Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study
Abstract Background In Kenya, violence is common among people who inject drugs (PWID) living with HIV and their sexual and injecting partners and may lead to decreased uptake of HIV services, increased HIV risk behaviors, and increased HIV transmission. Violence is defined as any physical harm, thre...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-023-00895-7 |
| _version_ | 1827770659571236864 |
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| author | Sai Win Kyaw Htet Aung Hanley Kingston Loice W. Mbogo Betsy Sambai Aliza Monroe-Wise Natasha T. Ludwig-Barron David Bukusi William Sinkele Esther Gitau Sarah Masyuko Joshua T. Herbeck Carey Farquhar Brandon L. Guthrie |
| author_facet | Sai Win Kyaw Htet Aung Hanley Kingston Loice W. Mbogo Betsy Sambai Aliza Monroe-Wise Natasha T. Ludwig-Barron David Bukusi William Sinkele Esther Gitau Sarah Masyuko Joshua T. Herbeck Carey Farquhar Brandon L. Guthrie |
| author_sort | Sai Win Kyaw Htet Aung |
| collection | DOAJ |
| description | Abstract Background In Kenya, violence is common among people who inject drugs (PWID) living with HIV and their sexual and injecting partners and may lead to decreased uptake of HIV services, increased HIV risk behaviors, and increased HIV transmission. Violence is defined as any physical harm, threatened harm, or forced sexual acts inflicted on a person in the past year. Understanding the nature of violence and its correlates among PWID and their partners will inform population-specific public health interventions and policy recommendations. Methods This is a cross-sectional study nested in a prospective cohort study conducted in eight public health centers, methadone clinics, and needle syringe programs in Nairobi, Kilifi, and Mombasa counties in Kenya. 3,302 sexual and/or injecting partners of PWID living with HIV were recruited through assisted partner services and participated in the study. Prevalence and correlates of violence were identified using the Wald test and negative binomial regression. Results Out of 3302 study participants, 1439 (44%) had experienced violence within the past year. Physical violence was the most common form of violence experienced (35%), followed by being threatened (23%) or subjected to sexual violence (7%). In an adjusted analysis, female participants reported higher experiences of sexual violence (prevalence ratio [PR] = 2.46; 95% confidence interval [CI] 1.62, 3.74; p < 0.001) compared to male participants. In adjusted analysis, coastal residents had a higher experience of overall violence (PR = 1.48; 95% CI 1.27, 1.72; p < 0.001) than those living in Nairobi. This regional effect was relatively stronger among the female respondents (p interaction = 0.025). Participants’ sex modified the association between region and experiencing violence after adjusting potential confounding factors. Conclusions The study reveals the prevalence of violence among PWID and identifies high-risk sub-groups, including women, specifically for sexual violence, and coastal residents. Tailored interventions addressing their unique needs are essential. A holistic approach that combines violence prevention and response, comprehensive harm reduction, healthcare access, and community support is crucial to address the complex issue of drug use and HIV burden among PWID in Kenya for improved health outcomes. |
| first_indexed | 2024-03-11T12:42:44Z |
| format | Article |
| id | doaj.art-6e9e4720901b43c6bb91c2b14f91c575 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-03-11T12:42:44Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-6e9e4720901b43c6bb91c2b14f91c5752023-11-05T12:11:39ZengBMCHarm Reduction Journal1477-75172023-11-0120111410.1186/s12954-023-00895-7Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional studySai Win Kyaw Htet Aung0Hanley Kingston1Loice W. Mbogo2Betsy Sambai3Aliza Monroe-Wise4Natasha T. Ludwig-Barron5David Bukusi6William Sinkele7Esther Gitau8Sarah Masyuko9Joshua T. Herbeck10Carey Farquhar11Brandon L. Guthrie12University of WashingtonUniversity of WashingtonUniversity of Washington Global Assistance Program-KenyaUniversity of Washington Global Assistance Program-KenyaUniversity of WashingtonUniversity of WashingtonKenyatta National HospitalSupport for Addiction Prevention and Treatment in Africa (SAPTA)Support for Addiction Prevention and Treatment in Africa (SAPTA)University of WashingtonUniversity of WashingtonUniversity of WashingtonUniversity of WashingtonAbstract Background In Kenya, violence is common among people who inject drugs (PWID) living with HIV and their sexual and injecting partners and may lead to decreased uptake of HIV services, increased HIV risk behaviors, and increased HIV transmission. Violence is defined as any physical harm, threatened harm, or forced sexual acts inflicted on a person in the past year. Understanding the nature of violence and its correlates among PWID and their partners will inform population-specific public health interventions and policy recommendations. Methods This is a cross-sectional study nested in a prospective cohort study conducted in eight public health centers, methadone clinics, and needle syringe programs in Nairobi, Kilifi, and Mombasa counties in Kenya. 3,302 sexual and/or injecting partners of PWID living with HIV were recruited through assisted partner services and participated in the study. Prevalence and correlates of violence were identified using the Wald test and negative binomial regression. Results Out of 3302 study participants, 1439 (44%) had experienced violence within the past year. Physical violence was the most common form of violence experienced (35%), followed by being threatened (23%) or subjected to sexual violence (7%). In an adjusted analysis, female participants reported higher experiences of sexual violence (prevalence ratio [PR] = 2.46; 95% confidence interval [CI] 1.62, 3.74; p < 0.001) compared to male participants. In adjusted analysis, coastal residents had a higher experience of overall violence (PR = 1.48; 95% CI 1.27, 1.72; p < 0.001) than those living in Nairobi. This regional effect was relatively stronger among the female respondents (p interaction = 0.025). Participants’ sex modified the association between region and experiencing violence after adjusting potential confounding factors. Conclusions The study reveals the prevalence of violence among PWID and identifies high-risk sub-groups, including women, specifically for sexual violence, and coastal residents. Tailored interventions addressing their unique needs are essential. A holistic approach that combines violence prevention and response, comprehensive harm reduction, healthcare access, and community support is crucial to address the complex issue of drug use and HIV burden among PWID in Kenya for improved health outcomes.https://doi.org/10.1186/s12954-023-00895-7ViolenceHIVDrug UsePeople who inject drugsKenya |
| spellingShingle | Sai Win Kyaw Htet Aung Hanley Kingston Loice W. Mbogo Betsy Sambai Aliza Monroe-Wise Natasha T. Ludwig-Barron David Bukusi William Sinkele Esther Gitau Sarah Masyuko Joshua T. Herbeck Carey Farquhar Brandon L. Guthrie Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study Harm Reduction Journal Violence HIV Drug Use People who inject drugs Kenya |
| title | Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study |
| title_full | Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study |
| title_fullStr | Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study |
| title_full_unstemmed | Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study |
| title_short | Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study |
| title_sort | prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with hiv in kenya a cross sectional study |
| topic | Violence HIV Drug Use People who inject drugs Kenya |
| url | https://doi.org/10.1186/s12954-023-00895-7 |
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