Flashblood: blood sharing among female injecting drug users in Tanzania

Addiction. 2010 Jun;105(6):1062-70. doi: 10.1111/j.1360-0443.2010.02908.x. Epub 2010 Mar 12.


Aims: This study examined the association between the blood-sharing practice of 'flashblood' use and demographic factors, human immunodeficiency virus (HIV) status and variables associated with risky sex and drug behaviors among female injecting drug users. Flashblood is a syringe-full of blood passed from someone who has just injected heroin to someone else who injects it in lieu of heroin.

Design: A cross-sectional study.

Setting: Dar es Salaam, Tanzania.

Participants: One hundred and sixty-nine female injecting drug users (IDUs) were recruited using purposive sampling for hard-to-reach populations.

Measurements: The association between flashblood use, demographic and personal characteristics and risky sex and drug use variables was analyzed by t-test and chi(2) test. The association between flashblood use and residential neighborhood was mapped.

Findings: Flashblood users were more likely to: be married (P = 0.05), have lived in the current housing situation for a shorter time (P < 0.000), have been forced as a child to have sex by a family member (P = 0.007), inject heroin more in the last 30 days (P = 0.005), smoke marijuana at an earlier age (P = 0.04), use contaminated rinse-water (P < 0.03), pool money for drugs (P < 0.03) and share drugs (P = 0.000). Non-flashblood users were more likely to live with their parents (P = 0.003). Neighborhood flashblood use was highest near downtown and in the next two adjoining suburbs and lowest in the most distant suburbs.

Conclusions: These data indicate that more vulnerable women who are heavy users and living in shorter-term housing are injecting flashblood. The practice of flashblood appears to be spreading from the inner city to the suburbs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Blood Transfusion / methods*
  • Blood-Borne Pathogens
  • Child
  • Child Abuse, Sexual
  • Cross-Sectional Studies
  • Disinfection / methods
  • Female
  • HIV Infections / blood
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • Heroin Dependence / complications*
  • Heroin Dependence / epidemiology
  • Heroin Dependence / psychology
  • Humans
  • Injections, Intravenous / adverse effects
  • Needle Sharing / adverse effects
  • Residence Characteristics
  • Risk Factors
  • Risk-Taking*
  • Sexual Behavior
  • Socioeconomic Factors
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / epidemiology
  • Substance Abuse, Intravenous / psychology
  • Substance Withdrawal Syndrome / prevention & control*
  • Tanzania / epidemiology
  • Vulnerable Populations / psychology
  • Young Adult