Africa, Development & Aid, Headlines, Health

KENYA: AIDS Prevention Amongst Drug Users a Challenge

Susan Anyangu

MOMBASA, Oct 21 2009 (IPS) - The United Nation Office on Drug and Crime (UNODC) claims that Kenya has more drug users than any other East African country. UNODC estimates there are 100,000 cocaine users, 200,000 using opiates like heroin and four million who smoke cannabis.

In the coastal city of Mombasa, Kenya's main port, which has the country's highest concentration of substance abusers, Masudi Omar of Reachout Centre Trust, a drug addiction treatment centre, says it's vital that AIDS prevention programmes reach this demographic.

"A research done by our partners USAID in 2005 revealed that 50 percent of injecting drug users who were tested for HIV were found to be positive. The challenge here is passing HIV risk reduction messages to drug and alcohol addicts as well as advising those who test positive to seek help in terms of care," Omar says.

These youth are at elevated risk of contracting HIV for multiple reasons. Chief among these is unsafe sex with multiple partners – a combination of indifference to safer sex practices and the demands of commercial sex work, which many addicts turn to in order to support their drug habits.

Kenya’s HIV prevalence rate is seven percent according to the most recent Kenya Aids Indicator Survey, it is feared this may be higher where addicts are concerned.

Abdul Aziz, who was able to quit using drugs six years ago, confirms that it is difficult to get this group to listen and take action to protect themselves.

"I am a recovering addict who was hooked on drugs for 22 years. I know that addicts are stubborn and in my case when I was approached with risk-reducing messages, I was stubborn. Addicts will resist help and it requires patience and time to get through to them," he says.

A study done by UNODC reveals that drug users in Mombasa typically share syringes, greatly increasing the risk that HIV is passed between them. Worse, few drug users seem aware that shared needles can expose them to HIV.

Peter Macharia, coordinator of Family Health Option Kenya, contends that dealing with addicts when raising awareness about STIs requires special skills and focus. He argues the government needs to establish centres that will cater to the special needs of addicts, especially youth.

"Currently, (the) organisations that are dealing with drug addicts and their reproductive health needs are non-governmental organisations. Their reach is modest thus the need for the government to come on board. This group has unique needs."

Omar from the Reachout Centre says addiction treatment centres are few and far between and their cost is prohibitive. Currently, Kenya has only two treatment centres, one each in Nairobi and Mombasa. Omar says costs range from 20 to 40 U.S. dollars a day, well beyond the means of most of those who need care.

The high cost of treatment means many of those who require help are not able to access it and remain in the streets hooked on drugs and alcohol. Most addicts who come to the Reachout Centre Trust are poor.

A four-month programme at the Centre one requires $132, but the centre is not able to offer a full range of care. Omar says they carry out HIV testing, but have to refer clients to a government facility for treatment.

For this reason, says Caroline Mutua, a counsellor at the Reachout Centre, case management and tracking of clients presents a challenge.

"One is never sure that they will continue attending the care service clinic. And if they do not stop abusing (drugs) then it becomes futile because they are bound to drink excessively and engage in risky behavior. For one to begin recovery they need to accept they have a problem and this is often the challenge," says Mutua.

The majority of substance-abusing patients only initiate HIV treatment when their condition has deteriorated and they are in need of acute medical care.

"For those women who brew illicit alcohol it is difficult to convince them to change their trade and avoid commercial sex because this is their only source of income," says Mweupe Alfani, another volunteer at the Centre.

"However, we are trying interventions through which we encourage them to venture into other businesses and so far there is some considerable change in behaviour."

Macharia says efforts by NGOs only reach about 10 percent of the population, leaving a large number of people in need of help. If not addressed, he says, this will deal a major blow to Kenya’s fight against HIV/AIDS.