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Background: It is estimated that there are 50,000 injectable drug users in Tanzania. Tanzania is the first sub-Saharan African country to provide methadone treatment. This study explored barriers to heroin injection behavior change among clients on methadone treatment clinics in Dar es Salaam, Tanzania.

Methods: This was exploratory cross sectional study. Purposive sampling was used to select ten participants. In in-depth interview guide was used to collect data. Transcribed data were analyzed manually and subjected to thematic analysis.

Results: Various factors hinder heroin injecting behaviour change among methadone clients on methadone treatment. Specifically lack of perceived benefits of methadone treatment i hinder behaviour change of injecting heroin when one is enrolled on methadone treatment clinics. Additionally, social environment contributes to failure to change heroin injecting behaviour among clients on methadone treatment.

Conclusion: Different measures should be taken by methadone programs and stakeholders to overcome heroin injecting behaviour among clients on methadone.

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