.
50.
Des Jarlais DC, Perlis TE, Stimson GV, Poznyak V, the WHO Phase II Drug Injection Collaborative Study Group. Using standardized methods for research on HIV and injecting drug use in developing/transitional countries: case study from the WHO Drug Injection Study Phase II. BMC Public Health. 2006;6:54.CrossRefPubMedCentralPubMed
51.
Beckerleg SE, Lewando Hundt G. The characteristics and recent growth of heroin injecting in a Kenyan coastal town. Addict Res Theory. 2004;12(1):41–53.CrossRef
52.
Adelekan ML, Lawal RA. Drug use and HIV infection in Nigeria: a review of recent findings. Afr J Drugs Alcohol Stud. 2006;5(2):118–29.
53.
Dewing S, Pluddemann A, Myers BJ, Parry C. Review of injection drug use in six African countries: Egypt, Kenya, Mauritius, Nigeria, South Africa, and Tanzania. Drugs. 2006;13(2):121–37.
54.
McCurdy SA, Ross MW, Kilonzo GP, Leshabari MT, Williams ML. HIV/AIDS and injection drug use in the neighborhoods of Dar es Salaam, Tanzania. Drug Alcohol Depend. 2006;82(Suppl 1):S23–7.CrossRefPubMed
55.
56.
Morineau G, Bollen LJ, Syafitri RI, Nurjannah N, Mustikawati DE, Magnani R. HIV prevalence and risk behaviours among injecting drug users in six indonesian cities implications for future HIV prevention programs. Harm Reduct J. 2012;9(1):37.CrossRefPubMedCentralPubMed
57.
Garfein RS, Vlahov D, Galai N, Doherty MC, Nelson KE. Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health. 1996;86(5):655–61.CrossRefPubMedCentralPubMed
58.
Garfein RS, Doherty MC, Monterroso ER, Thomas DL, Nelson K, Vlahov D. Prevalence and incidence of hepatitis C infection among young adult injection drug users. J Acquir Immune Defic Syndr. 1998;18(Suppl 1):S11–9.CrossRef
59.
Fennema JS, Van Ameijden EJ, Van Den Hoek A, Coutinho RA. Young and recent-onset injecting drug users are at higher risk for HIV. Addiction. 1997;92(11):1457–65.CrossRefPubMed
60.
Wodak A, Cooney A. Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence. Subst Use Misuse. 2006;41(6–7):777–813.CrossRefPubMed
61.
World Health Organization: Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users. In. Geneva, Switzerland; 2004.
62.
European Monitoring Centre for Drugs and Drug Addiction: Polydrug use: patterns and responses. In. Luxembourg; 2009.
63.
64.
Brands B, Blake J, Marsh DC, Sproule B, Jeyapalan R, Li S. The impact of benzodiazepine use on methadone maintenance treatment outcomes. J Addict Dis. 2008;27(3):37–48.CrossRefPubMed
65.
Ross J, Darke S. The nature of benzodiazepine dependence among heroin users in Sydney, Australia. Addiction. 2000;95(12):1785–93.CrossRefPubMed
66.
Eiroa-Orosa FJ, Haasen C, Verthein U, Dilg C, Schafer I, Reimer J. Benzodiazepine use among patients in heroin-assisted versus methadone maintenance treatment: findings of the German randomized controlled trial. Drug Alcohol Depend. 2010;112(3):226–33.CrossRefPubMed
67.
Latkin CA, Sherman S, Knowlton A. HIV prevention among drug users: outcome of a network-oriented peer outreach intervention. Health Psychol. 2003;22(4):332–9.CrossRefPubMed
68.
Latkin CA. Outreach in natural settings: the use of peer leaders for HIV prevention among injecting drug users’ networks. Public Health Rep. 1998;113(Suppl 1):151–9.PubMedCentralPubMed
69.
NIDA: The NIDA community-based outreach model: a manual to reduce the risk of HIV and other blood-borne infections in drug users. In. Rockville, MD: National Institute on Drug Abuse; 2000.
70.
World Health Organization: Evidence for action: effectiveness of community-based outreach in preventing HIV/AIDS among injecting drug users. In. Geneva: World Health Organization; 2004.
71.
World Health Organization: Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. In. Geneva, Switzerland; 2014.
72.
UNAIDS: Global Report: UNAIDS report on the global AIDS epidemic In.; 2012.
73.
Vlahov D, Robertson AM, Strathdee SA. Prevention of HIV infection among injection drug users in resource-limited settings. Clin Infect Dis. 2010;50(Suppl 3):S114–21.CrossRefPubMedCentralPubMed
74.
Binford MC, Kahana SY, Altice FL. A systematic review of antiretroviral adherence interventions for HIV-infected people who use drugs. Curr HIV/AIDS Rep. 2012;9(4):287–312.CrossRefPubMed
75.
Malta M, Magnanini MM, Strathdee SA, Bastos FI. Adherence to antiretroviral therapy among HIV-infected drug users: a meta-analysis. AIDS Behav. 2010;14(4):731–47.CrossRefPubMed
76.
Wood E, Hogg RS, Lima VD, Kerr T, Yip B, Marshall BD, Montaner JS. Highly active antiretroviral therapy and survival in HIV-infected injection drug users. JAMA. 2008;300(5):550–4.CrossRefPubMed
77.
Personal Communications: National AIDS and STI Control Programme (NASCOP), Ministry of Health (Kenya).
Metadata
Title
HIV and STI Prevalence and Injection Behaviors Among People Who Inject Drugs in Nairobi: Results from a 2011 Bio-behavioral Study Using Respondent-Driven Sampling
Authors
Waimar Tun
Meredith Sheehy
Dita Broz
Jerry Okal
Nicholas Muraguri
H. Fisher Raymond
Helgar Musyoki
Andrea A. Kim
Mercy Muthui
Scott Geibel
Publication date
01-02-2015
Publisher
Springer US
Published in
AIDS and Behavior / Issue Special Issue 1/2015
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-014-0936-3

Other articles of this Special Issue 1/2015

AIDS and Behavior 1/2015 Go to the issue

Original Paper

Critique and Lessons Learned from using Multiple Methods to Estimate Population Size of Men who have Sex with Men in Ghana

Original Paper

Prevalence of HIV, Sexually Transmitted Infections, and Risk Behaviours Among Female Sex Workers in Nairobi, Kenya: Results of a Respondent Driven Sampling Study

Original Paper

Prevalence of Rape and Client-Initiated Gender-Based Violence Among Female Sex Workers: Kampala, Uganda, 2012

Original Paper

Estimating the Number of Sex Workers in South Africa: Rapid Population Size Estimation

Original Paper

HIV Prevalence and Risk Behaviors Among Mozambicans Working in South African Mines

Original Paper

HIV Prevalence and Risk Behaviors Among People Who Inject drugs in Two Serial Cross-Sectional Respondent-Driven Sampling Surveys, Zanzibar 2007 and 2012
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits