title: Medical injection use among adults and adolescents aged 15 to 64 years in Kenya: results from a national survey.
abstract: BACKGROUND
  Unsafe medical injections remain a potential route of HIV transmission in Kenya. We used data from a national survey in Kenya to study the magnitude of medical injection use, medication preference, and disposal of medical waste in the community.
  
  
  METHODS
  The Kenya AIDS Indicator Survey 2012 was a nationally representative population-based survey. Among participants aged 15-64 years, data were collected regarding medical injections received in the year preceding the interview; blood samples were collected from participants for HIV testing.
  
  
  RESULTS
  Of the 13,673 participants who answered questions on medical injections, 35.9% [95% confidence interval (CI): 34.5 to 37.3] reported receiving ≥1 injection in the past 12 months and 51.2% (95% CI: 49.7 to 52.8) preferred receiving an injection over a pill. Among those who received an injection from a health care provider, 95.9% (95% CI: 95.2 to 96.7) observed him/her open a new injection pack, and 7.4% (95% CI: 6.4 to 8.4) had seen a used syringe or needle near their home or community in the past 12 months. Men who had received ≥1 injection in the past 12 months (adjusted odds ratio, 3.2; 95% CI: 1.2 to 8.9) and women who had received an injection in the past 12 months, not for family planning purposes (adjusted odds ratio, 2.6; 95% CI: 1.2 to 5.5), were significantly more likely to be HIV infected compared with those who had not received medical injection in the past 12 months.
  
  
  CONCLUSIONS
  Injection preference may contribute to high rates of injections in Kenya. Exposure to unsafe medical waste in the community poses risks for injury and infection. We recommend that community- and facility-based injection safety strategies be integrated in disease prevention programs.
authors.affiliation: *Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya; †National AIDS and Sexually Transmitted Infection (STI) Programme, Ministry of Health, Nairobi, Kenya; and ‡National Public Health Laboratory Services, Ministry of Health, Nairobi, Kenya.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kimani
authors.forename: Rachel
authors.initials: R
authors.lastname: Kamau
authors.forename: Victor
authors.initials: V
authors.lastname: Ssempijja
authors.forename: Katherine
authors.initials: K
authors.lastname: Robinson
authors.forename: Tom
authors.initials: T
authors.lastname: Oluoch
authors.forename: Mercy
authors.initials: M
authors.lastname: Njeru
authors.forename: Jane
authors.initials: J
authors.lastname: Mwangi
authors.forename: David
authors.initials: D
authors.lastname: Njogu
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D007267:Injections / Q000706:statistics & numerical data*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D017744:Medical Waste Disposal; D008875:Middle Aged; D009339:Needles; D057240:Patient Preference; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D012646:Self Administration / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D013594:Syringes; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D017744:Medical Waste Disposal; D004364:Pharmaceutical Preparations