Global Overview
Drugs, HIV and Hepatitis C
There are thought to be more than 200 million people using illicit drugs globally. Some of the most severe drug-related harms are associated with injecting drug use. At least 15.9 million people inject drugs around the world (1). Most live in low- and middle-income countries. The map below shows the 158 countries and territories where we know that injecting drug use occurs (2). Asia and Eastern Europe have the largest injecting populations, with the highest numbers residing in Russia, India and China.
HIV is one of the most serious harms associated with injecting drug use. Up to 10% of all new HIV infections occur through injecting drug use. Over 3 million people who inject drugs are living with HIV (3). In much of Western Europe as well as Australia and New Zealand, where harm reduction initiatives are long established, HIV prevalence among people who inject drugs remains below 5%. But in some other areas, up to 80% of people living with HIV are likely to have acquired the virus through unsafe injecting (4). Countries as far reaching as China, Estonia, India, Kenya, Myanmar, Nepal, Thailand and Vietnam have HIV prevalence rates of over 50% among people who inject drugs. More details can be found on the regional pages.
People who inject drugs are also particularly vulnerable to the hepatitis C virus. This virus is more infectious than HIV and can be transmitted via shared paraphernalia as well as needles and syringes. In many countries, over half of the injecting population have the virus. Further details can be found on the regional pages.
People imprisoned on drug-related charges make up a large proportion of prison populations around the world. Prisons often have higher prevalence of both HIV and hepatitis C than outside prisons.
The International Response
Measures to reduce the harms associated with drug use are promoted by multilateral and bilateral agencies. Support and best practice guidance on harm reduction policy and practice from agencies such as WHO, UNAIDS and UNODC is crucial in reducing drug-related harms around the world.
Many governments include harm reduction in their national policies on HIV and/or drugs. Many have also initiated, supported, or tolerated the implementation of harm reduction programmes such as needle and syringe exchange and opioid substitution therapy prescription. To find out which countries have employed harm reduction measures, visit the regional pages.
Civil society, including drug user organisations, play a vital role in harm reduction implementation and advocacy, at international, regional and local levels.
References
- Reference Group to the United Nations on HIV and Injecting Drug Use (2008) The global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet, vol 372. (DOC, 1 MB)
- Cook C & Kanaef N (2008) Global State of Harm Reduction 2008: Mapping the response to drug-related HIV and hepatitis C epidemics. London, International Harm Reduction Association
- Aceijas C et al (2004) Global overview of injecting drug use and HIV infection among injecting drug users. AIDS, 18:2295-2303
- Joint United Nations Programme on HIV/AIDS and World Health Organization (2007) AIDS epidemic update