Characteristics associated with HIV and hepatitis C seroprevalence among sexual and injecting partners of HIV positive persons who inject drugs in Nairobi and coastal Kenya.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
21 Jan 2022
Historique:
received: 03 09 2021
accepted: 05 01 2022
entrez: 22 1 2022
pubmed: 23 1 2022
medline: 27 1 2022
Statut: epublish

Résumé

Persons who inject drugs (PWID) have higher HIV and hepatitis C virus (HCV) seroprevalence than the general population in many parts of sub-Saharan Africa (SSA). The seroprevalences of HIV and HCV are also higher in coastal Kenya than in Nairobi. Understanding drivers of regional HIV and HCV variation among PWID in Kenya may inform population-specific prevention interventions. Using a cross-sectional study, we defined HIV and HCV seroprevalence among persons identified as sexual or injecting partners of HIV positive PWID in two regions of Kenya and used logistic regression to identify demographic and behavioral characteristics associated with higher seroprevalence. Among 2386 partners, 469 (19.7%) tested HIV positive and 297(12.4%) tested HCV antibody positive. Partners on the Coast were more likely to live with HIV (seroprevalences: Coast = 23.8%, Nairobi = 17.1%; p < 0.001) and be HCV antibody positive (seroprevalences: Coast = 17.0%, Nairobi = 8.6%; p < 0.001). After adjusting for sex, age, and years injecting and accounting for clustering by site, the higher prevalence of both diseases in the Coast remained significant for HIV (OR 1.68, 95% CI 1.13-2.51) but not for HCV (OR 1.72, 95% CI 0.84-3.74). Compared to those recruited in Nairobi, partners on the Coast were older (Coast = 35 years, Nairobi = 31 years; p < 0.001), more likely to be male (Coast = 77.6%, Nairobi = 61.7%; p < 0.001), to have paid (Coast = 59.2%, Nairobi = 32.8%; p < 0.001) or received (Coast = 44.2%, Nairobi 35.4%; p < 0.001) money for sex, or to have had sex with someone they knew to be HIV positive (Coast 22.0%, Nairobi 10.8%; p < 0.001). Partners who had injected for five or more years had 1.48 times greater odds (95% CI 1.20-1.82) of living with HIV compared to partners who injected less than 5 years and more than twice the odds of HCV (95% CI 1.84-4.11). HIV and HCV seroprevalence among sexual and injecting partners of PWID was, respectively, 5 times and > 12 times greater than is reported among the general population in Kenya (4% and < 1%, respectively). Providing resources and education will be crucial to reduce exposure and to maintain the lower needle and equipment sharing that we observed compared to other studies.

Sections du résumé

BACKGROUND BACKGROUND
Persons who inject drugs (PWID) have higher HIV and hepatitis C virus (HCV) seroprevalence than the general population in many parts of sub-Saharan Africa (SSA). The seroprevalences of HIV and HCV are also higher in coastal Kenya than in Nairobi. Understanding drivers of regional HIV and HCV variation among PWID in Kenya may inform population-specific prevention interventions.
METHODS METHODS
Using a cross-sectional study, we defined HIV and HCV seroprevalence among persons identified as sexual or injecting partners of HIV positive PWID in two regions of Kenya and used logistic regression to identify demographic and behavioral characteristics associated with higher seroprevalence.
RESULTS RESULTS
Among 2386 partners, 469 (19.7%) tested HIV positive and 297(12.4%) tested HCV antibody positive. Partners on the Coast were more likely to live with HIV (seroprevalences: Coast = 23.8%, Nairobi = 17.1%; p < 0.001) and be HCV antibody positive (seroprevalences: Coast = 17.0%, Nairobi = 8.6%; p < 0.001). After adjusting for sex, age, and years injecting and accounting for clustering by site, the higher prevalence of both diseases in the Coast remained significant for HIV (OR 1.68, 95% CI 1.13-2.51) but not for HCV (OR 1.72, 95% CI 0.84-3.74). Compared to those recruited in Nairobi, partners on the Coast were older (Coast = 35 years, Nairobi = 31 years; p < 0.001), more likely to be male (Coast = 77.6%, Nairobi = 61.7%; p < 0.001), to have paid (Coast = 59.2%, Nairobi = 32.8%; p < 0.001) or received (Coast = 44.2%, Nairobi 35.4%; p < 0.001) money for sex, or to have had sex with someone they knew to be HIV positive (Coast 22.0%, Nairobi 10.8%; p < 0.001). Partners who had injected for five or more years had 1.48 times greater odds (95% CI 1.20-1.82) of living with HIV compared to partners who injected less than 5 years and more than twice the odds of HCV (95% CI 1.84-4.11).
CONCLUSION CONCLUSIONS
HIV and HCV seroprevalence among sexual and injecting partners of PWID was, respectively, 5 times and > 12 times greater than is reported among the general population in Kenya (4% and < 1%, respectively). Providing resources and education will be crucial to reduce exposure and to maintain the lower needle and equipment sharing that we observed compared to other studies.

Identifiants

pubmed: 35062890
doi: 10.1186/s12879-022-07036-8
pii: 10.1186/s12879-022-07036-8
pmc: PMC8780315
doi:

Substances chimiques

Pharmaceutical Preparations 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

73

Subventions

Organisme : NIMH NIH HHS
ID : T32 MH019105
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA043409
Pays : United States
Organisme : FIC NIH HHS
ID : D43TW009580
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM081062
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States

Informations de copyright

© 2022. The Author(s).

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Auteurs

Betsy C Sambai (BC)

HTC and HIV Care, Kenyatta National Hospital, Box 20723-00202, Nairobi, Kenya.

Hanley Kingston (H)

Institute of Public Health Genetics, University of Washington, UW Box #351620, Seattle, WA, 98195, USA. hkings@uw.edu.

Aliza Monroe-Wise (A)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.

Loice Mbogo (L)

Global Assistance Program-Kenya, University of Washington, Box #20723-0020, Nairobi, Kenya.

Emily Juma (E)

HTC and HIV Care, Kenyatta National Hospital, Box 20723-00202, Nairobi, Kenya.

Natasha Ludwig-Barron (N)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.
Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA, 98195, USA.

Brandon L Guthrie (BL)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.
Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA, 98195, USA.

David Bukusi (D)

HTC and HIV Care, Kenyatta National Hospital, Box 20723-00202, Nairobi, Kenya.

Bhavna H Chohan (BH)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.
Center for Virus Research, Kenya Medical Research Institute (KEMRI), Box 54840-00200, Nairobi, Kenya.

John Scott (J)

Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Box #356423, Seattle, WA, 98195, USA.

Rose Bosire (R)

Centre for Clinical Research, Kenya Medical Research Institute (KEMRI), Box 54840-00200, Nairobi, Kenya.

Matthew Dunbar (M)

Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, 98195, USA.

Paul Macharia (P)

Global Assistance Program-Kenya, University of Washington, Box #20723-0020, Nairobi, Kenya.

Sarah Masyuko (S)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.
National AIDS and STI Control Program, Ministry of Health, Box #13131-00202, Nairobi, Kenya.

William Sinkele (W)

Support for Addictions Prevention and Treatment in Africa (SAPTA), Box #21761-00505, Nairobi, Kenya.

Joshua T Herbeck (JT)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.

Carey Farquhar (C)

Department of Global Health, School of Public Health, University of Washington, UW Box #351620, Seattle, WA, 98195, USA.
Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA, 98195, USA.

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