Substance Use Practices Among People who Inject Drugs in Kenya Preparing for Hepatitis C Treatment

Author: Lindsey Riback Mercy Nyakowa Helgar Musyoki John Lizcano Peter Cherutich Ann Kurth Matthew Akiyama

Theme: Epidemiology & Public Health Research Year: 2022

Despite advances in HCV treatment, ongoing injection drug use (IDU) can lead to HCV reinfection
among other adverse health impacts. We aimed to determine baseline consumption behaviors and
motivation to reduce IDU among people who inject drugs (PWID) engaged in medication-assisted
treatment (MAT) and needle and syringe programs (NSP) in Kenya prior to HCV treatment.
We surveyed 95 PWID intended to receive HCV treatment in Nairobi and Coastal Kenya to determine
HCV treatment outcomes and correlates of sustained virologic response (SVR) among PWID engaged
in MAT or NSPs. We conducted a secondary analysis examining drug practices and motivation to
reduce IDU at baseline.
Participants were predominantly male (85.3%), mean age of 36.5 years (SD=±6.5). While 72.6% were
receiving MAT, almost all (95.8%) reported any drug use in the last 30 days. Most participants (n=87,
91.6%) reported injecting an average of 3.1 (SD=±0.9) injections/day on the days they injected in the
last 30 days. Average age of first injection was 27.7 years (SD=±6.5). All individuals reporting IDU in
the last 30 days injected heroin (100%). During the same timeframe, those reporting IDU also
reported smoking marijuana (64.4%), ingesting or chewing bugizi/rohypnol (24.1%), and chewing
khat/miraa (9.2%). Many indicated they were ready to reduce or stop IDU (64.2%), 23.2% already
reduced or stopped IDU, three expressed some interest, and one did not perceive a need to reduce
their IDU despite injecting heroin and polysubstance use in the last 30 days.
Despite high MAT engagement and motivation to reduce or stop IDU, most participants reported
IDU in the last 30 days. Many also reported polysubstance use. Models of care that co-locate HCV
treatment within existing harm reduction services are essential to promote HCV treatment uptake,
SVR, and curb re-infection; however, additional supportive services are needed to promote
reduction in IDU and polysubstance use.
Disclosure of Interest Statement:
The project described was supported by the Grant Number R01DA032080 and R01DA032080-05S1
from the National Institute on Drug Abuse of the National Institutes of Health. The sponsor of the
study had no role in study design, data collection, data analysis, data interpretation, or writing of the

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