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Fact Sheet: HIV/AIDS and Substance Abuse

December 1, 1998

Currently, between 1.1 and 1.5 million people in the United States are injection drug users (IDU), costing society an estimated $58.3 billion each year. However, even more alarming than the numbers of injection drug users throughout the country is the rate at which this group is contracting HIV. According to the most recent Centers for Disease Control and Prevention (CDC) data, more than 200,000 reported AIDS cases in the United States, or 32%, are among injection drug users. Because laws exist restricting the possession, distribution and sale of any injection equipment in the United States, access to sterile needles is difficult and injection drug users across the country continue to share equipment, despite the risk of becoming infected with HIV.


HIV infections among teenagers and young adults, from every sector of the population, have been on the rise in recent years. It is estimated that young adults now account for nearly one half of all new infections. Injection drug use was a mode of exposure for almost one fourth (23%) of reported AIDS cases among adolescents and adults under age 25.

  • Approximately 1 out of every 50 high school students has reported injecting an illegal drug. These drugs include, but are not limited to, heroin and steroids.

  • Two thirds of all high school seniors have had sexual intercourse, 23% have had sex with four or more partners, and many reported having sex under the influence of drugs or alcohol.


  • Alcohol and illegal drugs lower inhibitions and influence young adults to have sex without protecting themselves against STDs or HIV.


In the United States, of the 98,468 reported AIDS cases among adult/adolescent females, HIV was transmitted through injection drug use in 44% of them. More than 4,000 of these cases were reported in 1997 alone.

  • Injection drug use is the number one mode of transmission of HIV/AIDS for women in America.

  • Women who engage in sexual intercourse with injection drug using partners may be unaware of their risk of contracting HIV. By the end of 1997, 16,800 women had been reported to have acquired AIDS in this manner.

  • 91% of all children reported with AIDS and 86% of all children reported to currently be infected with HIV were born to HIV-positive mothers. In 40% of the AIDS cases and 32% of the HIV cases, the mothers were injection drug users.

African Americans

Injection drug use among the African-American population accounts for 13% of all reported AIDS cases in the United States. According to CDC, HIV was transmitted through injection drug use in 60,118 cases of AIDS in African-American men and 24,981 cases in African-American women.

  • In 1997, approximately one fifth of reported AIDS cases among women were in African-American female injection drug users.

  • In 1997, approximately 14% of reported AIDS cases among men were in African-American males with injection drug use as a risk factor.

Information for Injection Drug Users

  • HIV transmission among injection drug users is the result of any piece of drug equipment that has been contaminated by HIV-infected fluids (usually blood) being reused by others without sterilization.

  • In addition to syringes and needles, the water used to rinse syringes, cotton used to filter drugs as they are drawn into the syringe, and even the shared drug itself can harbor the virus and serve as vehicles for transmitting HIV.

  • The following steps can reduce, but not completely eliminate, the risk of transmitting HIV through injection drug use:

    1. Use a sterile syringe for each injection.

    2. If you cannot use a new or sterile syringe for each injection, DO NOT SHARE.

    3. If you do share needles, always completely disinfect them with bleach.* However, disinfecting previously used needles is not as safe as always using a sterile or new one.

      *Contact your local health department for step-by-step instructions on how to correctly use liquid bleach to disinfect needles.

  • The U.S. government bans the use of federal funds for needle exchange programs, which may be defined as facilities where injection drug users may obtain sterile needles and syringes and return used injecting equipment, in order to reduce the harm associated with drug injection practices. The U.S. government does, however, contend that scientific studies have provided sufficient evidence that needle exchange programs do reduce transmission of HIV without increasing drug use when combined with a comprehensive prevention program.

For information on drug treatment programs call the National Drug and Alcohol Treatment Routing Service at 1-800-662-HELP.

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This article was provided by American Association for World Health. It is a part of the publication Be a Force for Change.
See Also
Ask Our Expert, David Fawcett, Ph.D., L.C.S.W., About Substance Use and HIV
More on Injection Drug Use and HIV