This paper reports on a questionnaire survey of 300 heroin users in Zanzibar town, in Tanzania. It was found that about 13% of respondents were current injectors of heroin, but that 38% of respondents reported have ‘ever injected’ heroin. Many injectors reported hiding their needles and syringes and almost half of them had shared their equipment during the past four weeks. Most of the respondents reported that they had not had sexual intercourse during the past four weeks. Of those who were sexually active most reported not having used a condom the last time they had intercourse. These findings highlight the need for a wider recognition of the extent of heroin use in East Africa as well as the urgent need to provide harm reduction and treatment services.
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