In the Philippines, Cebu City has the highest number of IDUs; in 1995 it became the first site of a harm-reduction program (HRP) (PNAC 2008 ). An integrated HIV behavioural and serological surveillance revealed that 52% of IDUs in Cebu City had shared needles at their last injection (Philippines DOH 2007) , and this figure may be as high as 77% (Mateo et al. 2004; Philippines DOH 2003) . The risk appeared high though this population generally knows that this practice can lead to infection.