The prevention of AIDS among injecting drug users

There is great potential for the spread of HIV amongst injecting drug users (IDUs) if they engage in unsafe injecting and sexual practices. This paper identifies a range of obstacles to safe behaviour, including availability of sterile injecting equipment, legal/policy factors, social norms and personal factors such as ignorance, beliefs, intoxication and craving. Two alternative policy options-harm reduction and use reduction-are discussed along with specific strategies for ameliorating risk. Strategies include drug treatment, provision of sterile injecting equipment, bleach, promoting alternate methods of drug administration, HIV testing and counselling and peer endorsement of safe behaviour. The paper concludes by considering the implications of these policy and programme options at the level of service delivery.