interventions can change the course of epidemics. HIV/AIDS

There is considerable evidence that public health interventions can change the course of
epidemics. HIV/AIDS prevention programmes have helped make drastic changes in whose
injecting risk behaviour and also sex risk behaviour. Dramatically lowered levels of HIV infection
have often rewarded countries that have worked with young people to reduce risky behaviour.
“In regions like Eastern Europe . . . we could effectively stop the development of largescale
(HIV) epidemics through strong efforts targeting injecting drug users.” Peter Piot,
Executive Director of UNAIDS, June 2001.
Injecting drug use and sexual behaviour
Drug injectors are at risk of getting infected with HIV virus and spreading the infection to their
sex partners through unsafe sex. Injecting drug users can act as a bridge to transmit HIV to
non-injectors with which they have sexual contacts. IDUs tend to underestimate the importance
of condom use in sexual intercourse and have very low levels of condom use.
Numerous studies have found drug injectors to be disproportionately likely to be involved in the
sex industry. Girls, who have sex in exchange for money or drugs, are at high risk for HIV
infection and can spread the virus to a large number of people.
In addition to sexual contact between drug injectors and non-injectors, drug injecting may also
contribute to an increased incidence of HIV infection through HIV transmission to the children
of drug injecting mothers (this is called “vertical transmission”).
HIV is also a risk among drug abusers who do not inject drugs through high-risk sexual behaviour.
The impact of many types of psychoactive substances, whether injected or not, including alcohol,
are risky to the extent that they are disinhibitors and affect the individual’s ability to make
decisions about safe sexual behaviour.
New epidemics have emerged in Estonia and Uzbekistan, while in Ukraine, more than 250,000 people
were living with HIV/AIDS by 2000. Although the epidemic is still concentrated among injecting
drug users and their sexual partners, growing prostitution and high level of sexually transmitted
infections could, in a climate of jolting social change, cause it to spread rapidly into the general
population [6].
The specific issues of young IDUs
You may be wondering why this manual focuses specifically on young IDUs and why it is important
to differentiate young IDUs from others. The reason is that young IDUs are not the same as
their older counterparts. We should remember that youth are the adults of the coming years and
countries will face economic and social instability if this group becomes the main concentration
of HIV/AIDS cases. Various factors make their issues unique and these have raised awareness for
the need to have services, which target them specifically.