When we talk about HIV, we don’t call it a sexually transmitted disease. That’s not an obscure technicality – it’s because HIV is spread through blood as often as it is through sex – specifically via shared needles.
These data point to the importance of HIV prevention efforts that go beyond promoting condom use. Safe-sex messages are no use in an epidemic that isn’t driven by sex. The report writers’ recommendations focus mainly on increasing the financial resources for efforts to reduce the negative impact of illegal drug use (ie harm reduction). They have calculated that approximately 3 cents a day is spent on harm reduction.
All HIV epidemics are not the same. We need to recognize that, and target HIV programs in ways that work. Including harm reduction as a tactic in countries like Russia where HIV is mostly transmitted through drug addiction, not sex, would substantially improve HIV prevention efforts.