Reducing sexual transmission of HIV for injecting drug users: The challenge for counselling

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Abstract
Harm minimization approaches have been recommended to reduce the risks of transmission of HIV for injecting drug users by the elimination of sharing injecting equipment. The risks associated with the sexual behaviours of these individuals have been given less emphasis, and where considered have been in terms of the threat to non-drug partners and potential penetration of HIV infection into the general population. Data are presented from four survey studies conducted between 1985 and 1990 focusing on both drug-taking behaviours and sexual activities. These provide evidence for larger shifts, over this period, in injecting practices than in sexual behaviours. The risks associated with sexual activities for injecting drug users and their sexual partners are considered. It is concluded that counsellors have an important role to play in introducing a second phase of harm minimization that involves interventions to modify sexual behaviours and offers integrated services for injecting drug users and their families.