Dissertation (MSc Nursing Mental Health)
Background: Injecting drug use has created a major international public health
problem where on average 6 million people are injecting drugs worldwide. This study
aimed to explore the potential of bridging the HIV infection from injection drug users
(IDUs) through sexual networks to the general population in Zanzibar. Seek to
understand the interplay between injection drug use, sexual behavior and the
epidemiological shift in the transmission of HIV infection between key population and
the general population, thereby contribute to reducing HIV epidemics in both sides.
Objective: The role of sexual networks in bridging HIV infection between
injection drug users to the general population in Zanzibar.
Methods: Quantitative cross-sectional study design was used whereby data was
collected from1308 adults of all sex with age ranging from 18 to 64 years who are
injection drug in Zanzibar. The data collection method was by the use of self–
administered questionnaires.
Results: Participants who had sexual debut below 18year were had a high risk in
sexual network to the general population OR= (95% CI) 1.353(0.999, 1.833) p<0.05,
most of the participants that practice steady partners were at risk in sexual network
OR= (95% CI) 1.407(1.047, 1.893) and p <0.05. Marital status was also the main
factor for IDU whereby participants who were reported to be separated, widow or
divorced were at less risk of IDU sexual network compared to those who were married
95%CI (0.347,0.753), and P< 0.05). Type of drug used was also the determinant for
IDU sexual network whereby participants that reported to take amphetamine were less
likely to be in sexual network compared to those taking heroin OR 0.279, 95%CI
(0.138, 0.564) and P < 0.05)
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Conclusion: We found evidence to support the hypothesis that sexual networks are
responsible for bridging HIV infection among injection drug users and the general
population in Zanzibar.
Recommendation: In order to control this problem, further efforts should focus mainly
on controlling the use of heroin, preventing sexual debuts below 18 and giving sexual
education among married groups. Establishment of awareness and ongoing risk
reduction programs of IDUs and community how to live in safety also, sexual practice
in an effort to achieve the goal of zero new infection due to the sexual network.