One of the Theni District Positive regular social events which provide relaxation, comfort and support, India © Gideon Mendel for the Alliance A peer education leads a life skills session © Nell Freeman for the Alliance

Drug use & HIV

Isaiah Wabwire an outreach worker with DARAT, an Alliance partner organisation, sits with injecting drug users 'Niko' and 'Omar', Mombassa, Kenya (c) Nell Freeman for the AllianceAn outreach worker counsels an injecting drug user, Ukraine © Gideon Mendel/Alliance

    Our programmes are informed by human rights, public health & development best practice 

95,585 injecting drug users reached with harm reduction services by Alliance Ukraine in 2008


Injecting drug use is a major factor in HIV transmission.  Our work in this area aims to provide people who use drugs with the information, the tools and the commodities to prevent HIV transmission, and to increase access to health care.

We believe that those most affected by drug use and HIV – people who use drugs, their families, friends, neighbours and communities – should be actively involved in local responses to drug use.

Our programmes on HIV and drug use are shaped by a harm reduction approach (see below), and are informed by human rights, public health and development best practice.

Our award-winning film Someone's mother, someone's brother shows the positive personal impact harm reduction programmes are having on people's lives:

Impact on communities

The sharing of injecting equipment, for example syringes, is a highly efficient way to transmit HIV, along with other blood borne viruses such as hepatitis C.

In many parts of Asia and Eastern Europe this is the most important cause of HIV infection. And in Africa, Latin America and the Caribbean, injecting drug use is increasingly contributing to HIV transmission.
In many parts of the world where HIV and harm reduction programming is needed most, the communities affected by drug use and HIV/AIDS have very few resources, including community organisations who work with local people to respond to HIV/AIDS and problematic drug use. There are also few ‘safety nets’ for people who use drugs, such as state welfare systems.

Drug users are more likely to be marginalised or treated badly by authorities, families, neighbours, police and health care staff. This can lead to them being excluded from health care and other services.

Drug dependency, poverty and homelessness make many women who use drugs more likely to engage in commercial sex or transactional sex. Women drug users are more likely to take risks in sex work and are less likely to work in brothels.

Harm reduction is an approach to drug use and HIV that aims to reduce the harms associated with drug use and HIV. One of the major harms associated with drug use is HIV transmission.  A harm reduction approach is a pragmatic and evidence based approach that treats drug use in a neutral way.

The Alliance approach

The Alliance works with people who use drugs and their families and households to make the changes necessary to improve health. We promote healthy behaviours such as safe injecting and safe sex, build skills to protect and promote health, and improve access to health services.

Many Alliance partners provide harm reduction services such as opiate substitution treatment, clean needle and syringe programmes, outreach to street drug users, information and education programmes, and psycho-social support programmes for people who use drugs, particularly for those who are taking ART or substitution treatment. We also provide sexual and reproductive health services for injecting drug users and their partners.

Alliance programmes also address the social norms and other social factors influencing communities where injecting drug users live. We educate local communities, health workers, police and officials about responding to drug use humanely. We challenge stigma and discrimination through campaigns and community education, and we mobilise communities to plan and act together to prevent HIV and care for people living with HIV who use drugs.

The Alliance advocates for laws and policies that support HIV prevention, treatment and care, and laws and policies that protect people who use drugs from harassment and abuse.

Achievements to date

  • In 2011, the Alliance began an ambitious new project that aims to expand harm reduction services to more than 180,000 injecting drug users, their partners and children in China, India, Indonesia, Kenya, and Malaysia. Read more about the Community Action on Harm Reduction Project.
  • Alliance Ukraine leads one of the world’s largest national HIV prevention programmes targeting people who use drugs.
  • SASO, an Alliance partner in North East India, provides a comprehensive range of services to people who use drugs in Manipur, including services for women who use drugs.
  • Alliance India are developing a programming approach to gender and drug use for work targeting women who use drugs, along with the female partners, wives and widows of men who use drugs.

Our partners

The Alliance is a member of the International Harm Reduction Association (IHRA) and the International Drug Policy Consortium (IDPC).  We work together to increase the amount of Global Fund monies that fund HIV and harm reduction programmes.

We are also working with the International Harm Reduction Association to reduce the cost of hepatitis C treatment.