HIV among people who inject drugs: Data factsheet

What are the latest data telling us about HIV among people who inject drugs?

Under the UN Sustainable Development Goal 3 of the 2030 Agenda for Sustainable Development, the 29 EMCDDA countries (EU-27, Türkiye and Norway) have committed to ending the epidemics of HIV/AIDS by 2030. The WHO regional action plan outlines the vision, goals and actions required to respond to the HIV/AIDS epidemic with interim targets for 2025. So, how are these countries performing in terms of targets relating to people who inject drugs?

Page last updated: 30 November 2023

Number of new infections linked to injection drug use

2022 data showed an increase in new HIV notifications linked to injecting drug use in the EU and Norway (992 new diagnosis, 5.9 % of new HIV cases with known transmission mode) compared to 2021. The increase observed in 2022 might partly reflect the rebound in HIV testing since the COVID-19 pandemic and increased movement of people living with a known HIV diagnosis in European countries, rather than more transmission. Looking at the long-term trend, and adjusting for the population, this corresponds to a decrease of 37 % compared to 2010. However, local HIV outbreaks linked to stimulant injecting continue to be documented in the EU. The greater availability of cocaine on the European drugs market and its injection is of particular concern for HIV outbreaks.

Number of needles/syringes distributed per year per person who injects drugs

Harm reduction approaches, particularly the provision of sterile injecting equipment — including in prisons and through pharmacies — are regarded as a basic component of reducing HIV transmission among people who inject drugs, as outlined in new EMCDDA–ECDC guidance on the prevention and control of infectious diseases among people who inject drugs (2023 update). However, coverage and access to needle and syringe provision remain insufficient in many countries, with only 5 of the 17 EU countries with available data achieving the WHO service provision target in 2021.

Percentage of new HIV diagnoses which are diagnosed at a late stage

In 2022, over 40 % of new HIV diagnoses linked to injecting drug use in the EU and Norway were diagnosed late (CD4 count levels<350cells per mm³ blood). Patients with a late HIV diagnosis are at increased risk of HIV-related morbidity and mortality and may have a poorer response to antiretroviral treatment. Voluntary and confidential infectious disease testing of people who inject drugs is a prerequisite for linkage to care and treatment provision. The new EMCDDA–ECDC guidance supports the implementation of tailored community-based testing services (i.e. testing outside formal healthcare facilities, such as outreach services).

Percentage of people who inject drugs living with HIV achieving viral load suppression

In 2022, no EMCDDA country had reached all 95-95-95 targets (¹) for the continuum of care among people who inject drugs. Overall, people who inject drugs living with HIV are less likely to be diagnosed, linked to care and virally suppressed than other HIV patients. This implies a greater risk of HIV-related morbidity and mortality, as well as more onward transmission. The new EMCDDA–ECDC guidance highlights how a more integrated approach to testing and linkage to care is an effective way to reduce this persistent health inequity.

Percentage of people living with HIV and key populations experiencing stigma and discrimination

Negative attitudes around injecting drug use still contribute to stigma and deter people from accessing HIV services. The new EMCDDA–ECDC guidance stresses that staff training is important in all types of services. It may be particularly crucial in settings such as prisons and pharmacies, where staff may not have as much experience working with people who inject drugs as compared to dedicated services.