1. www.aids2014.org Reducing Vulnerability Of Marginalized Drug Dependent Communities In Nairobi Kenya Through Socio-economic Opportunities Hezron Ogembo 1, Calleb Angira 1, Beth Mbugua 2, Reychad Abdool 2, Saade Abdallah 2 1.Nairobi Outreach Services Trust (NOSET) 2.United Nations Office on Drugs and Crime, Regional Office for Eastern Africa (UNODC ROEA)

2. www.aids2014.org Introduction People who use drugs in Kenya, including PWID suffer from socio-economic marginalization due to crime and HIV risk-related behaviour There are an estimated 18,327 PWIDs in Kenya HIV prevalence rate 18.3% among IDUS, versus 6.3% among general adult population HIV prevalence is 44.5% among female IDUs and16% among males

3. www.aids2014.org Nairobi Outreach Services Trust Located in Ngara, Nairobi Offers HIV prevention, care & treatment for PWUD since 2005 Operates in 2 broad districts of Westlands and Eastlands Covers 23 IDU drug use hot spots Through UNODC, implements OFID- funded Sustainable Livelihood Project since 2011

4. www.aids2014.org Vulnerability Context Decrease in protective factors: health hazardous behavior Drug dependence, imprisonment and related HIV infection Stigmatization, discrimination Exclusion from development process and socio-economic services Poverty, Marginalization, deprivation Vicious circle

5. www.aids2014.org Interventions HIV and Drug Use Prevention & Treatment: Drop-in-Centre: HTC, Nursing, addiction counseling; Outreaches: IEC, NSEP Referral: ART for HIV- positive clients, Sustainable Livelihood Interventions Daily meals and showers Shelter for women with children Microcredit training with loan provision Vocational training in IGAs

6. www.aids2014.org Methods Simple Excel cohort monitoring tool used to extract data for beneficiaries of SLP Inclusion criteria: at least two documented encounters for SLP interventions; Jan to Dec 2013 Total enrolled: 160 recovering PWUDs in cohort Retrospective review of service coverage and effects of basic socio-economic support and other PWUD interventions

7. www.aids2014.org Baseline Status

8. www.aids2014.org Immediate Outputs Basic Socio-Economic Support: 936 DUs, 624 IDU’s and 421 Females received daily meals 40 FWUDs received shelter 822 DUs, 1023 IDUs and 533 Females got Psychosocial and life skills support:

9. www.aids2014.org Medium/Long term Support 56 trained on basic entrepreneurship skills Micro credit groups:5 (30 DUs, 25 IDUs, 10 Females) Issued loans:42 (22 DUs, 12 IDUs, 8 Females) Servicing loans: 24 (10 DUs, 7 IDUs, 7 Females) Fully repaid :10 (8 DUs and 2 IDUs),defaulters:7 New enterprises:34(shoe selling, water containers, transportation using trolleys among others)

10. www.aids2014.org Behavioral Outcomes

11. www.aids2014.org Conclusion Socioeconomic interventions for PWUDs can lead to: Reduced risky sexual and drug use behavior. Reduced criminality Reduced vulnerability to HIV infection Increased potential to self reliance Improved general health

12. www.aids2014.org IGA Training by Jamii Bora Bank Staff

13. www.aids2014.org Beneficiary FWUD with Children

14. www.aids2014.org Lessons learnt Lunches, bathing & washing services attracted more clients to DIC services, including mothers with young children. A viable enterprise can sustain feeding programme. Recovering PWUD can successfully service loans and accrue small savings. As Kenya embarks on methadone maintenance treatment (MMT), socio- economic empowerment is vital to assure retention of female heroin users.

15. www.aids2014.org Acknowledgements Economic interventions shelter Basic intervention(food,clothing) OPEC Fund for International Development (OFID) Kenya’s Ministry of Health: NASCOP and Mental Health Directorate United Nations Office on Drugs and Crime (UNODC ROEA and HQ) Nairobi Outreach Services Trust (NOSET) Project Beneficiaries