In central asia and transcaucasia and in north

In Central Asia and Transcaucasia and in North America,
the prevalence of injecting drug use is also high: 0.72 per
cent of the population aged 15-64 in Central Asia and
Transcaucasia; and 0.65 per cent in North America. Those
three subregions combined account for 46 per cent of the
total number of PWID worldwide. Although the preva-
lence of injecting drug use in East and South-East Asia is
at a level below the global average, a large number of
PWID (27 per cent of the total number of PWID in the
world) reside in the subregion, given that it is the most
populated subregion. Three countries (China, Russian
Federation and United States) together account for nearly
half of the total number of PWID worldwide.
Drug use is a major risk factor for the
transmission of infectious diseases
Among people who inject drugs, one in seven
is living with HIV and one in two is living with
hepatitis C
PWID represent a key at-risk population for HIV and
hepatitis infections, with almost a third of new HIV infec-
tions outside sub-Saharan Africa occurring among
96 United Kingdom, Home Office, Drug Misuse: Findings for the
2013/14 Crime Survey for England and Wales (July 2014).
97 Mathers M. Bradley and others, “Mortality among people who
inject drugs: a systematic review and meta-analysis”, Bulletin of the
World Health Organization , vol. 91, No. 2 (2013), pp. 102-123.
98 Joint United Nations Programme on HIV/AIDS (UNAIDS), The
GAP Report 2014 (Geneva, 2014).
FIG. 14 Ratio of males to females among young
people (ages 12-17) who use cocaine,
prescription opioids and cannabis in the
United States, 2002-2013
Source: United States, SAMHSA, Center for Behavioral Health Sta-
tistics and Quality, R esults from the 2013 National Survey on Drug
Use and Health: Mental Health Detailed Tables (Rockville, Mary-
land, 2014).
0.4
0.6
0.8
1
1.2
1.4
1.6
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Ratio of males to females
Cocaine
Prescription opioids
Cannabis

CHAPTER I
Health impact of drug use
15
WORLD DRUG REPORT 2016
PWID. 99 Compared with non-injecting drug users, PWID
are approximately three times more likely to acquire
HIV,
100
as the sharing of contaminated needles and
syringes is a major risk for the transmission of HIV and
viral hepatitis. According to joint UNODC/WHO/
UNAIDS/World Bank estimates for 2014, 14.0 per cent
(or 1.6 million) of PWID are living with HIV, 52 per cent
(or 6.0 million) of PWID are infected with hepatitis C
and 9.0 per cent (or 1.1 million) are infected with hepa-
titis B.
99 Ibid.
100 Isabel Tavitian-Exley and others, “Influence of different drugs on
HIV risk in people who inject: systematic review and meta-analy-
sis”, Addiction , vol. 110, No. 4, pp. 572-584.
HIV prevalence is particularly high among PWID in
South-West Asia and in Eastern and South-Eastern Europe,
where 28.2 and 22.9 per cent of PWID, respectively, are
living with HIV. The two subregions combined account
for 53 per cent of the total number of PWID living with
HIV worldwide. Although both the prevalence of inject-
ing drug use and the prevalence of HIV among PWID in
East and South-East Asia are below the global averages, a
large number of PWID living with HIV (330,000, or 21
per cent of the world total) reside in the subregion. Four