Comprehensive HIV Prevention for People Who Inject Drugs, Revised Guidance (July 2010)


On July 16th, 2010, PEPFAR released revised guidance on comprehensive HIV prevention for people who inject drugs. The revised guidance provides support for a comprehensive package of prevention services that have been scientifically demonstrated to decrease HIV infection risk without increasing drug use, including the following three elements: (1) community-based outreach programs; (2) sterile needle and syringe programs (NSPs); and (3) drug dependence treatment, including medication-assisted treatment (MAT) with methadone or buprenorphine and/or other effective medications as appropriate, based on the country context.

The core interventions should include a combination of the following HIV prevention interventions and strategies, and they should be carried out in a manner consistent with human rights obligations:

  • Community-based outreach;
  • NSPs;
  • Opiod substitution therapy (OST) and other drug dependence treatment;
  • HIV counseling and testing (HCT);
  • ART for IDUs living with HIV;
  • Prevention and treatment of sexually transmitted infections (STIs);
  • Condom programs for IDUs and their sexual partners;
  • Targeted information, education, and communication (IEC) for IDUs and their sexual partners;
  • Vaccination, diagnosis, and treatment of viral hepatitis; and
  • Prevention, diagnosis, and treatment of TB.

The new guidance promotes close collaboration with country partners, including multiple sectors of government and civil society. Their leadership is essential to combat stigma and discrimination and to respect the human rights of IDUs, to provide safe spaces for them to access services, and to secure an environment in which evidence-based interventions for IDUs can succeed. PEPFAR shows special interest in supporting the facilitation of appropriate programs where governments have existing punitive policies that affect IDUs.

View the webpage for the revised PEPFAR guidance

pdfDownload the guidance (PDF, 137 KB)


Related Materials