HIV epidemics among people who inject drugs 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. An estimated 16 million people inject drugs, largely opioids, around the world in 151 countries and territories, which account for over 95 per cent of the world's total population. Around 3 million people who inject drugs live with HIV. Furthermore, UNODC's 2008 estimates suggest that over 17 million people of the world population aged 15-64 years used cocaine and about 33.5 million used amphetamine-type stimulants at least once during the past 12 months. These conservative estimates add up to a large reservoir of stimulant users, who are at risk for HIV due to high risk sexual practices.
Research shows that an HIV epidemic among people who inject drugs 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 people who inject drugs in countries where the use of contaminated injecting equipment can be a major means of transmitting the virus.
UNODC's role is therefore to assist countries to review and develop laws, policies and standards of care that enable them to put in place effective services for people who inject drugs. It also encourages law enforcement agencies to be more proactively involved in HIV prevention treatment 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 assist countries to scale up outreach services for people who inject drugs, 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 with assistance to expand evidence-informed drug dependence treatment services, particularly opioid maintenance therapy, as well as to 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 people who inject drugs 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.