Sharing drug-injecting equipment without sterilizing it between users is an extraordinarily efficient way of spreading HIV. Where equipment sharing is common, HIV infection can race through drug-injecting populations with unparalleled speed.
HIV prevalence rose rapidly among drug injectors in Moscow. Over 2700 cases of HIV were reported in the Russian capital in the first nine months of 1999 alone - three times as many as in all previous years combined.
Drug injecting is already the most common cause of AIDS in some countries, accounting for two-thirds of reported cases in Bahrain in 1998 and half in Islamic Republic of Iran. In Tunisia, injecting drug use is responsible for more than one-third of AIDS cases. In Egypt, one AIDS case in 10 is among drug injectors. In Pakistan, 5.4% of 703 drug injectors tested HIV positive in 1995. Recent studies by the United Nations International Drug Control Programme (UNDCP) in a few countries of the Middle East - Egypt, Iran and Lebanon - indicate that the magnitude of the drug abuse problem should not be underestimated.
Since drug injecting is illegal, it is very difficult to estimate the size of the drug-injecting popula-tion, let alone the extent to which they are linked in sexual networks with non-injectors.