The rise of injecting drug use in east Africa: a case study from Kenya
Studies on injecting drug use in East Africa are reviewed. The existingstudies document the spread of heroin injection in Kenya and Tanzania, both countries where HIV rates are high. No data from Uganda on injecting drug use was found by the authors. A case study of the growth of heroin injection in a Kenyan coastal town is presented. The need for needle-exchange programmes and other prevention services is discussed. lthough bearing the brunt of the AIDS epidemic, Africa has long been considered largely free of injection drug use. Notwithstanding the assessments of the UN International Drug Control Programme 1, international organisations have been slow to recognise either the spread of heroin use in Kenya or the existence of injection drug use. The largely unheeded spread of injection drug use in East Africa has wide implications for public health in the region. Injection drug users (IDU) are a 'high risk' or 'core group' for HIV infection. Many IDU share needles and syringes as well as having unprotected sex, and have been identified as a 'bridging population', speeding the spread of HIV to the general population [and .
Heroin injection now appears to be occurring in most large towns of Kenya and Tanzania. A study of 336 heroin users in Nairobi, Kenya found that 44.9% were, or had been, injectors Of 101 current injectors, 52.5% were HIV positive.