HIV prevalence rates are elevated among people who inject drugs (PWID) in all parts of the world, and in Kenya the documented prevalence is 18.7%, even higher than regional estimates. Because of the stigma they encounter, this population is also often denied essential health services and support, including antiretroviral therapy (ART).

In Nairobi County, Kenya, health authorities have taken action to reduce the spread of HIV among PWID. The first medically assisted therapy (MAT) clinic in the nation to support PWID was established in Nairobi in 2014 with the assistance of the University of Maryland, Baltimore. The clinic was established with funding from the US Centers for Disease Control and Prevention under PEPFAR as part of Ciheb’s PACT Endeleza Project in Kenya.

The Mathari National Teaching and Referral Hospital in Nairobi was selected by Kenyan health authorities to house this MAT clinic. Mathari is a national teaching and referral hospital that provides psychiatric services and has the resources and expertise in addiction management.

The Mathari MAT clinic offers free integrated services for PWID, including opioid substitution (methadone) therapy; HIV testing services; ART; condom distribution; vaccination, diagnosis and management of viral hepatitis; prevention and treatment of tuberculosis; and overdose prevention and treatment. The therapy centers on harm reduction, which comprises a range of services that mitigate the adverse consequences of drug use and protect public health. Harm reduction acknowledges that people face challenges in freeing themselves from drug use, and that abstinence should not be a precondition for support and treatment.