WHAT IS HARM REDUCTION?
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs. This fact sheet focuses on harm reduction applied to drug use and HIV.
Harm reduction incorporates a spectrum of strategies that includes safer use, managed use, abstinence, meeting people who use drugs “where they’re at,” and addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve people who use drugs reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.
HOW DOES INJECTION DRUG USE RELATE TO HIV?
Sharing needles, syringes, or other drug injection equipment—for example, cookers—puts people at risk for getting or transmitting HIV and other infections. About 1 in 10 new HIV diagnoses in the U.S. are attributed to injection drug use or male-to-male sexual contact AND drug use.
The risk for getting or transmitting HIV is very high if an HIV-negative person uses injection equipment that someone with HIV has used. This is because the needles, syringes, or other injection equipment may have blood in them and blood can carry HIV. HIV can survive in a used syringe for up to 42 days, depending on temperature and other factors.
Substance use disorder can also increase the risk of getting HIV through sex. When people are under the influence of substances, they are more likely to engage in risky sexual behaviors, such as having anal or vaginal sex without protection (like a condom or medicine to prevent or treat HIV), having sex with multiple partners, or trading sex for money or drugs.
Even if you continue to inject drugs, there are ways to protect yourself and others. Keep reading to find out about ways to minimize harm to yourself and others.
NEVER SHARE NEEDLES, SYRINGES, OR OTHER DRUG INJECTION EQUIPMENT
- Use new, clean syringes and injection equipment every time you inject.
- Many communities have syringe services programs (SSPs) where you can get new needles and syringes and safely dispose of used ones.
- Some pharmacies sell needles without a prescription.
- PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV take to prevent HIV.
- If taken as prescribed, PrEP is highly effective at preventing HIV from injection drug use.
- PrEP is much less effective when it is not taken as prescribed.
DON’T HAVE SEX WHEN YOU’RE HIGH ON DRUGS
IF YOU DO SHARE NEEDLES, SYRINGES, OR OTHER DRUG INJECTION EQUIPMENT, USE BLEACH TO CLEAN THEM
OTHER INJECTION TECHNIQUES THAT MIGHT PROTECT YOU
- Use sterile water to prepare drugs (for example, boiled water).
- Use a new or disinfected container (cooker) and a new filter (cotton) each time you prepare drugs.
- Before you inject, clean the area of your body you’re going to inject into with a new alcohol swab.
- Safely dispose of needles and syringes after one use so you don’t use them again, and other people aren’t at risk of accidental exposure.
DECIDE NOT TO INJECT DRUGS
- This is the best way to prevent getting HIV through injection drug use.
- Talk with a counselor or healthcare provider about treatment for substance use disorder, including medication-assisted treatment.
WHAT SHOULD I DO IF I HAVE INJECTED UNSAFELY?
If you think you have shared needles with someone who has HIV (or any other bloodborne virus) make sure you get tested as soon as possible.
If you are sexually active, use a condom until you get your test results. If you have HIV but don’t yet know it, and you don’t use a condom, you may pass on HIV to another person.
You may also be able to get post-exposure prophylaxis (PEP). Taken within 72 hours of possible exposure, PEP can stop HIV from spreading in your body. However, it is not available everywhere. Your healthcare provider will be able to talk you through your options.
National Harm Reduction Coalition: Getting Off Right: A Safety Manual for Injection Drug Users
Psychonaut Wiki: Safer Injection Guide
North America Syringe Exchange Network (NASEN): Find a syringe service program (SSP) near you
Find a treatment center near you or call 1-800-662-HELP (4357)
Reviewed March 2021Print PDF