This is a revised version of a paper presented at the 7th International Conference on Reduction of Drug Related Harm, Hobart, March 1996. Injecting drug use, is a major component of the AIDS epidemic throughout the world. Although the critical link between substance use and the spread of HIV was recognised early on, there were were a number of factors which delayed and Prevented effective intervention to deal with unsafe injecting behaviour. Harm reduction interventions have been shown to slow the course of HIV among IDUs in many developed countries but in Asia the concept of harm reduction is still new.
Prevention is still focused on abstinence.
In Nepal a 4 harm reduction approach has been in place since 1991. In many Asian countries, this began with epidemics of HIV infection involving drug users. After an interval, the epidemic spread to the general population. In other countries, the epidemic began in other populations or began in ways which have not yet been determined. However, in many of these Asian countries, HIV among injecting drug populations has clearly intensified the spread of the epidemic.