Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent driven sampling survey

• Published in: BMC public health 2021-08, Vol.21 (1), p.1-1549, Article 1549
• Main Authors: Oguya, Francis O, Kenya, Patrick R, Ongecha, Francisca, Mureithi, Patrick, Musyoka, Helgar, Muraguri, Nicholas, Mundia, Ben, Angira, Caleb, Shose, Mohammed, Basheeb, Taib A, Mohamed, Abdalla Ahmed, Oyore, John P, Ochieng, Otieno G, Dida, Gabriel O, Abdalla, Saade, Abdool, Reychard
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Age; AIDS; Cannabis; Cigarettes; Coastal zone; Coasts; Cocaine; Colleges & universities; Complications and side effects; Condoms; Disease prevention; Disease transmission; Drug abuse; Drug use; Drugs; Epidemics; Gender; Health care facilities; Health risks; Hepatitis; Heroin; HIV; HIV infection; HIV-related behaviors; Human immunodeficiency virus; Infections; Injection drug users (PWIDs); Intravenous drug abuse; Kenya; Men; Methadone; Mombasa; Nairobi; Narcotics; NGOs; Nongovernmental organizations; Population; Public health; Respondent driven sampling; Risk; Risk factors; Risk taking; Sampling; Sampling methods; Sexual behavior; Sexually transmitted diseases; Smoking; Social aspects; STD; Substance abuse treatment; Surveys; Syringes
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-021-11373-9

Background A Cross-sectional Rapid Situational Assessment of People Who Inject Drug (PWIDs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injecting drug users in Nairobi and Coastal regions of Kenya. There is paucity of data and information on injecting drug use in sub-Saharan Africa and there is sufficient evidence of existence of the environment for development and growth of injecting drug use. Past studies on PWID and its association to HIV and AIDS that have been conducted in Kenya do not provide sufficient information to support effective planning and comprehensive national response to the HIV and AIDS epidemic. Methods A cross-sectional study design was adopted in which a set of initial subjects referred to as 'seeds' were first identified from which an expanding chain of referrals were obtained, with subjects from each wave referring subjects of subsequent waves. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, community based organizations (CBO's) among others. Three NGOs located in the coast region and one in Nairobi region were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides. Results A total of 646 individuals (344 in Nairobi and 302 at the coast) were recruited for the study between January and March 2010. Of these 590 (91%) were male and 56 (9%) were female. Findings showed that most PWIDs initiated injecting drug use between the ages of 20-29 years, with the youngest age of initiation being 11 years and oldest age being 53 years. Most commonly injected drug was heroin (98%), with a small (2%) percentage injecting cocaine. Other non-injecting methods such as smoking or combining these two drugs with other drugs such as cannabis or Rohypnol were also common. Most PWIDs used other substances (cigarettes, alcohol, and cannabis) before initiating injecting drug use. The adjusted national HIV prevalence of PWIDs was 18.3% (19.62% unadjusted) with PWIDs in N