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HIV & harm reduction from injecting drugs fact sheet

Sharing needles and syringes to inject drugs risks infections such as HIV and hepatitis. 

Find out about the services and treatments available to reduce these risks.

What is harm reduction from injecting drugs?

Methods that reduce the harm and risk of infections from injecting drugs. Harm reduction methods to prevent HIV from injecting drugs include:

  • needle & syringe programmes (NSP)
  • opioid substitution therapy (OST).

Injecting drugs and HIV

  • Blood stays in needles and syringes after use.
  • There may be HIV in the blood if someone who is HIV-positive used them.
  • The more blood in the syringe, the longer it takes HIV to die.1 
  • Do not share this equipment, always use your own!2 

You can get new needles, syringes and other equipment from places such as: 

  • NSP sites and vans
  • pharmacies
  • friends.3

Needle and syringe programmes and HIV

They give out new, sterile needles and syringes, usually for free. Dispose of used needles & syringes here.

Some needle and syringe programmes (NSPs) have an age restriction, i.e. won’t give equipment to people under 18 or 21.

Basic NSP services:

  • clean needles & syringes
  • needle & syringe disposal
  • health information & advice
  • counselling        
  • referrals to other services.            

Extra NSP services:

  • other injecting equipment
  • medical care    
  • HIV/STI/pregnancy testing        
  • free condoms        
  • opioid substitution therapy (OST).4         

Opioid substitution therapy (OST) and HIV

  • OST could benefit anyone who uses opioids such as heroin.5
  • Opioid medicines are an alternative to the opiate drugs you take.
  • Your craving for opiate drugs will lessen over time, allowing you to overcome withdrawal symptoms and manage your addiction.
  • Harm or risk of HIV infection is reduced, as you use oral OST instead.6 
  • You will be monitored for a period of time while you take OST.7  

Opioid substitution medicines

Methadone is:

  • the most common option
  • a syrup or pill
  • taken once a day
  • started on a low dose - increased gradually.

The preferred option if you:

  • experience anxiety as a withdrawal symptom
  • have used drugs for a long time
  • used more than one drug (including alcohol).8

Buprenorphine is:

  • second most common option
  • taken once a day or every other day
  • taken under the tongue
  • more expensive than methadone
  • less sedating than methadone
  • milder withdrawal symptoms than methadone
  • not recommended if you have liver dysfunction
  • not recommended during pregnancy.9

Benefits of OST

  • Reduces the need to inject drugs and therefore the risk of harm or HIV from injecting drugs decreases.
  • Reduces withdrawal symptoms
  • Improves mental and physical health
  • No need to buy street drugs
  • Can take methadone throughout pregnancy and after childbirth
  • Find links to other healthcare services such as HIV care.10


  • No set length of treatment time, it varies from person to person
  • Currently no option for non-opioid drugs
  • Some countries consider OST illegal, check with your healthcare professional
  • Some countries believe in total drug abstinence, before OST may be started.

Drug consumption rooms

This is a location where you can inject safely, with medical staff present. This reduces the chance of harm or HIV when injecting. It also prevents the risk of overdose. However, they are not available everywhere.

Know your rights

You have the right to:

  • not share used equipment
  • new sterile needles and syringes
  • refuse a drug detox.


Last full review: 
10 March 2016

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Last updated:
29 June 2017
Last full review:
10 March 2016