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Catherine Mwangi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment. Heroin is the main drug taken by injection in Kenya. But estimates range between 18 and 33 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 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 were 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. The high HIV prevalence among women who use drugs is not just an issue in Kenya. The same can be seen in Senegal — Our findings could help identify which girls and women are at risk. The hope is that this could better inform strategies to stop them from becoming drug users. We spoke to women from low-income settlements in Nairobi who were attending a community harm reduction programme ran by a non-govermental organisation. The women were injecting drugs — mainly heroin, in combination with other drugs like bhang, valium, rohypnol and artane. The women were between 18 and 42 years old. Most of the women were born in low-income settlements and did not have much of a formal education. Most of the women started to use drugs when they were about 17 years old. They also tended to have had sex at a younger age, usually with male partners who were already using drugs. The women usually started with licit drugs such as alcohol and Miraa Khat. The men were usually older, able to support the women financially and controlling and abusive. Relationships would frequently break up and the stress of this meant they would use more licit and illicit drugs. The women would also start new relationships, which would sometimes introduce new drugs, like heroin. To get money to buy the heroin women would engage in sex work or be in a relationship with male users so that they could share it with them. These insights are important to inform the design of effective HIV prevention interventions. They show that HIV programmes for adolescent girls and young women must also address substance abuse, gender based violence and the stigma towards women who take drugs. Health policies and programmes for women who inject drugs must identify and target potential users early. These could help young women to avoid, or positively manage the risk of substance use in sexual relationships. These interventions include needle and syringe programmes, drug dependence treatment, HIV testing and counselling, antiretroviral therapy, prevention and treatment of sexually transmitted infections and targeted information, education and communication. The interventions have been successful in reducing the sharing of needles and syringes among people who inject drugs, reducing the risk of HIV transmission. But, the programme has its limitations. Various surveys show that the people who engage most with drug reduction programmes are men. Going forward HIV prevention programmes must target girls in their adolescent phase with a package composed of identifying girls at risk, substance use interventions, sexual health education and improved educational attainment. Edition: Available editions Europe. Become an author Sign up as a reader Sign in. Authors Dr. Events More events.

A rapid assessment of heroin use in Mombasa, Kenya

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Federal government websites often end in. The site is secure. Approximately 1. The HIV epidemic is concentrated among key populations, including people who use and inject drugs. It is estimated that 27, people in Kenya inject drugs. The prevalence of HIV in this group is 18 percent compared to 4. With limited access to health services and poor adherence to treatment, death from HIV in common in this group. Document Cover Image. Kenya Fact Sheet.

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