The risk of HIV transmission occurs through the following activities

Injection related risk behaviour
It has been established that young people share injection equipment more often than older
drug users and that they perceive less risk in doing so.
The risk of HIV transmission occurs through the following activities:
Direct sharing/repeated use of needles and syringes for injecting.
Indirect sharing/sharing of the paraphernalia used for drug injection. This includes:
Sharing or using unclean water, cookers or cotton
Using used syringe plungers to stir the drug solution
Backloading: the drug solution is transferred from one previously blood-contaminated
syringe to another. The plunger is removed from the syringe into which the drug will be
transferred and the drug mixture is then squirted into the back of the syringe
Frontloading: the drug solution is transferred from one previously blood-contaminated
syringe to another by removing the needle on the syringe receiving the solution, and
then squirting the drug into the syringe’s hub or barrel. This is now relatively
uncommon, since most insulin syringes used by IDUs do not have removable needles
Squirting the drug solution from a previously blood-contaminated syringe into the drug
mixing “cooker” or “spoon” and then drawing it into another syringe.
Rinsing a used, blood-contaminated syringe in water that other IDUs also use to rinse
their own syringes or to dissolve drugs.
“Risky injecting episodes usually took place within specific contexts: late at night or early
morning with no access to sterile syringes, when people were ‘hanging out’ or withdrawing from
drugs or during periods of intoxication or binging, particularly when cocaine was involved . . .
from the perspective of IDUs [in Cabramatta], backloading is not a ‘risk behaviour’ but an
efficient, equitable and even low-risk method of apportioning drug solution. As one participant
noted: ‘I don’t let the tip touch anything—just in and then out—very careful [15].”