Sharing blood in this manner carries a very high risk of transmitting viruses such as hepatitis and HIV, which are prevalent among injection drug users in East Africa.
Despite the small number of individuals using this technique, its use among sex workers and the sharing and reuse of syringes exposes users to "the highest possible risk" of transmitting hepatitis and HIV.
Dr. Nora Volkow of the National Institute on Drug Abuse called it "a crazy practice" that is the "most effective way of infecting yourself with H.I.V.".
While Africa was traditionally bypassed by heroin traffickers as being too poor to afford their product, dealers had started using East African port cities on their smuggling routes to Europe, with some of the heroin used as bribes to law enforcement officials or received by couriers as payment.
[2] A February 2010 report by the United Nations Integrated Regional Information Network (IRIN) indicated that the practice was becoming increasingly common in Kenya's second-largest city, Mombasa.