In 2007, injecting drug users (IDUs) comprised the largest share of total HIV cases in at least 20 nations in Asia and the former Soviet Union. The percentage of cases attributed to injecting drug use is over 70 percent in some countries in Eastern Europe and Central Asia, the region where HIV grew fastest in 2006.
In many of these countries, harm reduction has made important inroads—all countries in Eastern Europe and the former Soviet Union except Turkmenistan had needle exchange programs in 2007. In most, they remain too small to contain the HIV epidemic. Reports that new HIV cases among drug users have stabilized often reflect trends in testing rather than the impact of prevention. In Asia, home to more than half the world's population, even low percentage rates of HIV cases translate into huge numbers of people infected, with profound economic and social implications. China, Indonesia, Malaysia, and Vietnam all have injection-driven HIV epidemics, and have all shown a willingness to adopt some of the measures necessary to halt the spread of HIV among IDUs and their sexual partners. The challenge for many of the hardest-hit countries, however, lies in turning commitments into practice, without sacrificing protection of human rights.
This Open Society Foundations report provides a snapshot of some key developments in HIV prevention, policy, and treatment for IDUs in developing and transitional countries with injection-driven epidemics, and includes overviews on such issues as community mobilization, methadone and buprenorphine treatment availability, harm reduction in prisons, and HIV treatment for IDUs.