People who inject drugs

HIV PrEP is recommended for people who inject drugs who are at risk of HIV infection, defined as having any of the following HIV acquisition risks.

HIV acquisition risk in the previous 3 months that is expected to continue in the next 3 months:

• sharing injecting equipment with an HIV-positive person or a homosexual or bisexual man of unknown HIV status
• at least one episode of condomless anal or vaginal sex (insertive or receptive) with a regular HIV-positive partner who is either not on treatment, or on treatment with a detectable viral load
• at least one episode of condomless receptive anal or vaginal sex with a casual HIV-positive male partner or a male homosexual or bisexual partner of unknown HIV status.

Expected HIV acquisition risk in the next 3 months, despite not having had HIV acquisition risk in the previous 3 months; examples include a person who:

• recently started or restarted injecting drugs and plans to share injecting equipment with an HIV-positive person or with a homosexual or bisexual man of unknown HIV status
• plans to travel to countries that have a high prevalence of HIV where they may share injecting equipment with HIV-positive people or people of unknown HIV status
• will be entering or leaving an institutional or correctional facility in the near future where they may share injecting equipment with HIV-positive people or people of unknown HIV status.

When assessing risk of HIV exposure, also consider relevant risk factors that apply to any of the following patient groups:

• men who have sex with men
• transgender and gender diverse people
• heterosexual people
• women who have sex with women.