This guide is designed to assist in expanding the response to HIV among injecting drug users globally. The transmission of HIV among injecting drug users and related populations of sex workers, youth and other vulnerable people is greatly adding to the burden of disease in countries worldwide. Evidence from 20 years of research shows that needle and syringe programmes (NSPs) prevent, control and ultimately reduce prevalence of HIV and other blood-borne infections among injecting drug users.

To do this, many more NSPs will need to be established. Many existing NSPs also need to expand the services that they offer and greatly increase their coverage. How to do this is the topic of sections III and IV. The scaling up of programmes must also include the establishment of many more NSPs in prisons and detention centres. The particular needs of NSPs in such “closed settings” are also covered.