ArticleBMJ open2015
Is the promise of methadone Kenya's solution to managing HIV and addiction? A mixed-method mathematical modelling and qualitative study.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Prevalence and epidemiological distribution of substance use among people living with HIV in the East African region: a meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Multinational appraisal of the epidemiological distribution of opioid fatalities: a systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- A Systematic Review of Simulation Models to Track and Address the Opioid Crisis.Epidemiologic reviews · 2022Pooled it
- Pooled it
- Feasibility, Acceptability, and Preliminary Efficacy of a Pilot Study To Integrate Buprenorphine into a Harm-reduction Drop-in-Center in Kampala, Uganda.AIDS and behavior · 2026Article
- Hydromorphone Hopes: A Qualitative Study of People Initiating Supervised Short-Acting Injectable Opioid Treatment in Australia.Drug and alcohol review · 2025Article
- Impact of scaling up harm reduction interventions on injecting risk behaviours, ART outcomes and HIV incidence among people who inject drugs in Kenya.The International journal on drug policy · 2025Article
- Risk factors for poor treatment outcomes among opioid-dependent clients taking methadone in Mombasa, Kenya.Advances in drug and alcohol research · 2024Article
- Substance use patterns and negative urine opioid screen among patients on methadone treatment at a referral hospital in Nairobi, Kenya.PLOS mental health · 2024Article
- A phylogenetic assessment of HIV-1 transmission trends among people who inject drugs from Coastal and Nairobi, Kenya.Virus evolution · 2024Article
- Exploring user experiences of a text message-delivered intervention among individuals on opioid use disorder treatment in Kenya: A qualitative study.PLOS digital health · 2023Article
- Exploring the experiences of clients receiving opioid use disorder treatment at a methadone clinic in Kenya: a qualitative study.Addiction science & clinical practice · 2022Article
- Challenges and best practices for hepatitis C care among people who inject drugs in resource limited settings: focus group discussions with healthcare providers in Kenya.Global public health · 2022Article
- Impact of COVID-19 on substance use disorder treatment services in Kenya: Qualitative findings from healthcare providers.The International journal on drug policy · 2022Article
- Participation in methadone programs improves antiretroviral uptake and HIV viral suppression among people who inject drugs in Kenya.Journal of substance abuse treatment · 2022Article
- The prevalence and pattern of cannabis use among patients attending a methadone treatment clinic in Nairobi, Kenya.Substance abuse treatment, prevention, and policy · 2022Article
- Characteristics associated with HIV and hepatitis C seroprevalence among sexual and injecting partners of HIV positive persons who inject drugs in Nairobi and coastal Kenya.BMC infectious diseases · 2022Article
- Modelling the impact of HIV and HCV prevention and treatment interventions for people who inject drugs in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2021Article
- Overview of the epidemiological conditions of HIV among key populations in Africa.Journal of the International AIDS Society · 2021Review
- Estimate cost of providing methadone maintenance treatment at a methadone clinic in Nairobi Kenya: direct costs.The Pan African medical journal · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
Abstract
BACKGROUND AND
objectivesPromoted globally as an evidence-based intervention in the prevention of HIV and treatment of heroin addiction among people who inject drugs (PWID), opioid substitution treatment (OST) can help control emerging HIV epidemics among PWID. With implementation in December 2014, Kenya is the third Sub-Saharan African country to have introduced OST. We combine dynamic mathematical modelling with qualitative sociological research to examine the 'promise of methadone' to Kenya. METHODS, SETTING AND
participantsWe model the HIV prevention impact of OST in Nairobi, Kenya, at different levels of intervention coverage. We draw on thematic analyses of 109 qualitative interviews with PWID, and 43 with stakeholders, to chart their narratives of expectation in relation to the promise of methadone.
resultsThe modelled impact of OST shows relatively slight reductions in HIV incidence (5-10%) and prevalence (2-4%) over 5 years at coverage levels (around 10%) anticipated in the planned roll-out of OST. However, there is a higher impact with increased coverage, with 40% coverage producing a 20% reduction in HIV incidence, even when accounting for relatively high sexual transmissions. Qualitative findings emphasise a culture of 'rationed expectation' in relation to access to care and a 'poverty of drug treatment opportunity'. In this context, the promise of methadone may be narrated as a symbol of hope-both for individuals and community-in relation to addiction recovery.
conclusionsMethadone offers HIV prevention potential, but there is a need to better model the effects of sexual HIV transmission in mediating the impact of OST among PWID in settings characterised by a combination of generalised and concentrated epidemics. We find that individual and community narratives of methadone as hope for recovery coexist with policy narratives positioning methadone primarily in relation to HIV prevention. Our analyses show the value of mixed methods approaches to investigating newly-introduced interventions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.