"Injecting drug use is estimated to account for approximately 10 per cent of HIV infections worldwide and 30 per cent of all HIV cases outside Africa,113 while in the eastern countries of the WHO European Region114 more than 80 per cent of all HIV infections occur among PWID [People Who Inject Drugs].115 PWID are estimated to be 22 times more likely than people in the general population to be living with HIV.116

"The 2018 joint UNODC/WHO/UNAIDS/World Bank estimate of the global prevalence of HIV among PWID is 12.6 per cent, amounting to 1.4 million PWID living with HIV. This estimate is based on reporting of the prevalence of HIV among PWID by 121 countries, covering 96 per cent of the estimated global number of PWID. Data on HIV prevalence were available for all PWID in North America, South-West Asia, South Asia, Eastern Europe and South-Eastern Europe, but only for 33 and 32 per cent of all PWID in Central America and the Caribbean, respectively. Of all the countries that provided details of the methodology used to collect their data and estimate the prevalence of HIV, almost three quarters (reports from 89 countries) could be graded as “class A methodology” (seroprevalence study).117 In 2018, new or updated estimates of HIV among PWID were available for a total of 40 countries.

"The subregional prevalence of HIV among PWID continues to be the highest by far in South-West Asia (29.5 per cent) and Eastern Europe (25.2 per cent), followed by Southern Africa (21.4 per cent). In Africa, the HIV prevalence among PWID aged 15–64 was estimated at 11.3 per cent, compared with 3.9 per cent among the general population (aged 15–49) for the same year. In Europe, the HIV prevalence among PWID was 20.2 per cent, compared with 0.4 per cent among the general population.118 HIV prevalence in PWID in East Africa and the Caribbean was also higher than the global average, at 17.4 and 14.0 per cent, respectively.

"The largest number of PWID living with HIV reside in Eastern Europe, East and South-East Asia and South-West Asia, which together account for 67 per cent of the global total. Although the prevalence of HIV among PWID (9.3 per cent) is below the global average, a fifth of the global number of PWID living with HIV reside in East and South-East Asia. A small number of countries continue to account for a large proportion of the total global number of PWID living with HIV. In 2018, for example, PWID living with HIV in China, Pakistan and the Russian Federation accounted for almost half of the global total (49 per cent), while PWID in those three countries comprise only a third of all PWID worldwide."


World Drug Report 2020. Booklet Two: Drug Use and Health Consequences. June 2020. United Nations publication, Sales No. E.20.XI.6).