Recent shifts in patterns of drug use and trafficking indicate that a shift from smoking to injecting heroin is taking place in Kenya. In addition, recent estimates of HIV infection in Kenya indicate that the number of cases of HIV attributed to injection drug users is increasing with 4.8% of new infections attributed to injection drug use. Community-based outreach is an evidence-based model for delivering HIV prevention to difficult to access drug users in the United States and Europe. This paper reports on the development and implementation of a community outreach programme for HIV prevention with drug users in Mombasa and Nairobi and offers lessons learned for other countries with emerging epidemics of HIV among drug users