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Injection Drug Use and HIV/AIDS

Key Issues:

    • HIV infections associated with injection drug use is becoming a public health crisis.
    • Harm reduction measures are not about condoning drug use but rather a reasonable response to an existing issue.
    • More needle exchange programs need to be implemented across Canada.
Social norms, up-bringing, peers and the media socialize men to meet standards of masculinity that set them apart from women. Men are generally encouraged to project an image of being strong, competitive, assertive, dominant, self-reliant and willing to take risks. Boys are generally not encouraged to show their emotions, or to ask for help. Men tend not to seek out services for psycho-social or physical problems. This can result in men living with levels of stress that are detrimental to their over-all health. Men, more frequently than women, use coping mechanisms that are harmful or will engage in activities that place them at risk for a number of social and physical dangers.

Rates of HIV infection are increasing among injection drug users: some feel that Canada is in the midst of a public health crisis as a result1. According to 1996 Canadian statistics, it was estimated that over half of all new HIV infections result from injection drug use2. The increase is most remarkable in large cities such as Montreal, Vancouver, Toronto and Ottawa; however this trend is now also being tracked in smaller cities across Canada3.

Sharing needles and other drug injection equipment (spoons, cookers and filters) is common practice among injection drug users and allows HIV to be transmitted easily. Most people associate injection drug use with heroin, however it is not uncommon to inject cocaine. Cocaine is sometimes, and in some areas, cheaper and easier to get than heroin but the effects of cocaine do not last as long as heroin. This combination results in drug users injecting drugs (shooting up) more often in the course of a day (sometimes up to 20 times per day) and increases the frequency with which an individual could be sharing needles with potentially HIV-positive drug users4.

Sexual risks are also a factor in the increasing rates of HIV infection among injection drug users. It is not uncommon among male street youth to trade unprotected sex for drugs or money5. Furthermore, consistent condom use with regular and casual sexual partners is not widely practiced. In part this is because it is often very difficult for sex trade workers to insist that their clients wear a condom. This results in sex trade workers being exposed to HIV from their clients and non-injection drug users being potentially exposed to HIV through a partner who may share needles and/or engage in unprotected sex6.

There are precautions that could be practiced by injection drug users. They include using sterile needles with each drug injection; bleaching shared drug injection equipment, including needles if sterile ones are not available; and using a new condom for each sexual encounter. But injection drug users frequently cannot access these tools. Needle exchange programs lack necessary funding to provide adequate prevention tools.

HIV/AIDS associated with injection drug use should be viewed as a health crisis. If we were to treat drug use as a social, rather than a criminal problem we would be able to treat drug users more effectively and to decrease the incidence of HIV transmission. Decriminalizing certain drugs would free up money spent on law enforcement that could then be spent on education and prevention efforts.

Needle exchange programs should be more adequately funded and more widely available for these reasons: they allow clean needles to be distributed, they provide front-line workers with the opportunity of providing HIV/AIDS educational information and they help connect injection drug users with treatment and other social and health related services and information.

Harm reduction measures would help reduce the incidence of HIV in Canada. Some harm reduction measures could include: providing safe and clean spaces where drug users can inject themselves (this would be beneficial to the general population as well); providing services that injection drug users can access while still using drugs; and expanding existing methadone maintenance treatment programs.

The practice of harm reduction measures does not mean that society is condoning injection drug use, but rather it is a realistic approach to a problem that already exists within our society. Harm reduction is concerned with providing accurate information so that an individual can assess the level of risk associated with a particular activity; it is a way of reducing the negative and harmful effects of particular activities7.

For more information on how to prevent HIV infection, please contact the Canadian AIDS Society at 1-800-499-1986 or visit our web-site at

  1. Men & AIDS - A Gendered Approach, 2000 World AIDS Campaign. UNAIDS, 2000. p. 6
  2. Ibid p. 11
  3. L. Leonard, Epidemiological Update and HIV and Women Who Use Injection Drugs, University of Ottawa, Department of Epidemilogy and Community Medicine. 1999
  4. Injection Drug Use and HIV/AIDS: The Facts, Canadian HIV/AIDS Legal Network, 1999
  5. HIV/AIDS Epi Updates, HIV/AIDS Among Injection Drug Users in Canada, Bureau of HIV/AIDS, STD & TB Laboratory Centre for Disease Control, April 2000.
  6. Bureau of HIV/AIDS, STD & TB Laboratory Centre for Disease Control, Health Canada, April 2000, p. 44
  7. Injection Drug Use and HIV/AIDS: The Facts, The Canadian HIV/AIDS Legal Network, 1999

Injection Drug Use and HIV/AIDS. © Canadian AIDS Society. Published 07/27/2007. Updated 03/21/2011. Web. Retrieved 08/25/2016 from