“White” heroin became readily available in East Africa starting in the late 1990s, resulting in an increase in HIV infections through drug use.

Carty said, “It relates to drug trafficking routes coming out of South Asia and the fact that those routes have actually expanded and, you know, a lot of the sort of coastal cities of East Africa – Mombasa and Zanzibar and Dar es Salaam – have become more and more an entry point for drug trafficking out of the South Asia region in through Africa and then very often up through Europe and on to the United States.”

Getting high, getting infected

Dr. Phil Nieberg, senior associate with the Global Health Policy Center, is co-author of the CSIS report. He said the sharing of syringes by drug addicts is a very easy way to transmit HIV. Far easier than sexual transmission.

“The reason is that usually with needle sharing there’s blood left in the syringe or in the needle. So, basically, the second person to use the needle is getting an injection of someone else’s blood that has a lot of virus in it,” he said.

Women bear the brunt

And, as is the case in many sectors of the HIV/AIDS epidemic, women have it worse than men.

“Women who are drug users have a much higher HIV risk than men who are drug users. So that one reason for that is that many women, who inject drugs, turn to sex as a way of raising money to buy drugs. So there’s an overlap between sex work and drug use,” he said.