Injecting drugs and marginalisation

People who inject drugs are perhaps the most marginalised group at risk of HIV infection. According to nongovernmental sources reporting to UNAIDS, only 16% of countries have laws or regulations protecting drug users from discrimination, compared with 21% and 26% of countries providing protection for sex workers and men who have sex with men, respectively

Injecting drugs for purposes not prescribed by a doctor is illegal worldwide, and the criminalisation of drug use and possession can hinder attempts to engage IDUs with available HIV services. There have been documented incidences of Ukrainian police arresting and beating IDUs near needle exchanges for possessing used and sterile syringes.²⁰ Police in Thailand have reportedly acted similarly despite possession of syringes being legal in the country.²¹ It is estimated that 40% of countries have laws that interfere with their ability to reach injecting drug users.²²

IDUs who find themselves on the wrong side of the law and in confrontation with the police may be mistrustful of the authorities in general and hesitate to seek treatment or take advantage of prevention initiatives in the first place. Following a major drug operation by Vancouver police in the Downtown Eastside district, in which there were reported cases of unnecessary force and illegal search and seizure, the number of sterile syringes provided nightly by a local needle exchange program dropped by a third.