The higher level of global and local interconnectivity in Nairobi makes it particularly vulnerable to the spread of the SARS-CoV-2 virus. Baseline data were collected on HIV status, antiretroviral therapy and methadone adherence. We used logistic regression to identify factors associated with antibody positivity and descriptive statistics to report SARS-CoV-2 antibody prevalence. == Results == One thousand participants were enrolled between April and July 2021, of whom 323 (32.3%) were women and 677 (67.7%) were men. Median age of participants was 36 years (interquartile range: 30, 42). SARS-CoV-2 antibody positivity was found in 309 (30.9%) participants. Disruption in obtaining methadone support was reported by 106 (24.3%) of the participants. Men were significantly less likely than women to have SARS-CoV-2 antibodies (adjusted odds ratio [aOR] = 0.68, 95% confidence interval [CI] 0.51, 0.95;p< 0.01) Participants who reported a sexual or injecting partner diagnosed with SARS-CoV-2 were twofold more likely to have SARS-CoV-2 antibodies detected (aOR = 2.21, 95% CI 1.06, 4.58;p< 0.032). Living with HIV was not associated with presence of SARS-CoV-2 antibodies. == Conclusion == The seroprevalence of SARS-CoV-2 of 30.9% in this cohort suggests high transmission rates within this population. SARS-CoV-2 seroprevalence was comparable for people living with and without HIV. A large portion of this populace was Oglemilast noted to have had disruption in access to harm reduction services. Keywords:SARS-CoV-2 antibody, HIV/AIDS, Sub-Saharan Africa, PWID, Kenya == Key findings == We found a high seroprevalence of SARS-CoV-2 antibodies in people who inject drugs and their sexual and injecting partners. We also found that participants who reported a sexual or injecting partner diagnosed with SARS-CoV-2 were more likely to have SARS-C0V-2 antibody positivity. Living with HIV was not associated with presence of SARS-CoV-2 antibodies. A large proportion of people who inject drugs was noted to have had disruptions in access to harm reduction services during the study period. Key implications Kenyas national healthcare policymakers should implement special interventions like increased access to take-home doses of methadone and waivers for daily in-person check--ns for this populace during current and future crises to Oglemilast maintain continuity of treatment and access to harm reduction services. == Introduction == People who inject drugs (PWID) in sub-Saharan Africa are more likely than the general populace to be living with undiagnosed HIV and to experience poverty, food and housing instability, stigma, and discrimination that could lead to increased transmission of SARS-CoV-2 and worse outcomes for those with the respiratory viral disease. It is also more challenging for PWID to access healthcare when services have been limited by lockdowns and to adhere to interpersonal distancing measures to prevent spread of respiratory viruses, such as SARS-CoV-2 that causes COVID-19 [1]. In addition, recent emergence of newer SARS-CoV-2 variants has led to multiple waves of outbreaks which threaten to halt the progress made thus far in the spread of the computer virus. In Kenya, from January 2020 to Edn1 December 2021, there were more than 300,000 confirmed cases of SARS-CoV-2 infections and over 5400 reported deaths [2]. Poorly controlled HIV infection, when combined with socio-economic vulnerability and co-morbid conditions associated with injection drug use, may result in increased SARS-CoV-2 acquisition and transmission, more symptomatic COVID-19 disease [3], and poor clinical outcomes [47]. While cohort studies and meta-analyses from the USA and Spain who have relatively low numbers of people living with HIV (PLWH) did not find current HIV contamination to be a risk factor for SARS-COV-2 infections [8,9], larger population-level cohort studies have found PLWH to have a higher risk for COVID-19 associated morbidity [4,6,1012]. Despite this, little COVID-19 testing is being conducted among PWID and their social networks in sub-Saharan Africa, limiting understanding of the pandemics effects on their health and well-being. Determining SARS-COV-2 antibody prevalence, defining transmission dynamics of SARS-CoV-2, and its risk factors in this study populace will provide foundational data to inform Kenyan national strategies around access to HIV and methadone services and potentially scale-up COVID-19 testing, vaccination, surveillance and other public health steps for PWID. == Methods == == Study design == This cross-sectional study Oglemilast was nested within an ongoing prospective cohort study. From April July 2021 we recruited 1000 PWID and their sexual and injecting partners, 500 living with HIV and 500 living without HIV. All were participants in the parent cohort study and were recruited at needle-syringe program (NSP) sites and methadone clinics in Kenya. To conduct the study, we partnered with 4 non-governmental businesses: Support for Addictions Prevention and Treatment in Africa for Nairobi sites; Omari.