Evidence for action on HIV/AIDS and injecting drug use POLICY BRIEF: PROVISION OF STERILE INJECTING EQUIPMENT TO REDUCE HIV TRANSMISSION SHARING OF INJECTING EQUIPMENT

The shared use of syringes and needles was recognized as being associated with HIV transmission among injecting drug users at the onset of the HIV/AIDS pandemic. Commonly referred to as syringe sharing or needle sharing, it involves two or more drug users sequentially using the same needle and/or syringe in order to inject a dose of liquefied drugs, such as heroin, cocaine, amphetamines or buprenorphine. Behaviours that can lead to needle and syringe sharing include borrowing and lending, selling, buying and renting, or even picking up a syringe discarded by a previous user. A lack of a perceived risk of HIV infection can lead to the sharing of needles and syringes. Moreover, the practice of sharing can be strongly influenced by the context in which it occurs, group norms and rituals, inaccessibility of injecting equipment, and an inability to carry injecting equipment because of familial, social or legal environments. Such factors explain why needles and syringes are shared with others even when sterile equipment is available. There are various additional avenues for HIV transmission, generally in social situations where injecting drug users prepare and use drugs together. For example, injecting drug users often share other items while preparing drugs for consumption, e.g. cookers, water cups, filters, spoons, swabs, ampoules and other containers used for drug preparation, storage and transport. NEEDLE AND SYRINGE PROGRAMMES