DEMOGRAPHIC AND SUBSTANCE USE CONTRIBUTORS OF POOR HEALTH OUTCOMES IN INJECTION DRUG USING WOMEN IN NAIROBI, KENYA

Abstract

<italic>Background</italic>: Injection drug use (IDU), while still uncommon in sub-Saharan Africa, has risen markedly in the last two decades. There is currently relatively little data on IDU in the region, in particular for Nairobi and among women. While women constitute a small minority of IDUs, they are of particular concern due both to the heightened risk they face and to their potential for bridging populations. <italic>Methods</italic>: A cross-sectional survey was administered by peer-advisors working for a Nairobi based substance-use NGO to purposively sampled women (n=89) at injection sites near two of its service centers. The survey covered basic demographics, substance use, HIV status and care, reproductive health and gender violence. Analysis included investigation of bi-variate correlations and appropriate regressions. <italic>Results</italic>: The sample reported high prevalences for multiple outcomes of interest, including living with HIV/AIDS (37.1%), unprotected vaginal intercourse (91.%), sexual assault (68.6%), gender violence (95.4%), history of arrest (94.3%), and sharing injection equipment (85.1%). Starting age of substance use increased with client age (b: 0.057, SE: 0.016, p < 0.001, 95% CI: 0.025, 0.089) and level of education (b: 0.266, SE: 0.099, p < 0.001, 95% CI: 0.070, 0.462). Frequency of daily use increased with client age (b: 0.047, SE: 0.015, p < 0.003, 95% CI: 0.016, 0.077). Lifetime likelihood of experiencing sexual assault decreased with an increase in starting age of substance use (OR: 0.545, p<0.035, 95% CI: 0.310, 0.958).