title: An ethnographic exploration of drug markets in Kisumu, Kenya.
abstract: BACKGROUND
  Illegal drug markets are shaped by multiple forces, including local actors and broader economic, political, social, and criminal justice systems that intertwine to impact health and social wellbeing. Ethnographic analyses that interrogate multiple dimensions of drug markets may offer both applied and theoretical insights into drug use, particularly in developing nations where new markets and local patterns of use traditionally have not been well understood. This paper explores the emergent drug market in Kisumu, western Kenya, where our research team recently documented evidence of injection drug use.
  
  
  METHODS
  Our exploratory study of injection drug use was conducted in Kisumu from 2013 to 2014. We draw on 151 surveys, 29 in-depth interviews, and 8 months of ethnographic fieldwork to describe the drug market from the perspective of injectors, focusing on their perceptions of the market and reports of drug use therein.
  
  
  RESULTS
  Injectors described a dynamic market in which the availability of drugs and proliferation of injection drug use have taken on growing importance in Kisumu. In addition to reports of white and brown forms of heroin and concerns about drug adulteration in the market, we unexpectedly documented widespread perceptions of cocaine availability and injection in Kisumu. Examining price data and socio-pharmacological experiences of cocaine injection left us with unconfirmed evidence of its existence, but opened further possibilities about how the chaos of new drug markets and diffusion of injection-related beliefs and practices may lend insight into the sociopolitical context of western Kenya.
  
  
  CONCLUSIONS
  We suggest a need for expanded drug surveillance, education and programming responsive to local conditions, and further ethnographic inquiry into the social meanings of emergent drug markets in Kenya and across sub-Saharan Africa.
authors.affiliation: Department of Anthropology, The Ohio State University, 4046 Smith Laboratory, 174 W. 18th Ave., Columbus, OH 43210-1106, USA. Electronic address: Syvertsen.1@osu.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Syvertsen
authors.affiliation: Impact Research and Development Organization, P.O. Box 9171-40141, Kisumu, Kenya.
authors.forename: Spala
authors.initials: S
authors.lastname: Ohaga
authors.affiliation: Impact Research and Development Organization, P.O. Box 9171-40141, Kisumu, Kenya.
authors.forename: Kawango
authors.initials: K
authors.lastname: Agot
authors.affiliation: Department of Politics and International Studies, SOAS, Thornhaugh Street, Russell Square, London, England WC1H 0XG, United Kingdom.
authors.forename: Margarita
authors.initials: M
authors.lastname: Dimova
authors.affiliation: Division of Global Public Health, University of California, San Diego, Central Research Services Facility (CRSF), La Jolla, CA 92093-0507, USA; London School of Hygiene & Tropical Medicine, Keppel Street, London, England WC1E 7HT, United Kingdom.
authors.forename: Andy
authors.initials: A
authors.lastname: Guise
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, England WC1E 7HT, United Kingdom.
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
authors.affiliation: School of Community Health Sciences, University of Nevada, Reno, 1664 N. Virginia St. MS 0274, Reno, NV 89557, USA.
authors.forename: Karla D
authors.initials: KD
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000884:Anthropology, Cultural; D003042:Cocaine / Q000191:economics / Q000600:supply & distribution; D003132:Commerce / Q000191:economics*; D003625:Data Collection; D004340:Drug Contamination; D064423:Drug Trafficking / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D003932:Heroin / Q000191:economics / Q000600:supply & distribution; D006801:Humans; D013287:Illicit Drugs / Q000191:economics / Q000600:supply & distribution*; D007407:Interviews as Topic; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D003932:Heroin; D003042:Cocaine
keywords: Cocaine; Drug markets; Drug trafficking; Heroin; Kenya; sub-Saharan Africa
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