Infectious diseases: prevention measures

The main approaches taken to reduce drug-related infectious diseases among people who inject drugs include the provision of opioid substitution treatment, sterile injecting equipment, injection risk behaviour counselling, hepatitis B vaccination, infectious disease testing, hepatitis treatment and HIV treatment.

For those who inject opioids, being in substitution treatment significantly lowers infection risk, with some analyses indicating increasing protective effects when high treatment coverage is combined with high levels of syringe provision. Evidence shows that needle and syringe programmes are effective in reducing the transmission of HIV among people who inject drugs. Of the 30 countries monitored by the EMCDDA, all except Turkey provide clean injecting equipment at specialised outlets free of charge. However, considerable differences exist between countries regarding the geographical distribution of syringe outlets and the coverage of the target population by the intervention. Information on the provision of syringes through specialised programmes is available from 25 countries, which together report the distribution of over 52 million syringes in 2014/15. This is a major underestimation, as several large countries, such as Germany, Italy and the United Kingdom, do not report full national data on syringe provision.

Coverage of specialised syringe programmes: number of syringes provided per estimated injecting drug user

Establishing links between drug and sexual health service providers may be particularly important for responding effectively to problems linked to the injection of stimulants by men who have sex with men. Important prevention interventions for this group include testing and treatment of infections, health education and the distribution of prevention materials, including condoms and sterile injecting equipment. To prevent sexually acquired HIV infection, pre-exposure prophylaxis is an additional prevention option for populations at highest risk.