1. People who inject drugs
Last updated: December 2018

2. CONTENT Population size estimates HIV prevalence and epidemiology
Risk behaviors
Vulnerability and HIV knowledge
National response

3. Population size estimates

4. People who inject drugs size estimates
Country
Estimated size
Definition
Males
(15-49)
As% of males
Afghanistan(2015)
40,900
Information not available
8,049,121
0.5
Australia(2005)
215,000
5,822,784
3.7
Bangladesh(2015)
33,067 (Total)
32,021 (Male)
1045 (Female)
Males who injected drugs within the last 1 year
Females who injected drugs within the last 1 year
45,033,462
0.07
Cambodia(2012)
1300 (Total)
1124 (Male)
176 (Female)
18+yrs; who injected drugs at least one time in the last 1 year
3,966,282
0.03
China(2013)
1,930,000
Persons who ever injected drugs
400,323,128
India(2009)*
177,000
365,281,206
Indonesia(2016)
33,492 (Male)
People aged 15 years or older who injected drugs categorized as narcotics in the last 12 months
71,618,154
0.05
Lao PDR (2018)
1600
1,817,676
0.1
Malaysia(2017)
120,000
Males 18+ yrs; who injected drugs in the last 6 months
8,472,244 2
Myanmar(2017)
93,000
Males 15+ yrs, who injected drugs for non-medical purposes in the past one month
14,191,807
0.6
Nepal(2016)
30,868
People who inject various drugs into their muscles or veins for the purpose of intoxication in the last 12 months
7,145,550
0.4
Pakistan(2016)
113,776
Persons 15+ yrs; who injected drugs regularly, for non-therapeutic purposes in the last 6 months
51,045,195
0.2
Philippines(2015)
Males 15+ yrs; who injected drugs for non-medical purposes in the last six months
24,435,734
Sri Lanka(2013)
423
Persons who are currently injecting drugs
5,049,250
0.01
Thailand(2015)
42,650
People who inject drugs at least once within the last month
17,685,689
Viet Nam(2013)
271,506
26,182,125
1.0
* India reported 2009 PWID population estimates in latest Global AIDS Monitoring (GAM) 2018 reporting.
Source: Global AIDS Monitoring reporting to 2018, China 2013 HIV estimation, and United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision

5. HIV prevalence and epidemiology

6. HIV prevalence among people who inject drugs, 2012-2017
Source: Prepared by based on Global AIDS Response Progress Reporting and Global AIDS Monitoring Reporting 2017 and 2018

7. HIV prevalence among who inject drugs by gender, 2012-2017
* Male PWID – Dhaka and Hili; female PWID – Dhaka **Small sample size for female PWID
Source: Prepared by based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; and 3) UNAIDS. Global AIDS Monitoring Reporting (GAM) Reporting

8. HIV prevalence among people who inject drugs, 2012-2017
HIV prevalence among PWID in geographical locations that are higher than national prevalence,
HIV prevalence among people who inject drugs,
Source: Prepared by based on HIV Sentinel Surveillance Reports and Integrated Biological and Behavioral Surveillance Reports and GAM Reporting

9. Double disease burden of HIV and HCV among PWID in Asia and the Pacific
Prepared by based on Platt, L., Easterbrook, P., Gower, E., et al. Prevalence and burden of HCV co-infection in people living with HIV:
a global systematic review and meta-analysis. The Lancet Infectious Diseases

10. Hepatitis C and syphilis prevalence among PWID, countries where data is available, 2009-2017
Source: Prepared by based on 1) Integrated Biological and Behavioural Surveys and 2) HIV Sentinel Surveillance Surveys

11. Risk behaviours

12. Married or in partnership
HIV and HCV burden among PWID and population interactions with other populations - implications on onward transmissions
Half a million PWID living with HIV
430 K
HCV co-infection
4.1 M
PWID
Married or in partnership
Had sex with FSW
Had sex with males
51%
(33%- 70%)
27%
(10%- 42%)
14%
(4%-37%)
Note: HCV prevalence among PWID in the region varies with a range of 20% to 80%
Source: Prepared by based on Integrated Behavior and Biological Surveillance (IBBS) and HIV sentinel surveillance plus (HSS+) reports and Platt, L., Easterbrook, P., Gower, E., et al. Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. The Lancet Infectious Diseases

13. Less than one in three people who inject drugs used a condom at the last sexual encounter
Condom use at last sex among people who inject drugs in Asia and the Pacific,
Source: Prepared by based on Global AIDS Monitoring (GAM) reporting

14. Condom use at last sex among PWID by gender, (2013-2017)
Condom use among both male and female who inject drugs are still below 60% in many countries
Condom use at last sex among PWID by gender, ( )
* sample size of female PWID < 50
Source: Prepared by based on Global AIDS Response Progress Reporting and Global AIDS Monitoring Reporting

15. Safe injecting practices among people who inject drugs in Asia and the Pacific
Percentage of people who inject drugs reporting the use of sterile injecting equipment the last time they injected ( )
Source: Prepared by based on Global AIDS Monitoring (GAM) reporting

16. Safe injection practice among male and female PWID, 2015-2017
No remarkable difference in safe injection practice among male and female PWID in countries where data is available
Safe injection practice among male and female PWID,
* Female PWID sample size
Source: Prepared by based on and Global AIDS Response Progress Reporting and Global AIDS Monitoring 2017

17. The syndemic of HIV related risk and co-morbidities among women who use drug in Kuala Lumpur, Malaysia
Source: Prepared by based on Loeliger, K. B., Marcus, R., Wickersham, J. A., et al. (2016). The syndemic of HIV, HIV-related risk and
multiple co-morbidities among women who use drugs in Malaysia: Important targets for intervention. Addictive Behaviors, 53, 31-39

18. Average number of injections among people who inject drugs, 2011-2017
* Cebu and Mandaue; ** median value; ***More than half of all respondents injected 2-3 times a day or more.
Source: Prepared by based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys;

19. Average duration of injecting drugs among PWID, 2009-2017
Source: Prepared by based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys

20. Proportion of PWID engaged in commercial sex in the past 12 months, 2009-2017
Source: Prepared by based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys

21. Proportion of PWID reported consistent condom use, 2011-2017
Source: Prepared by based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys

22. Vulnerability and HIV knowledge

23. Proportion of PWID with comprehensive HIV knowledge, 2008-2017
Source: Prepared by based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys; 3) other surveys and reports

24. HIV expenditure

25. Prevention spending on people who inject drugs is heavily dependent on international financing sources
HIV expenditure on harm reduction programmes for PWID in
Asia and the Pacific, latest available year,
Domestic funding
by income level
International funding
Source: Prepared by based on Global AIDS Response Progress Reporting; UNAIDS. (2016). Do No Harm: Health, Human Rights and People Who Use Drugs and

26. Key populations account for 60-90% of new HIV infections in Asia and the Pacific countries but only a third was spent for key populations HIV prevention programme
Proportion of prevention spending among key populations in Asia and the Pacific region
35%
19%
10% 6%
of total
prevention
spending
15 countries: Afghanistan, Bangladesh, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Nepal, Palau,
Pakistan, Philippines, Solomon Island, Sri Lanka, Thailand and Vietnam
Source: Prepared by based on GARPR reporting

27. Trends in spending on PWID harm reduction programmes out of total prevention spending, countries where HIV prevalence among PWID is more than 10%,
Source: Prepared by based on

28. Regionally, less than one-fifth of PWID prevention spending comes from domestic public sources
Source: Prepared by based on

29. Proportion of AIDS spending by major spending category, Asia and the Pacific, 2009-2013
AIDS spending breakdown is not available for China and India
Source: Prepared by based on

30. Proportion of prevention spending by category, 2009-2013
Youth
Prevention mother-to-child
General prevention and others
Sex workers and their clients
People who inject drugs
Men who have sex with men
Note: Data from latest available year. China and India did not report prevention spending breakdown.
Source: Prepared by based on

31. Spending on HIV prevention programmes focused on PWID, 2009-2013
Note: Data from latest available year. China and India do not report prevention spending breakdown.
Source: Prepared by based on

32. National response

33. Snapshot of harm reduction in Asia and the Pacific, 2017
Needle and syringe programmes operational
Needle and syringe programmes coverage
Possession of needle and syringe used as evidence for arrest
Opioid substitution therapy programmes operational
Opioid substitution therapy programmes coverage
Naloxone available through community distribution
Afghanistan
Yes
NO INFO No
Australia
Bangladesh*
Cambodia
China
India
Indonesia
Lao PDR
Malaysia
Myanmar
Nepal**
New Zealand
Pakistan
Philippines
Sri Lanka
Thailand
Viet Nam
Countries with HIV prevalence among PWID ≥ 5%
NSP programme coverage
(syringes per PWID per year)
High coverage: >200
Medium coverage: >100–<200
Low coverage: <100
No service
No info/ not reported
OST programme coverage
(% opioid injectors on OST)
High coverage: >40%
Medium coverage: 20 – ≤ 40%
Low coverage: < 20%
No service
No info/ not reported
* HIV prevalence from sentinel sites – Dhaka A1, A2 and Hili; **Kathmandu
Source: Prepared by based on Global AIDS Monitoring (GAM) reporting

34. Needles and syringes distributed per PWID per year in Asia and the Pacific, 2014-2017
High coverage: ≥200 syringes per PWID per year
Medium coverage: ≥100–<200 syringes per PWID per year
Low coverage: <100 syringes per PWID per year
Source: Prepared by based on Global AIDS Response Progress Reporting and Global AIDS Monitoring Reporting

35. Coverage of opioid substitution therapy among people who inject drugs, 2016-2017
High coverage: >40%
Medium coverage: 20 – ≤ 40%
Low coverage: <20%
Source: Prepared by based on Global AIDS Monitoring Reporting

36. Reported number of people who use drugs received opioid substitution therapy, 2012-2014
* only number people on methadone is reported in and 2013 reported numbers includes number of people on methadone and estimate people on buprenorphine.
Source: Prepared by based on Global AIDS Response Progress Reporting 2015

37. NSP and OST sites by country where data is available, 2012-2017
Number of needles/syringes programme sites
Number of opioid substitution therapy sites
Afghanistan (2014) 27 1
Bangladesh (2016) 49 4
Cambodia (2017)
China (2014)
814
767
India (2014)
401
178
Indonesia (2014)
232 90
Lao PDR (2012)  5  8
Malaysia (2016)
694
907
Maldives (2014)
Mongolia (2013)  1
Myanmar (2017) 55 51
Nepal (2017) 21 15
Pakistan (2016) 29
Thailand (2016) 17
147
Viet Nam (2016)*
 230
416
* 2014 data for NSP sites
Source: Prepared by based on 1.Global AIDS Response Progress Reporting; and 2.Global AIDS Monitoring & Malaysia Satellite Data Hub

38. HIV testing response gap to reach Fast-Track target: less than half of people who inject drugs know their HIV status
90%
Source: Prepared by based on Global AIDS Monitoring Reporting

39. HIV testing coverage among male and female PWID, 2013-2017
Female PWID have similar level of HIV testing coverage comparing to their male cohort
HIV testing coverage among male and female PWID,
* Female PWID sample size
Source: Prepared by based on and Global AIDS Response Progress Reporting

40. HIV testing and treatment coverage, and response gap among PWID, select countries, 2016
HIV testing coverage
Treatment coverage
27%
90%
28%
81%
Bangladesh
HIV testing coverage
39%
90% 6%
81%
Pakistan
Treatment coverage
Response gap
53%
90% 5%
81%
Viet Nam
Source: Prepared by based on Global AIDS Monitoring (GAM) Reporting 2017

41. Impact of drug policies on HIV among people who inject drugs
HIV prevalence (%)
Select countries that have early and consistently implemented comprehensive harm reduction strategies
Select countries that have introduced
harm reduction strategies partially (or)
late in the progress of the HIV epidemic
Select countries that have consistently
resisted large scale implementation of
harm reduction strategies, despite the
presence of the epidemic, drug injection
and sharing
*Information on year of survey conducted not available
Source: Prepared by based on and Global AIDS Response Progress Reporting (GARPR)

42. Punitive laws hindering the HIV response among PWID in South Asia
Compulsory detention centres for people who use drugs
Death penalty for drug-related offences
Afghanistan NO
NO INFO
Bangladesh
YES
Bhutan
India
Maldives
Nepal
Pakistan
Sri Lanka
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

43. Punitive laws hindering the HIV response among PWID in South-East Asia
Compulsory detention centres for people who use drugs
Death penalty for drug-related offences
Brunei
YES
Cambodia NO
Indonesia
Lao PDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
Viet Nam
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

44. Punitive laws hindering the HIV response among PWID in East Asia
Compulsory detention centres for people who use drugs
Death penalty for drug-related offences
China
YES
Japan NO
Mongolia
DRP Korea
Rep of Korea
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

45. Punitive laws hindering the HIV response among PWID in the Pacific
Compulsory detention centres for people who use drugs
Death penalty for drug-related offences
Fiji NO
NO INFO
Kiribati
Marshall Islands
FSM*
Nauru
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
*Federated States of Micronesia
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

46. slides compiled by www.aidsdatahub.org
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slides compiled by
Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge if slides are lifted directly from this site