"We only trust each other": A qualitative study exploring the overdose risk environment among persons who inject drugs living with HIV in Nairobi, Kenya
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View abstract on PubMed
Summary
This summary is machine-generated.Overdose risk for people who inject drugs (PWID) in Kenya is high, influenced by social, economic, and political factors. Comprehensive strategies addressing harm reduction, naloxone access, and policy reform are crucial for reducing overdose deaths.
Area Of Science
- Public Health
- Addiction Medicine
- Sociology
Background
- Overdose is a significant public health issue in Kenya, disproportionately affecting people who inject drugs (PWID).
- PWID living with HIV (PWID-LH) face heightened overdose risks due to complex environmental factors in Kenya.
- Understanding Kenya's specific overdose risk environment is critical for developing effective interventions.
Purpose Of The Study
- To characterize the overdose risk environment for PWID in Kenya using qualitative inquiry.
- To identify precursors, safety strategies, and treatment barriers related to overdose experiences.
Main Methods
- Qualitative study involving semi-structured interviews with purposively recruited PWID living with HIV in Kenya.
- Participants were selected from a larger cohort study (September-December 2018).
- Thematic analysis was applied using a risk environment framework.
Main Results
- Nearly all participants (96%) reported personal or observed overdose experiences, with heroin being the most common substance (79%).
- Identified overdose precursors include increased consumption, polysubstance use, incarceration, rushed injections, and violence (especially for women).
- Low naloxone awareness (25%) and significant barriers to treatment (stigma, cost, limited access, punitive policies) were reported.
Conclusions
- Kenya's overdose risk environment necessitates comprehensive strategies addressing physical, social, economic, and political determinants.
- Reducing overdose morbidity and mortality requires enhanced harm reduction education, increased naloxone awareness and access, and destigmatization.
- Reforming punitive policies criminalizing PWID is essential for improving health outcomes.
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