Heroin and HIV Stalk Zanzibar

The growth in heroin smuggling from Afghanistan through east Africa en route to Europe has boosted the drug's availability in Zanzibar, posing an HIV threat. An estimated 4,000 to 6,000 people inject drugs in the tropical archipelago of 1 million. While HIV prevalence is generally less than 1% in Zanzibar, it is 26% percent among injection-drug users.

"The problem is the increase in [drug] use. There is not any family that hasn't been affected by someone taking heroin," says Mahmoud Mussa, substance abuse and rehabilitation coordinator at Zanzibar's ministry of health and social affairs.

The U.N. office on Drugs and Crime estimates the proportion of the population using heroin in east Africa is twice that of the rest of Africa. "Zanzibar has been established as a major heroin-consuming island," says Reychad Abdool, UNODC's regional HIV adviser. "We believe there is an increase in trafficking through east Africa regarding heroin and this is going to be a major threat to building development and security in the future."

"The problem is we have more than 250 unofficial ports, so it's not easy to chase," says Mussa. He described typical smugglers as arriving by sea in dhows -- traditional Arab sailing vessels -- with heroin hidden in ice from Tanzania. A single hit of heroin, about 0.05 grams, costs 75 cents.

"The most affected group by HIV is [IDUs] because they share the syringe within the group and they sell their bodies to buy drugs," says Suleiman Mohammed Mauly, an outreach worker with the U.S.-funded International Center for AIDS Care and Treatment Programs.

Some of the prevention initiatives targeting IDUs include treatment and rehabilitation centers, drop-in centers, HIV testing programs, and telephone hot lines.