ABSTRACT
Injection drug use (IDU) was recognized as one of the major routes of transmission of HIV infection in the earliest days of the HIV/AIDS epidemic. In the early years of the epidemic in the United States, as many as one-third of all HIV-infected patients had acquired infection by means of IDU through needle sharing. In recent years, the number of individuals infected through IDU has declined. This decrease has been attributed both to the advent of effective antiretroviral therapy (ART) and to needle exchange programs in many areas of the country (1,2). Despite this change in the demographics and epidemiology of HIV/AIDS, however, the death rate from AIDS among injection drug users has risen (3). IDU remains an important route of transmission in other regions of the world. Eastern Europe and Central Asia saw a rapid rise in spread by this means beginning in the 1990s. The epidemic in those regions is now transforming and broadening to involve the sexual partners of injection drug users (4).
