» Articles » PMID: 40009634

Characterising People Who Inject Drugs, and Association with HIV Infection: A Situation Analysis in Kampala City, Uganda

Overview
Specialty Public Health
Date 2025 Feb 26
PMID 40009634
Authors
Affiliations
Soon will be listed here.
Abstract

Uganda implements interventions for injection drug use, but significant barriers hinder efforts to effectively reach and support persons who inject drugs (PWID). We describe characteristics of PWID, and associated risk behaviour, to inform the designing of programmes that are tailored to clients' needs and preferences. A cross-sectional survey (August 23rd to December 5th, 2023) in Kampala interviewed 354 PWID (≥18-years) at selected venues(bars,lodges, street corners and ghetto). Peer eductors and counsellors administered a structured questionnaire covering socio-demographics, drug use, sexual risk, and medical history. HIV serostatus was determined by self-report or testing for consenting participants without history of recent testing Binary logistic regression was used to establish the relationship between HIV infection and risky drug- and sexual behaviour of PWID. Participants were predominantly Ugandan (95.2%), male (73.2%), unmarried (55.9%), unemployed (81.8%), with higher levels of education and varying ages. Mental disorders were prevalent, with 48.7% reporting at least one underlying condition, including depression (30.8%) and anxiety (9.6%). Physical health issues included fever (32.9%), cough (32.5%), malaria (22%), and sexually transmitted infections (15%). Over 82.6% were introduced to drugs by close acquaintances. HIV prevalence among participants was 3.7%, higher in females (8.4%) and non-Ugandans (16.7%). Being female and experiencing difficulty accessing sterile injection materials were associated with HIV-positive status. Our study provides valuable insight into the socio-demographic, mental, physical health, and HIV risk behaviour of PWID in Kampala, Uganda. The findings indicate significant vulnerabilities to injecting drug use, mental disorders, and high-risk behaviors that predispose this population to HIV infection. Despite a low HIV prevalence in this population compared to previous estimates, the interplay between drug use, risky injecting practices, and sexual behaviour suggests an urgent need for targeted interventions to address these intertwined challenges.

References
1.
Dua T, Barbui C, Clark N, Fleischmann A, Poznyak V, van Ommeren M . Evidence-based guidelines for mental, neurological, and substance use disorders in low- and middle-income countries: summary of WHO recommendations. PLoS Med. 2011; 8(11):e1001122. PMC: 3217030. DOI: 10.1371/journal.pmed.1001122. View

2.
Mudiope P, Mutamba B, Komuhangi L, Nangendo J, Alamo S, Mathers B . Retention of people who inject drugs enrolled in a 'medications for opioid use disorder' (MOUD) programme in Uganda. Addict Sci Clin Pract. 2024; 19(1):39. PMC: 11094991. DOI: 10.1186/s13722-024-00468-4. View

3.
Lion R, Watt M, Wechsberg W, Meade C . Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa. Subst Use Misuse. 2017; 52(6):773-784. PMC: 5600888. DOI: 10.1080/10826084.2016.1264964. View

4.
Atkinson J, McCurdy S, Williams M, Mbwambo J, Kilonzo G . HIV risk behaviors, perceived severity of drug use problems, and prior treatment experience in a sample of young heroin injectors in Dar es Salaam, Tanzania. Afr J Drug Alcohol Stud. 2012; 10(1):1-9. PMC: 3460543. View

5.
Dickson-Gomez J, Twaibu W, Christenson E, Dan K, Anguzu R, Homedi E . Injection and sexual risk among people who use or inject drugs in Kampala, Uganda: An exploratory qualitative study. PLoS One. 2020; 15(4):e0231969. PMC: 7176107. DOI: 10.1371/journal.pone.0231969. View