Annals of Health Law
ACHIEVING AN AIDS-FREE GENERATION
II. EVIDENCE-BASED HIV PREVENTION FOR INJECTING DRUG USERS
Sharing hypodermic needles, syringes, and other drug devices can transmit
HIV among IDUs. Injection drug use remains an important mechanism for
HIV transmission in the United States, with disproportionate impact on
women and minorities. However, as detailed below, SEPs have proven
effective in reducing the risk of HIV transmission among IDUs.
A. HIV Transmission by Injecting Drug Users
HIV transmission among IDUs begins when drug users share hypodermic
needles, syringes, and other drug devices.31 “Needle sharing” may transfer
bodily fluids and blood contaminated with HIV, or other infectious diseases
such as hepatitis and syphilis.32 When a user injects drugs into a vein or
muscle, a small amount of the user’s blood is deposited back into the needle.33
If the needle is shared with another IDU, the residual blood—potentially
infected with HIV—is injected into that person’s bloodstream, easily
transmitting the virus.34 In addition to sharing needles, IDUs can transmit
blood between users who share other drug-related equipment.35
31. DIV. OF HIV/AIDS PREVENTION, CTRS. FOR DISEASE CONTROL & PREVENTION, HIV
AMONG WOMEN 1–2 (2011), available at http://www.cdc.gov/hiv/topics/women/pdf/
women.pdf; Div. of HIV/AIDS Prevention, AIDS Associated with Injecting-Drug Use, supra
note 14; Des Jarlais, supra note 15, at 1441; A. Grigoryan et al., HIV Infection Among
Injection-Drug Users—34 States, 2004–2007, 58 MORBIDITY & MORTALITY WKLY. REP. 1291
(2009); Access to Sterile Syringes, supra note 15.
32. Lawrence O. Gostin, The Interconnected Epidemics of Drug Dependency and AIDS,
26 HARV. C.R.- C.L. L. REV. 113, 115, 117 (1991); Access to Sterile Syringes, supra note 15.
33. HIV Transmission, CTRS. FOR DISEASE CONTROL & PREVENTION,
http://www.cdc.gov/hiv/resources/qa/transmission.htm (last modified Mar. 25, 2010).
34. Gostin, supra note 32, at 115–16; HIV Transmission, supra note 33.
35. HIV Transmission, supra note 33. Other drug-related equipment that can transmit
blood includes “spoons” and “cookers” designed to dissolve drugs in water, cotton filters used
to remove particles from the drug solution, and unclean water used to rinse syringes after their
use. Id.; see also Why is Injecting Drug Use a Risk for HIV Transmission?, AIDSMAP,
page/1324128/ (last visited Mar. 7, 2013).
36. Div. of HIV/AIDS Prevention, AIDS Associated with Injecting-Drug Use, supra note
14; Gostin, supra note 32, at 117. Heterosexual partners of IDUs and their children are labeled
“non-risk” groups but for their contact with IDUs. Id. (“Nearly seventy-two percent of all
heterosexual cases of AIDS reported in the United States involve persons who have had sexual
contact with an [IDU]. . . . Seventy-nine percent of all children born infected with HIV have a
mother who either was an [IDU] or had sexual relations with an [IDU].”). Id. Importantly,