"This report describes data from 11,437 PWID who participated in NHBS in 2018, of whom 69% identified as male, 30% female, and 1% transgender; 39% were white, 33% were black, and 21% were Hispanic or Latino; 36% were aged ≥50 years (Table 1). Among all participants, 26% had no health insurance, 21% had not visited a health care provider, and the household income of 75% of participants was at or below the federal poverty level.

"In 2018, 6% of participants with a valid NHBS HIV test result tested positive for HIV (Table 2). By gender, HIV prevalence was as follows: 6% among males, 6% among females, and 28% among transgender. By race and ethnicity, HIV prevalence was as follows: 9% among blacks, 8% among Hispanics or Latinos, and 4% among whites.

"CDC recommends that persons at increased risk of HIV infection, including PWID, undergo HIV testing at least annually [10]. Among participants who did not report a previous HIV-positive test result or who had received their first HIV-positive test result less than 12 months before the interview, 55% reported that they had been tested for HIV in the 12 months before the interview, and 90% reported that they had ever been tested (Table 3).

"Among participants who reported being tested for HIV in the 12 months before the interview, 66% reported their most recent test was performed in a clinical setting while 29% reported being tested in a nonclinical setting, such as an HIV counseling and testing site, an HIV street outreach program or mobile unit, a SSP, or at home (Table 4)."

"UNODC, UNAIDS, WHO and the World Bank jointly estimate that some 11.2 million persons worldwide injected drugs in 2020. There has been no measurable change in the estimated global prevalence of injecting drug use from the previous estimate for 2019, which was also 0.22 per cent of the population aged 15–64. However, any trend data must be viewed with caution as the methodologies used to produce national or subnational PWID population size estimations may have changed.

"Approximately 59 per cent of PWID worldwide reside in East and South-East Asia, Eastern Europe and North America. Injecting drug use remains particularly prevalent in Eastern Europe and, to a lesser extent, Central Asia and Transcaucasia, and North America, with rates that are 5.8, 2.6 and 2.5 times the global average, respectively."