The primary focus of this tool is people who inject drugs because of the particular vulnerability to HIV and HCV associated with injecting practices. However, some people who do not inject but use stimulants and other psychoactive drugs can be at high risk of contracting HIV through unprotected sex, and they are subject to structural barriers similar to those faced by people who inject drugs.
Previously published United Nations (UN) guidance documents describe the content of effective HIV and HCV prevention interventions for people who inject drugs, in the context of harm reduction and HIV prevention for key populations. UN guidance is also grounded in an approach expressed in the critical enablers described in Table 2—strategies, activities and approaches to increase the accessibility, acceptability, coverage, quality and uptake of interventions and services for key populations. This tool offers practical advice on how to implement these programmes and these approaches for and with people who inject drugs, across the full continuum of HIV and HCV prevention, diagnosis, treatment and care, aligned with UN guidance. It contains examples of good practice from around the world that may support efforts in planning programmes and services, and describes issues that should be considered and how to overcome challenges.
This tool does not seek to ignore the complex policy and legislative environment around drugs and
injecting drug use in most countries, nor the need for advocacy to confront the stigma, discrimination and human-rights violations faced by people who inject drugs.