Shah Abdul Latif Bhitai Welfare Society is working in injection equipment to either inject or split drugs—including syringes, cookers, water and cotton—is a high risk factor for IDUs. Sharing mainly occurs because there are not enough needles and syringes available or they are not affordable to IDUs. Unprotected sexual activity with an HIV+ partner is also a high risk factor for IDUs, especially male IDUs who have sex with men, women IDUs who trade sex for money and women with IDU partners. Risk varies depending on drug use; for example, speed (methamphetamines) increases sexual desire and has been shown to lead to unsafe sex.

IDUs often struggle with multiple health risks due to social, economic and psychological factors. HIV prevention may not be their top concern since they face other more pressing daily challenges such as addiction, poverty, incarceration, homelessness, stigma,