Background:
People who use drugs (PUD), especially injectors (IDUs), face high risks of HIV, TB, and mental health issues, particularly in West Africa’s precarious contexts. In Côte d’Ivoire, limited recent data prompted a study in Abidjan, Bouaké, and San Pedro to assess the prevalence of these vulnerabilities among the PUD population.
Methods:
This is a descriptive cross-sectional study conducted in November 2023 among 954 PUDs aged over 16, recruited from 7 consumption sites. Data collection combined face-to-face interviews, HIV and TB testing (GeneXpert), and psychiatric diagnosis (DSM-5). Analyses focused on prevalence indicators, risky practices, access to care and stigmatization.
Results:
HIV prevalence is 2%, down significantly on previous studies (5.4% in 2018). TB affects 5% of PUDs, including 0.97% of multidrug-resistant TB. HIV/TB co-infections affect 1.3% of PUDs. Among injectors (14.2% of PUDs), 32% share needles. Major depression affects 50% of PUDs, post-traumatic stress 1% and psychotic disorders 9%. Aggravating factors include unemployment (47%), social isolation (77% single), and a prison history (53%). Access to care remains limited despite community interventions.
Conclusion:
This study highlights persistent medical and social vulnerabilities among PUD in Côte d’Ivoire, with increasing comorbidities. Integrating mental health into harm reduction, improving HIV/TB prevention, expanding IDU care access, and addressing stigma remain priorities. A multi-sectoral approach is crucial, especially in precarious settings, where normative tools like therapeutic injunctions leave advocacy space open. |