Strategies for the prevention of HIV infection among and from injecting drug users.

Despite a substantial reduction in the level of high-risk behaviours among injecting drug users (IDUs) documented in an impressive number of studies from many countries, human immunodeficiency virus (HIV) infection continues to spread among and from this population, reflecting the high baseline levels of these risk behaviours before the epidemic. In many countries, the control of HIV spread among IDUs is critical to efforts to control the epidemic in the population as a whole. Although the evaluation of individual or multiple strategies is problematic, there is accumulating evidence and increasing confidence that the course of the epidemic can be altered by implementing some or all of a range of strategies. Authorities mindful of their public health responsibilities should estimate the risk of spread of HIV among and from IDU populations in their jurisdiction and plan their response accordingly by selecting prevention measures that are appropriate for local conditions and by vigilantly monitoring developments.