HIV prevalence in injecting drug users globally

The prevalence of HIV amongst people who inject drugs varies enormously across the world. In countries that have, like the UK, introduced interventions to reduce the rates of sharing injecting equipment, levels of HIV infection among injecting drugs users (IDUs) are relatively low. Australia and New Zealand are the key examples, with widespread and early introduction of harm reduction initiatives including needle and syringe exchange programmes resulting in very low infection rates (reported as 1.5% in a 2008 international study).1

However, according to UNAIDS, “Use of contaminated injecting equipment during drug use accounts for more than 80% of all HIV infections in Eastern Europe and Central Asia and is a major entry point for HIV epidemics in countries in the Middle East, North Africa, South and South-East Asia and Latin America. Alarmingly, new epidemics of injecting drug use are being witnessed in countries of sub-Saharan Africa.”2

An international study reported in 2008 that just under one-in-five IDUs globally may be infected with HIV. Estimates done for the study suggested that 15.9 million people might inject drugs worldwide, and that three million of these may be HIV-positive.

The largest numbers of injectors were found in China, the USA and Russia, where estimates of HIV prevalence among injectors were around 12, 16 and 37%, respectively. HIV prevalence among injecting drug users was 20 to 40% in five countries and over 40% in nine.1

Outside of Africa, UNAIDS estimates that nearly one of three new HIV infections is now due to injecting drug use. Contaminated injection equipment accounts for the largest share of HIV infections not only in Russia and Ukraine, but in China, Indonesia, Malaysia, Vietnam, the Baltics, the former Soviet Union, and much of South America. For example, as of March 2006, 83% of Russia’s total registered HIV cases were among IDUs and, in 2007, 72% of people with HIV in Malaysia had been infected through injecting drug use.3 


  1. Mathers BM et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review The Lancet (online edition), 24 September, 2008
  2. UNAIDS People who use injecting drugs. UNAIDS, Geneva. Available online at, 2009
  3. International Harm Reduction Development Program Harm Reduction Developments 2008: Countries with INjection-Driven HIV Epidemics International Harm Reduction Development Program of the Open Society Institute, New York, 2008
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Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

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We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

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The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap