Qualitative Analysis of Community Support to Methadone Access in Kenya

Datos Bibliográficos

ID21646615
AutoresJames Ndimbii (0000-0003-2291-0868, Kenya AIDS NGOs Consortium, Nairobi, Kenya, autor de correspondencia), Andrew Guise (0000-0002-0981-4663, King's College London), Andy Guise (King's College London), Emmy Kageha Igonya (0000-0001-7155-3786, University of Nairobi), Frederick Owiti (University of Nairobi), Steffanie A Strathdee (0000-0002-7724-691X, University of California San Diego), Steffanie Strathdee (University of California San Diego), Tammy Rhodes (0000-0003-2400-9838, Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, London, UK)
Año2021
Volumen56
Número9
Páginas1312-1319
Fecha de publicación2021-07-29
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaSubstance Use & Misuse (JOURNAL)
Identificadores de la revistaISSN: 1082-6084 • E-ISSN: 1532-2491
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10826084.2021.1922450
PMID34027819
OpenAlexW3165660164
IdiomaEN
Citas recibidas6
Referencias citadas34

BACKGROUND: Methadone, as part of Medically Assisted Therapy (MAT) for treatment of opioid dependence and supporting HIV prevention and treatment, has been recently introduced in Kenya. Few low income settings have implemented methadone, so there is little evidence to guide ongoing scale-up across the region. We specifically consider the role of community level access barriers and support. OBJECTIVES: To inform ongoing MAT implementation we implemented a qualitative study to understand access barriers and enablers at a community level. METHODS: We conducted 30 semi-structured interviews with people who use drugs accessing MAT, supplemented by interviews with 2 stakeholders, linked to participant observation in a community drop in center within one urban area in Kenya. We used thematic analysis. RESULTS: We developed five themes to express experiences of factors enabling and disabling MAT access and how community support can address these: 1) time, travel and economic hardship; 2) managing methadone and contingencies of life, 3) peer support among MAT clients as treatment ambassadors, 4) family relations, and 5)outreach project contributions. Crosscutting themes address managing socioeconomic constraints and gender inequities. CONCLUSIONS: People who use drugs experience and manage socio-economic constraints and gender inequities in accessing MAT with the support of local communities. We discuss how these access barriers could be addressed through strengthening the participation of networks of people who use drugs in drug treatment and supporting community projects working with people who use drugs. We also explore potential for how socio-economic constraints could be managed within an integrated health and social care response

Environmental health · Methadone · Psychiatry · Qualitative analysis · Qualitative research · Sociology · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Substance Abuse Treatment and Outcomes