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A qualitative analysis of transitions to heroin injection in Kenya: implications for HIV prevention and harm reduction

Overview of attention for article published in Harm Reduction Journal, September 2015
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  • Good Attention Score compared to outputs of the same age (74th percentile)

Mentioned by

8 tweeters
1 Google+ user

Readers on

57 Mendeley
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A qualitative analysis of transitions to heroin injection in Kenya: implications for HIV prevention and harm reduction
Published in
Harm Reduction Journal, September 2015
DOI 10.1186/s12954-015-0061-2
Pubmed ID

Andy Guise, Margarita Dimova, James Ndimbii, Phil Clark, Tim Rhodes


Heroin injection is emerging as a significant dimension of the HIV epidemic in Kenya. Preventing transitions to injecting drug use from less harmful forms of use, such as smoking, is a potentially important focus for HIV prevention. There is, however, little evidence to support comprehensive programming in this area, linked to a shortage of analysis of the social and structural context for transitions, particularly in low-income settings. We explore accounts of transitions from smoking to injecting in Kenya to understand the role of individual, social and structural processes. We combine data from two separate studies conducted in Kenya: an in-depth qualitative study of HIV care access for people who inject drugs (study 1) and an ethnographic study of the political economy of the heroin trade in Kenya (study 2). In-depth interviews with PWID and community observation from study 1 are triangulated with accounts from stakeholders involved in the heroin trade and documentary data from study 2. People who inject drugs link transitions to injecting from smoking to a range of social and behavioural factors, as well as particular aspects of the local drug supply and economy. We present these results in the form of two narratives that account for factors shaping transitions. A dominant narrative of 'managing markets and maintaining a high' results from a process of trying to manage poverty and a shifting heroin supply, in the context of deepening addiction to heroin. A secondary narrative focuses on people's curiosity for the 'feeling' of injecting, and the potential pleasure from it, with less emphasis on structural circumstances. The narratives we describe represent pathways through which structural and social factors interact with individual experiences of addiction to increase the risk of transitions to injecting. In response, HIV and harm reduction programmes need combinations of different strategies to respond to varied experiences of transitions. These strategies should include, alongside behaviour-oriented interventions, structural interventions to address economic vulnerability and the policing of the drug supply.

Twitter Demographics

The data shown below were collected from the profiles of 8 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 57 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 57 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 8 14%
Student > Doctoral Student 7 12%
Student > Master 7 12%
Researcher 6 11%
Librarian 4 7%
Other 11 19%
Unknown 14 25%
Readers by discipline Count As %
Medicine and Dentistry 17 30%
Social Sciences 8 14%
Psychology 5 9%
Nursing and Health Professions 4 7%
Agricultural and Biological Sciences 2 4%
Other 4 7%
Unknown 17 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 January 2016.
All research outputs
of 13,533,438 outputs
Outputs from Harm Reduction Journal
of 521 outputs
Outputs of similar age
of 238,632 outputs
Outputs of similar age from Harm Reduction Journal
of 1 outputs
Altmetric has tracked 13,533,438 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 521 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one is in the 31st percentile – i.e., 31% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 238,632 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them