Preventing HIV infection among injecting drug users in high risk countries: an assessment of the evidence.

The sharing of contaminated injecting equipment has become a driving force behind the global AIDS epidemic and is the primary mode of HIV transmission in many countries, particularly throughout Eastern Europe, the Commonwealth of Independent States, and significant parts of Asia. In some cases, HIV is spreading rapidly from drug users to their partners through sexual transmission, and from drug users and their partners to newborns. Reversing the rise of HIV infection among injecting drug users has thus become an urgent global challenge--one that remains largely unmet. In response to this crisis, in 2005 the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Bill & Melinda Gates Foundation commissioned the Institute of Medicine to evaluate strategies for preventing HIV transmission among injecting drug users. The resulting report, Preventing HIV Infection among Injecting Drug Users in High Risk Countries, finds that several key approaches can reduce the use and injection of illegal drugs, and also curb other drug- and sex-related risk behavior that increases the risk of HIV infection. The report provides evidence-based recommendations regarding drug dependence treatment, sterile needle and syringe access, and outreach and education. The report urges high-risk countries to take immediate steps to make effective HIV prevention strategies widely available