Drug and substance abuse is undermining Kenya’s progress in the battle to end HIV infections and AIDS-related deaths by 2030. Among people who inject drugs, at least two in every ten are HIV positive, a grim statistic that highlights the dangerous intersection between addiction and disease transmission.
The widespread use of heroin, particularly in the Coast region, is a significant driver of new infections. Needle sharing remains common among users, exposing them to HIV and hepatitis B and C. The consequences are devastating, with entire families affected, lives lost, and communities grappling with the aftermath.
One of the key strategies in place is the harm reduction programme, which provides clean needles and methadone therapy. This approach reduces the risk of infections by discouraging needle sharing and helping users gradually wean off hard drugs. Thanks to such interventions, the proportion of new HIV infections among people who inject drugs has dropped from 33% in 2011 to 13% in 2022, with further declines in HIV prevalence recorded.
However, the challenge remains significant. Drug use among the youth is rising, with the average age of users dropping to as low as 15. Substances like miraa and muguka, though legal, are contributing to increased sexual activity and risky behaviour, exacerbating the spread of HIV.
In Nairobi and regions like Kilifi, Mombasa, and Lamu, drug trafficking, economic hardship, and social disintegration have created fertile ground for substance abuse. Inland areas are also reporting increased drug use due to improved connectivity and urbanisation.
Rehabilitation centres are playing a critical role in recovery. They offer methadone, antiretroviral therapy, psychosocial support, vocational training, and safe spaces where users can recover with dignity. Still, many recovering users face stigma and barriers to reintegration, prompting efforts to promote community acceptance and economic empowerment.
Prescription drug misuse and polydrug use are also on the rise, with some users mixing stimulants like miraa with illegal depressants. This dangerous combination is fuelling addiction and complicating recovery.
Experts stress that prevention must go hand in hand with treatment. Tighter control of supply chains, regulation of pharmacies, and community education are essential. Addressing emotional trauma, peer pressure, and poverty will also reduce the number of people turning to drugs.
While gains have been made in reducing infections linked to injecting drug use, continued vigilance, policy reform, and community-based solutions are needed to stop drug abuse from derailing Kenya’s goal of ending HIV as a public health threat.
