Injecting drug use

HIV epidemics among injecting drug users are characterized by notable regional and in-country variations. Nevertheless, once the virus is introduced into an injecting drug user community, prevalence can rise up to 90 per cent in less than two years. UNODC data from 2006 show that more than 13 million people use cocaine, more than 16 million use opiates, and about 35 million use amphetamine-type stimulants. These conservative estimates add up to a reservoir of 64 million people who, if they start injecting drugs and use contaminated injection equipment, significantly risk being infected with HIV.

Research shows that an HIV epidemic among injecting drug users can be prevented, halted and even reversed if responses are based on a sound assessment of the specific drug use situation and the socio-cultural and political context and on scientific evidence. The overall goal is to increase and improve HIV prevention and care services for injecting drug users in countries where the use of contaminated injecting equipment can be a major means of transmitting the virus.

UNODC's role is therefore to help countries review and develop laws, policies and standards of care that enable them to put in place effective services for injecting drug users. It also encourages law enforcement agencies to be more proactively involved in HIV prevention and care, and promotes collaboration amongst health, criminal justice sectors, and community-based and civil society organizations.

One of the major thrusts of UNODC's HIV programme is to help countries to scale up outreach services for injecting drug users providing them with HIV and AIDS information, education and the means of reducing HIV related risk practices, as agreed by the governments in the UNAIDS Policy Position Paper on Prevention in 2005 and the General Assembly Political Declaration, June 2006, with the aim to reach as close as possible of universal access to HIV prevention by 2010. In addition, countries are also provided assistance to expand evidence-informed drug dependence treatment services, particularly opioid maintenance therapy for injecting drug users as well as create awareness among drug dependence treatment services regarding the need to address HIV prevention and care issues, and to develop interventions to prevent the transition from non-injecting drug use to injecting drug use. Other types of services that UNODC promotes to help prevent transmission of HIV among injecting drug users include offering voluntary and confidential HIV counselling and testing, treating sexually-transmitted infections, providing antiretroviral therapy and interventions for specific sub-groups - including prisoners, sex workers who inject drugs and injecting drug users who may also exchange sex for drugs or money.