Annals of Health Law
ACHIEVING AN AIDS-FREE GENERATION
HIV.12 Injecting drug use is a pervasive mode of HIV transmission that
accounts for 18% of males and 32% of females living with HIV in the United
States.13 After men who have sex with men, IDUs have the second largest
rate of HIV transmission.14
The Centers for Disease Control and Prevention (“CDC”) recommends
that IDUs cease drug use altogether because sharing used needles and
syringes or preparation equipment increases the chance of HIV transmission
between IDUs.15 However, public health organizations including CDC, the
American Foundation for AIDS Research (“amFAR”), and the World Health
Organization (“WHO”) have found that a comprehensive approach to
substance abuse prevention, HIV treatment, and access to clean, sterile
syringes can curb the rate of new HIV infections among IDUs.16 While
eliminating injecting drug use is the most effective HIV prevention strategy,
SEPs are a valuable means for preventing the spread of HIV among IDUs.17
operate the human immune system, thus removing the body’s primary disease barrier and
making it easy for opportunistic diseases to cause infection. NAT’L INST. OF ALLERGY &
INFECTIOUS DISEASES, supra, at 33; see also How HIV Causes AIDS, NAT’L INST. OF ALLERGY
& INFECTIOUS DISEASES, http://www.niaid.nih.gov/topics/hivaids/understanding/
howhivcausesaids/Pages/ cause.aspx (last updated Apr. 3, 2012).
12. CDC, Thirty Years of HIV, supra note 11; Lucian Torian et al., HIV Surveillance—
United States, 1981–2008, 60 MORBIDITY & MORTALITY WKLY. REP. 689 (2011). As of 2009,
there remain 1,178, 350 people in the United States living with HIV. Id. In the United States
alone, a total of 594,495 people have died from AIDS since it was discovered in 1981.
Injecting drugs users account for the lowest proportion of HIV-positive individuals surviving
twelve, twenty-four, and thirty-six months after diagnosis. 21 CTRS. FOR DISEASE CONTROL &
PREVENTION, HIV SURVEILLANCE REPORT: DIAGNOSES OF HIV INFECTION AND AIDS IN THE
UNITED STATES AND DEPENDENT AREAS, 2009, at 10, 46 (2011), available at
ort.pdf [hereinafter CDC, DIAGNOSES 2009]. While the number of new diagnoses of HIV
remained stable between 2006 and 2009 at a rate of 17.4 persons per 100,000, there may be a
decreasing trend in infections attributed to injecting drug use. Id. at 6–7.
13. CDC, DIAGNOSES 2009, supra note 12, at 10. The transmission categories commonly
used to study HIV/AIDS transmission and prevention are different for male and female adults.
Male transmission categories include male-to-male sexual contact, injecting drug use, male-to-male sexual contact and injecting drug use, heterosexual contact, and other. Female
transmission categories include injecting drug use, heterosexual contact, and other. Id. at 34.
14. Div. of HIV/AIDS Prevention, Ctrs. for Disease Control & Prevention, AIDS
Associated with Injecting-Drug Use—United States, 1995, 45 MORBIDITY & MORTALITY
WKLY. REP. 392 (1996) [hereinafter Div. of HIV/AIDS Prevention, AIDS Associated with
Injecting-Drug Use]; Dennis H. Osmond, Epidemiology of HIV/AIDS in the United States,
HIV INSITE (Mar. 2003), http://hivinsite.ucsf.edu/insite?page=kb-01-03.
15. Access to Sterile Syringes, CTRS. FOR DISEASE CONTROL & PREVENTION (Dec. 2005),
http://www.cdc.gov/idu/facts/aed_idu_acc.htm; see also Don C. Des Jarlais et al., Doing
Harm Reduction Better: Syringe Exchange in the United States, 104 ADDICTION 1441 (2009).
16. Syringe Exchange Programs, CTRS. FOR DISEASE CONTROL & PREVENTION (Dec.