The chance of contracting HIV is 29 times higher for people who use drugs compared to the rest of the population. Fear of arrest and discrimination can make people reluctant to carry new syringes or disclose their use of drugs to health workers.

As a result, it is estimated that one in ten new HIV infections are caused by the sharing of needles. In certain regions however this is much higher. For example, 43% of new HIV infections in the Middle East and North Africa are among people who inject drugs.

Moreover, it is estimated that there are approximately 14.2 million people who inject drugs worldwide, of whom 12% are thought to be living with HIV. However, global provision of harm reduction interventions is critically low, with only 53 countries currently including supportive references to harm reduction in their national policies.

Our harm reduction programmes can help change that.


We focus on support rather than punishment. We work with people who use drugs to design programmes that meet their specific needs. Such programmes include:

  • Clean needle and syringe programmes.
  • Opioid substitution treatment.
  • Overdose management and information about safe injecting.

In addition to providing services, we also support people who use drugs who face human rights abuses. We advocate for changes to laws, policies and practices to support HIV prevention, treatment and care for people who use drugs.

We advocate to national governments and international society to move away from punishing people who use drugs, encouraging more supportive and humane approaches to deal with drug use and its related social problems.

We also help people who use drugs, especially women who use drugs, to access other services, such as protection from violence and exploitation. By supporting independent peer-based networks, we break down barriers and encourage other people who use drugs to come forward for services.


We’re proud of the support our harm reduction services provide. In 2019, Frontline AIDS and our partners:

  • Distributed 25.6 million needles and syringes to people who use drugs.
  • Provided needle and syringe programmes to 265,000 people who use drugs.
  • Enabled 17,000 people to receive opioid substitution therapy for at least six months.
  • Reached 275,000 people who use drugs with HIV prevention programmes.


Introduced to drugs as a teenager, Annabella is now struggling to stop using heroin. Like many young people who use drugs, she faces the daily threat of discrimination, violence and arrest, making it difficult to access the support she desperately needs.

“For my life to change, I need someone to talk to, somebody who cares,” says Annabella. “I would like the violence to stop, and access to methadone and friendly health services. I need shelter and somebody to give me a chance and a job.”

Annabella is determined to change her situation, and is now getting help from a Frontline AIDS partner. Through this support she is now accessing the health services she needs.

Read Annabella’s story


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