HIV Prevalence, Estimated Incidence, and Risk Behaviors Among People Who Inject Drugs in Kenya
HIV Prevalence, Estimated Incidence, and Risk Behaviors Among People Who Inject Drugs in Kenya
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DOI：
10.1097/qai.0000000000000769
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发表时间：
2015-12-01
影响因子：
3.6
通讯作者：
Cherutich, Peter
中科院分区：
文献类型：
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作者：
Kurth, Ann E.;Cleland, Charles M.;Cherutich, Peter
在撒哈拉以南非洲，艾滋病毒感染越来越多地发生在注射毒品者（PWID）中。肯尼亚是最早实施国家针头和注射器计划的国家之一。我们的研究进行了基线评估的一部分，在寻求，测试，治疗，并保留approach.Methods：参与者在2012年5月至12月从10个网站。应答者驱动的抽样是用来达到1785 PWID的HIV-1的流行率和病毒载量测定和survey data.Results：估计的HIV流行率，调整不同的网络大小和招聘关系，分别为14.5%，在内罗毕（95%CI：10.8至18.2）和20.5%，在沿海地区（95%CI：17.3至23.6）。内罗毕的病毒载量（log（10）转换）范围为1.71 - 6.12（中位数：4.41;四分位数间距：3.51-4.94），沿海地区为1.71 - 5.88（中位数：4.01;四分位数间距：3.44-4.72）。使用log（10）病毒载量2.6作为HIV病毒抑制的阈值，内罗毕和沿海地区的HIV感染参与者中病毒抑制的百分比分别为4.2%和4.6%。海洛因是这两个地区最常注射的药物，93%的参与者在过去一个月使用过，通常每天注射2-3次。最后一次注射时共用针头/注射器的情况在内罗毕（23%）比在沿海地区（4%）更为常见。估计发病率之间的新注射者为2.5/100人年，在内罗毕和1.6/100人年的Coast.Conclusions：艾滋病毒流行是建立在两个内罗毕和海岸地区的PWID。在公共卫生领域大规模实施艾滋病毒综合预防有可能极大地限制这一脆弱和过渡性人群的流行。
Objective: HIV infection in sub-Saharan Africa increasingly occurs among people who inject drugs (PWID). Kenya is one of the first to implement a national needle and syringe program. Our study undertook a baseline assessment as part of evaluating needle and syringe program in a seek, test, treat, and retain approach.Methods: Participants enrolled between May and December 2012 from 10 sites. Respondent-driven sampling was used to reach 1785 PWID for HIV-1 prevalence and viral load determination and survey data.Results: Estimated HIV prevalence, adjusted for differential network size and recruitment relationships, was 14.5% in Nairobi (95% CI: 10.8 to 18.2) and 20.5% in the Coast region (95% CI: 17.3 to 23.6). Viral load (log(10) transformed) in Nairobi ranged from 1.71 to 6.12 (median: 4.41; interquartile range: 3.51-4.94) and in the Coast from 1.71 to 5.88 (median: 4.01; interquartile range: 3.44-4.72). Using log(10) viral load 2.6 as a threshold for HIV viral suppression, the percentage of HIV-infected participants with viral suppression was 4.2% in Nairobi and 4.6% in the Coast. Heroin was the most commonly injected drug in both regions, used by 93% of participants in the past month, typically injecting 2-3 times/day. Receptive needle/syringe sharing at last injection was more common in Nairobi (23%) than in the Coast (4%). Estimated incidence among new injectors was 2.5/100 person-years in Nairobi and 1.6/100 person-years in the Coast.Conclusions: The HIV epidemic is well established among PWID in both Nairobi and Coast regions. Public health scale implementation of combination HIV prevention has the potential to greatly limit the epidemic in this vulnerable and bridging population.