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Last updated: 26 March 2025

1.1 People who use drugs, HIV and HCV

• There are an estimated 27,056 people who inject drugs living in Kenya, with the majority living in Nairobi, Kilifi, Kwale, Mombasa, Lamu and Kisumu.
• There is an estimated HIV prevalence of 11.3% among people who inject drugs.
• The prevalence of hepatitis C (HCV) in the general population is 6.31%, and among people who inject drugs it is 20%.

1.2 Prevention and Harm Reduction Coverage

• OAT coverage is 13.3%. There are more than ten public methadone maintenance treatment (MMT) clinics in Kenya, and over 35 drop-in centres (DICs) providing NSP.
• The number of needles and syringes distributed per person per year to people who inject drugs is 189, falling below the recommended UN coverage of 200.
• Take-home naloxone and peer-to-peer distribution programmes for naloxone are available, although these programmes are precarious and highly vulnerable to changes in funding and regulations.

PEPFAR and the Global Fund have provided the majority of funding for harm reduction programmes in Kenya. While the Global Fund has supported needle and syringe programmes and drop-in centres, PEPFAR support has primarily covered OAT programmes.

Approximately 28 clinics that offer HIV services, including some that offer OAT and relied heavily on PEPFAR funding, have had to close or reduce their services.

The funding cuts have heightened the vulnerability of people who use drugs, as without adequate support, they face greater risks of HIV infection and other health issues.

The Kenyan government would need to allocate an estimated KES 66.9 billion (USD 518 million) to cover the funding gap left by the US funding cuts.

In Nairobi, two clinics offer MAT/OAT: Ngara MAT Clinic and Mathari MAT Clinic. Ngara MAT Clinic, operated by Nairobi County in partnership with various partners, continues to provide uninterrupted services, benefiting from healthcare workers supplied by the county.

Mathari MAT Clinic, under the national government, is experiencing service disruptions due to stop-work directives. This has led to inadequate psychosocial support, particularly a shortage of counselors, and the absence of defaulter re-enrolment.

The NOSET drop-in centre in Kawangware, Kenya, funded by PEPFAR through the Center for International Health Education and Biosecurity-Kenya (CIHEB), has been closed. Six peer educators previously working there have been put on leave pending further communication.

Limited Drop-in Centre Access: With NOSET closed, the only remaining operational drop-in centre is SAPTA, funded by the Global Fund. While no individuals have been turned away from sexual and reproductive health services, challenges have arisen, including a shortage of some family planning methods at the SAPTA drop-in centre. Clients on HIV treatment are now facing a reduction in HIV drug refills from three months to a one-month supply. Additionally, a woman who uses drugs on TB treatment missed doses initially at the NOSET drop-in centre but later received medication.