ABSTRACT
Few would deny that HIV infection is one of the major international public health crises of this century. The factors which have contributed to the global dissemination of both injecting drug use and associated HIV infection are extremely complex and dynamic. Whereas sexual transmission of HIV remains the most significant route at a global level, injecting drug use has played a critical role in fuelling the epidemic in various regions, particularly in some countries in Asia, certain developed country communities (including in France, Italy, Spain and the United States of America), and more recently in Eastern Europe and parts of the Commonwealth of Independent States. In previous chapters, some of these factors have been discussed, with consideration given to individual, social and environmental determinants. Recognizing the great diversity of injecting drug use patterns, the complex interplay of factors influencing drug use and sexual behaviour, and differing contexts of drug injecting, it is evident that effective strategies to minimize risks and prevent HIV spread need to be comprehensive, multi-faceted, integrated and flexible.
