- Sharing a needle or syringe to inject any type of substance (including steroids, hormones or silicone) puts you at risk of HIV and other infections found in the blood like hepatitis C. This applies whether injecting under the skin or directly into the blood stream.
- Sharing needles and syringes is not the only risk. Sharing water to clean injecting equipment, reusing containers to dissolve drugs, and reusing filters can also transmit HIV.
- To reduce transmission risk avoid shared needles and other injecting equipment, use a new or disinfected container and a new filter each time you prepare drugs, and use clean water when preparing dugs.
If you inject drugs, make sure you know how to do it safely to protect yourself from HIV and other infections.
How do you get HIV from injecting drugs?
During an injection, some blood goes into the needle and syringe. A needle and syringe that someone living with HIV has used can still contain blood with the virus in it after the injection. If you then use the same equipment without sterilising it, you can inject the infected blood directly into your bloodstream.
Can I get HIV from any type of injecting?
Some people who inject drugs wrongly believe they are not at risk of HIV if they avoid injecting into a vein (intravenous injecting). You can also get HIV from injecting into the fat under the skin (subcutaneous injecting) and injecting directly into a muscle (intramuscular injection).1
Sharing a needle or syringe for any use, including injecting drugs under the skin (skin popping), steroids, hormones or silicone, can put you at risk of HIV and other infections found in the blood like hepatitis C.2
There are many ways you could get HIV from injecting drugs, including:
- preparing drugs with syringes that contain infected blood
- sharing water used to flush blood out of a needle and syringe
- reusing bottle caps, spoons, or other containers ("cookers") to dissolve drugs into water and to heat drugs solutions
- reusing filters - normally small pieces of cotton or cigarette filters – used to filter out particles that could block the needle
- unsafe disposal of used needles or syringes where infected blood accidently gets into the body of another person.3
If I use drugs, how can I reduce my risk of HIV?
If you inject drugs, don't share needles, syringes or other injecting equipment like spoons or swabs, as this exposes you to HIV and other viruses found in the blood like hepatitis C.
In many countries, used needles can be exchanged for clean ones at pharmacies and needle exchanges. If you take heroin, consider joining a methadone or buprenorphine programme. These substances are swallowed as a liquid, reducing your risk of HIV as well as helping you to manage your drug addiction.4 A doctor or healthcare worker can advise you about the availability of needle exchanges and methadone/buprenorphine programmes.
Another option may be to take pre-exposure prophylaxis (PrEP). This is when you take HIV treatment before possible exposure to HIV (such as injecting drugs) to prevent infection. It’s now recommended for people who inject drugs, although it‘s only available in a few countries.5
There are other things you can do to reduce your risk of HIV from injecting drugs:
- use sterile water to prepare drugs (e.g. boiled water)
- use a new or disinfected container (“cooker”) and a new filter (“cotton”) each time you prepare drugs
- before you inject, clean the area of your body with a new alcohol swab
- safely dispose of needles and syringes after one use so you don’t use them again.
If you are having a tattoo or piercing, make sure that a clean, sterilised needle is used.6
What should I do if I have injected unsafely?
If you think you have shared needles with someone who has HIV (or another blood-borne virus) make sure you get tested.
If you are having sex, make sure you wear a condom until you get your test results. This is because if you are infected, you may pass the virus to your partner.
You may also be able to get post-exposure prophylaxis (PEP). Taken within 72 hours after you injected, PEP can stop an HIV infection from spreading in your body. However, it is not available everywhere.7
Photo credit: Copyright AVERT
- 1. Aidsmap ‘Why is injecting drug use a risk for HIV transmission?' [accessed May 2015]
- 2. AIDS.gov (2014) ‘Substance Abuse/Use’
- 3. Aidsmap ‘Why is injecting drug use a risk for HIV transmission?' [accessed May 2015]
- 4. NHS Choices (2014) ‘HIV and AIDS – Prevention’
- 5. WHO (2015) 'Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV'
- 6. AIDS.gov (2014) ‘Substance Abuse/Use’
- 7. WHO (2014) ‘Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents and children: recommendations for a public health approach: December 2014 supplement’