A Study on the Linkages Between Drug Abuse, Injecting Drug Use and HIV/AIDS in Kenya: A Rapid Situation Assessment (RSA)
There is a growing body of world literature that drug abuse has an association with HIV/AIDS. There are two main possible associations. People under the influence of druas may lose inhibition, leading them to indulge in risky sexual behaviour that exposes them to HIV/AIDS. Secondly, people on Intravenous Drug Abuse (IDU) will expose themselves to HIV/AIDS through direct blood-to-blood transmission. Whereas the first association has been studied extensively and acknowledged in most countries, the latter has not been extensively studied in Africa and Kenya in particular. Kenya has developed policies on how to combat HIV/AIDS. Kenya is also at advanced stages of developing policy strategies for combating drug abuse at various fronts - education, treatment, rehabilitation, demand reduction and control of availability of drugs. In the absence of solid scientific data on the linkage between IDUs and HIV/AIDS. Kenya has not developed a strategy that addresses these issues. This study set out to establish this linkage, using both available secondary data and primary data, which were collected during the study using instruments developed for this purpose. The first main finding of this study was the confirmation of lack of awareness in all the stakeholders of this association, with the stakeholders in these two problems working parallel to each other. This was reflected in the total lack of policy by the Government on the association between the two conditions. • i The second major finding of this study was the actual linkages between IDUs and HIV. Those who knew they were HIV positive anti.were also on IDUs constituted 34-44% of the total of IDUs. On average only half knew their HIV status and half did not know their HIV status. Since they have equal chance of being HIV positive, then it can be concluded that 68-88% of all IDUs are also HIV positive, a figure that is similar to what has been found in other countries. The third major finding was that there was a regional variation in risky sexual behaviour across the five study sites astride the line from the Coast in the East to the Western border of the country. It is therefore misleading to pool country data together. Fourthly, in one region, mainly in the western side of Kenya, where already there is high prevalence rates of HIV/AIDS, there is relatively small prevalence of IDUs, though case reports were made by people who did not know their HIV status. This is a potentially explosive situation in the event IDUs were to increase in prevalence, hence the need to move very fast to prevent any emergence of IDUs in this area. A serological survey in Mombasa revealed the close relationship between drug abuse, injecting drug abuse and HIV/AIDS. A proportion of 49.5% of IDUs tested positive for HIV, although this is most likely an underestimate. It can therefore be'fconeluded that there is a linkage between drug abuse and in particular intravenous drug use (IDUs) and 111V transmission in Kenya. This calls for appropriate policy to take this reality into consideration.