Drug injecting and HIV infection: new directions for social science research.

An overview is presented of the relationship between drug injecting and HIV infection. The pattern of spread of HIV infection among drug injectors and risk factors associated with the spread of HIV among drug injectors are considered, together with evidence on the adoption of behavior changes intended to reduce such risks. Some promising reduction in risky behaviors has been evident among established drug injectors. Public health prevention strategies, such as syringe distribution and exchange and AIDS outreach work, appear to have fostered decreases in HIV-related risks among drug injectors. The role of methadone maintenance remains uncertain. Despite advances, many obstacles remain. The future research agenda requires work on prevention strategies and the role of drug user treatment. Social scientists need to address the fact that patterns of drug-using behavior reflect powerful "structural factors" such as poverty, unemployment, and housing conditions.