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 He was diagnosed with HIV in 2014 and realized that he needed to
give up drugs after years of sharing needles with fellow addicts.
"I didn't think that when you inject, or share the same injection
with your friend, it may cause HIV," said Mohammed, 34, who has been
receiving methadone treatment for a year to wean his body off
heroin.
"I thought it was only sex."
The number of Kenyans injecting heroin has surged in recent years as
the East African nation has become a major transit route for
international drug cartels moving heroin from Afghanistan to Europe,
experts say.
Narcotics have spilled on to the local market, where people are
largely unaware that injecting drugs can lead to HIV infection,
sparking concerns that Kenya's success in tackling HIV could be
reversed.
"The numbers (of users) are increasing both along the coast and in
Nairobi and there is evidence that it is also spreading out to
places like Kisumu," said Calleb Angira, director of the Nairobi
Outreach Services Trust (NOSET), who has worked with addicts for
almost 30 years.
"That is because the interventions we have are not enough," said
Angira, who set up NOSET in 2005 to offer HIV prevention and
treatment services to drug users in Ngara, an estate outside
Nairobi's city center.
Over the past 20 years, Kenya has slashed its HIV prevalence rate to
6 percent today from 11 percent in 1996 through campaigns to
encourage safer sex between heterosexual couples and improved access
to antiretroviral drugs, according to the United Nations Programme
on HIV/AIDS (UNAIDS).
But little has been done in Kenya to reduce the risk to injecting
drug users, sex workers and men who have sex with men, who together
make up more than 30 percent of new infections, government data
shows.
AT RISK
HIV prevalence among injecting drug users is around 18 percent -
three times the national prevalence rate - and around 4 percent of
new HIV infections occur among people who inject drugs, government
figures show.
Kenya had 18,000 injecting drug users in 2011, according to
government statistics.
"The majority of injectors worldwide are young men," said Chris
Beyrer, president of the International AIDS Society.
"This is a sexually active population and very often their wives,
girlfriends, female partners are very much at risk."
Injecting drug users need easy access to sterile needles to make
their habits safer, opiate substitutes to help them stop injecting
and HIV testing and treatment, experts say.
But stigma and punitive laws often mean they are mistreated or
turned away when they seek services, according to UNAIDS.
"Society rejects them," Angira told the Thomson Reuters Foundation.
"Even their families reject them. They're isolated. They're
criminalized. They're seen as hopeless people."
Drug users fear asking for clean needles, as this can lead to police
harassment or criminal prosecution.
Governments and donors are also reluctant to fund these services
because of a false belief that they condone drug use and encourage
illegal behavior, Beyrer said.
"Despite the evidence that shows very clearly that providing sterile
injecting equipment does not encourage people to inject, it's a
widely held view that what we should be doing is stopping injecting
drug use," he said.
Kenya was slow to initiate programs for injecting drug users, but
recognized the need for specialized services after some 100 addicts
died from withdrawal during a 2011 heroin shortage, triggered by a
crackdown on drug barons.
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Addicts came out from the shadows seeking help.
"We realized that we didn't have the capacity as government to
provide treatment," said Helgar Musyoki, a program manager with
Kenya's National AIDS and STI Control Programme (NASCOP).
"We learned our lesson."
CLEAN NEEDLES
In 2013, the government approved its first needle and syringe
program. Funded with donor money, it provides drug users with clean,
free equipment to reduce the transmission of HIV and other diseases.
The government has not put any of its own money into these services
but has allowed donors to open seven needle and syringe programs in
its two largest cities.
More are needed, experts said.
"What the needle and syringe program did was to bring them (drug
users) out very clearly, knowing that the program was actually
targeting them," said Angira of NOSET.
"They came and said: 'I'm injecting' and that made them access other
services like HIV testing."
The government opened its first clinic providing oral heroin
substitutes in 2014, and has pledged to treat 2,000 patients over
two years.
Three methadone clinics are operating in Kenya, with another three
scheduled to open in August. It also plans to equip three mobile
vans with methadone to reach injecting drug users across the
country.
NOSET staff says that even the limited services offered to injecting
drug users are having an impact.
"With the interventions, the (HIV) rates are going down,” said Nancy
Ndwiga, who oversees NOSET's HIV treatment.
More funding is needed for services and to train heath workers to
provide services to injecting drug users.
"This is a new route of HIV transmission. There's not a lot of
people in any African country with experience (of it)," said Beyrer.
Former heroin users like Mohammed are grateful for the services that
exist for injecting drug users.
"They (NOSET) saved my life," he said.
Although he has been clean for over a year, he has yet to contact
his family who he has not seen since he left home.
"It's not easy to be trusted, but I know one day I will earn their
trust again."
(Editing by Katy Migiro and Katie Nguyen.; Please credit the Thomson
Reuters Foundation, the charitable arm of Thomson Reuters, that
covers humanitarian news, women’s rights, trafficking, property
rights and climate change. Visit http://news.trust.org to see more
stories.)
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