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Injection Drug Use and HIV Risk

Sharing needles, syringes, or other injection equipment (works) to inject drugs puts people at risk for getting or transmitting HIV and other infections. About 1 in 10 new HIV diagnoses in the United States are attributed to injection drug use or male-to-male sexual contact and injection drug use.

Risk of HIV

The risk for getting or transmitting HIV is very high if an HIV-negative person uses injection equipment that someone living with HIV has used. This is because the needles or works may have blood in them, and blood can carry HIV. HIV can survive in a used needle for up to 42 days, depending on temperature and other factors.

Substance misuse can also increase the risk of getting HIV through sex. When people are high, they are more likely to have risky anal or vaginal sex, such as having sex without a condom or without medicines to prevent or treat HIV, having sex with multiple partners, or trading sex for money or drugs.

Risk of Other Infections and Overdose

Sharing needles or works also puts people at risk for getting viral hepatitis. People who inject drugs should talk to a doctor about getting vaccinated for hepatitis A and B and getting a blood test for hepatitis B and C.

In addition to being at risk for HIV and viral hepatitis, people who inject drugs can get other serious health problems, like skin infections or abscesses. People can also overdose and get very sick or even die from having too many drugs in their body or from products that may be mixed with the drugs without their knowledge (for example, illegally made fentanyl).

Reducing the Risk

The best way to reduce the risk of getting or transmitting HIV through injection drug use is to stop injecting drugs. Talk with a counselor, doctor, or other health care provider about substance use disorder treatment, including medication-assisted treatment. To find a treatment center near you, check out the locator tools on Substance Abuse and Mental Health Services Administration (SAMHSA) or, or call 1-800-662-HELP (4357).

If you continue injecting drugs, never share needles or works. Many communities have syringe services programs (SSPs) where you can get free sterile needles and syringes and safely dispose of used ones. They can also refer you to substance use disorder treatment and help you get tested for HIV and hepatitis. Contact your local health department or North American Syringe Exchange Network (NASEN) to find an SSP. Also, some pharmacies may sell needles without a prescription.

Other things you can do to lower your risk of getting or transmitting HIV, if you continue to inject drugs, include:

  • Cleaning used needles with bleach. This may reduce the risk of HIV but doesn’t eliminate it.
  • Using sterile water to fix drugs.
  • Cleaning your skin with a new alcohol swab before you inject.
  • Being careful not to get someone else’s blood on your hands or your needle or works.
  • Disposing of needles safely after one use. Use a sharps container, or keep used needles away from other people.
  • Getting tested for HIV at least once a year.
  • Asking your doctor about taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP).
  • Using a condom the right way every time you have anal or vaginal sex. Learn the right way to use a male condom.

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).