Association between substance use and concurrent sexual relationships among urban slum dwellers in Nairobi, Kenya

ABSTRACT

While the overall incidence and prevalence of HIV/AIDS are declining in Africa, substance use-related HIV/AIDS is on the rise. The main objectives of this study were to elicit the types of commonly used substances and to examine the association between substance use and concurrent sexual relationships among slum dwellers in Kenya. Freelisting elicitation techniques were used to identify the most commonly used substances using 53 key informants. This was followed by a self-administered, structured questionnaire using a convenience sample of 506 participants. Findings from our freelisting analysis produced 27 substances that were used in the community. Analysis of the survey data shows that participants who reported using substances in the past three months were more likely to be involved in concurrent sexual relationships than those who did not (86.2% vs. 74.0%; p = .002). In the multivariable model, the odds of ever having concurrent sexual relationships were higher among participants who used any substance in the past three months (aOR 2.46; 95% CI 1.37–4.42, p < .01). The observed association between substance use and concurrent sexual relationships may be influenced by social and economic factors such as poverty and lack of opportunity among urban slum dwellers.

KEYWORDS:

• Substance use
• concurrent sexual relationships
• urban slum
• Kenya

Acknowledgements

We are also grateful for the support we have received from Pambazuko Mashinani, an NGO, working on maternal and sexual health issues based in, Korogocho, Nairobi, Kenya. We would like to thank the hundreds of Korogochians who participated in the study and the many friends and community members who welcomed us to their homes.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Dawit Okubatsion Woldu http://orcid.org/0000-0003-2400-8931

Zelalem T. Haile http://orcid.org/0000-0002-2912-8564

Additional information

Funding

This work was supported by the Institute for the African Child at Ohio University.