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South Africa Health Experts Warn of Risk and Futility of Sharing Blood to Get High

Medical experts in South Africa have issued stark health warnings to people engaging in “bluetoothing", whereby people inject the blood of someone who has already injected drugs in a futile attempt to get high.

“Bluetoothing”, named after the technology by which electronic devices connect to each other over a short distance, gained sudden notoriety in South Africa this month after several newspapers published graphic exposés of the practice.

Despite extensive media coverage of “bluetoothing” in South Africa, it is not believed to be a common practice, but inaccurate media reports of it may actually be increasing its prevalence.

A similar practice – nicknamed “flash blood” – has been reported in Kenya and Tanzania over the past decade.

“Bluetoothing” is allegedly associated with the use of either heroin or whoonga. The precise contents of whoonga, an illegal drug that is seemingly unique to South Africa, are unknown, but studies have found that it often contains a mixture of antiretroviral HIV medication and heroin.

In an interview in The Times, a South African daily paper, a man describes how he resorts to blood-sharing when he exhausts his own whoonga supply.

"When I do not have anything and my friend has a hit‚ he injects himself and then I draw his blood and inject it in myself to get my high," he says.

Despite individuals’ claims of acquiring a “high” from blood-sharing, experts insist that the practice is futile.

“There’s not enough heroin in the blood that you are taking from the other person to get you high,” asserts Shaun Shelly, the Policy, Advocacy and Human Rights Manager for the TB/HIV Care Association (THCA).

“Any reaction you are seeing is purely the placebo effect,” he added.

The prevalence of blood-sharing may now rise, Shelly noted, because newspapers have widely publicised the practice without stating that it does not actually lead to a high.

"Our project teams and peer outreach workers who spend six hours a day with people who inject drugs in [the city of] Tshwane have heard the odd report about bluetooth, but have never seen it happen … It is vital that the message that bluetooth doesn't work gets reported and spread, because otherwise with all the media coverage, [it] will spread".

While the potential pleasure derived from blood-sharing is minimal at best, the health risks are huge.

In a Facebook post in early February, the South African National Blood Service warned that "the reported practice of 'bluetooth' … has two-fold dangers".

The risk of transmitting a blood-borne virus – such as HIV – is “greatly increased when passing infected blood from one directly into the vein of another person”.

While the aforementioned risk also exists among people who share needles for injecting drug use, blood-sharing presents an added danger – the statement notes – as “mixing incompatible blood types can be fatal”.

South African authorities continue to strictly criminalise people for drug-related offences, but this may only increase instances of “bluetoothing” – as individuals with problematic drug use may resort to more desperate measures when their living conditions worsen.

Rather, to reduce instances of “bluetoothing”, authorities may find more success in providing education, so that people are aware that it is a futile and dangerous activity, as well as providing harm reduction services.

There are currently limited harm reduction services for people who inject drugs in South Africa. The THCA’s Step Up project provides sterile needle and other harm reduction tools. The THCA is also set to team up with the Durban University of Technology to provide a methadone programme for people with problematic opioid use.

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