While a lack of reliable data on injecting drug use among youth makes it challenging to firmly establish the numbers of youth affected, research suggests that injecting drug use is a significant source of HIV infection among youth in some regions (particularly the Middle East, North Africa, Asia, and Latin America). Yet most drug treatment services cater to adults or addicts, and the needs of young injecting drug users (IDUs)—especially those in the early stages of injecting or those who do not consider themselves addicts—are often overlooked. 

Most IDUs start the practice when they are young. Motivations for the first injection are similar across cultures. Curiosity, peer pressure, and availability are key factors. First injections rarely occur alone; they usually take place in a social situation, with a young person injected by a friend, relative, or sexual partner. Many young IDUs are involved in the sex industry and report multiple sexual partners and unprotected sex. Young people who inject drugs are often unaware of risks associated with their behavior, including the severity of health problems they may encounter. Since drug use is illegal and often stigmatized, young IDUs tend to avoid mainstream society and vice versa.

The WHO strongly recommends that a ‘harm reduction’ approach be adopted with all IDUs, including vulnerable youth, that includes a defined and comprehensive package including:

  • Needle and syringe programs
  • Drug dependence treatment (particularly opioid substitution therapy
  • HIV testing and counseling
  • HIV treatment and counseling
  • Information, education and risk reduction counseling
  • Condom distribution and STI management
  • Management of TB and viral hepatitis

In addition, programs focused more specifically on youth should focus on prevention and minimizing risk while acknowledging that most IDUs among youth are occasional users.

  • Preventing HIV by discouraging young people from initiating injecting drug use
  • Reducing risks of HIV associated with injecting drug use (i.e., "harm reduction")
  • Address other challenges facing youth, including employment, abuse, and social isolation

HIV and Young People who Inject Drugs: A Technical Brief

This technical brief summarizes the state of knowledge on injecting drug use among youth with a focus on its implications for HIV. The report reviews the knowledge on prevalence of IDU among youth, programmatic responses that have shown promise, a section specifically on young women, and recommendations for program and policy going forward (2015).

Injecting Drug Use Among Under-18s: A Snapshot of Available Data

This report, published as a part of Harm Reduction International’s series, “The Global State of Harm Reduction,” attempts to compile all available data on IDU by children (under age 18). The report highlights the lack of data at both the country and global levels for this age group, reviews available data by region, and suggests recommendations for national governments, researchers and multilateral organizations (2013).

YouthLens No. 26: Youth and Injecting Drug Users

Most injecting drug users start the practice before age 25, yet few HIV prevention programs targeting injecting drug use focus on youth — either to prevent the initiation of injecting or to reduce risks of HIV associated with injecting drugs. A YouthLens research brief from the Interagency Youth Working Group summarizes the evidence on this topic available at the time and discusses recommendations for further work in this area (2008).

A Young Peer Trainer’s Guide to Provide Sexual Health and Drug-Related Harm Reduction Education 

This guide is based on training given by youth in Mexico, Canada, Romania, and India as a part of the RISE UP program, and provides young people with much needed free access to training resources about HIV/AIDS, substance use, and sexual health. More specifically, the guide includes basic information about HIV/AIDS and drug use; strategies for reducing sexual and drug-related harms; and issues related to the stigma and discrimination that often accompany particular sexual behaviors and drug use. The project was funded by MTV Staying Alive Foundation.