By Catherine Mwangi and John Gachohi
Heroin is the main drug taken by injection in Kenya. Mostly found and used in Kenya’s big cities – Mombasa and Nairobi – it’s hard to know just how widespread heroin use is. But estimates range between 18 000 and 33 000 people.
There are concerns that heroin use is growing but also concern over the high HIV infection rates of users, particularly among women. Injection drug behaviours are recognised as key facilitators of HIV transmission.
Research conducted four years ago among people who inject drugs in Nairobi found that 18.3% of them were HIV positive. Of these, 16% of men were HIV positive and 44.5% of women were HIV positive. Women who inject drugs are therefore more than two times more likely to have HIV than men.
Our research sought to understand why and how young girls and women progressed from using legal drugs – like alcohol and cigarettes – into illicit narcotics, like heroin.
We found that most women were introduced into drug use by male sexual partners in their teenage years, between the ages of 11 and 17 years. A key factor in their continued drug use was these, often volatile, relationships.
Our findings also gave us insights into why women were more at risk of HIV infections: they often faced significant stigma which meant they were less likely to participate in drug treatment or needle exchange programmes and they usually depended on male partners for drugs and needles. This meant that they shared equipment. In addition, many of the women participated in commercial sex work to fund their drug habit and often didn’t use condoms.
The high HIV prevalence among women who use drugs is not just an issue in Kenya. The same can be seen in Senegal – 13.0% versus 3.0% for men and in Nigeria (37.7% versus 7.4%).
