Sharing needles...sharing death

AIDS appears personified as Death, bearing needles infected with HIV, in this advertisement for a needle exchange programme in Honolulu, Hawaii. Sharing needles is a common cause of HIV transmission between intravenous drug users, as blood drawn back into syringe after injecting may contain the virus. Hepatitis B can also be transmitted this way. The only way to avoid infection is to use clean injecting equipment, but the supply of hypodermic needles is often limited in an attempt to control illegal drug use. Needle exchange programmes, in which drug users typically exchange one used syringe for each clean syringe, were pioneered in Holland, and in some places gradually supplanted the message that cleaning needles with bleach protected against infection. Because of their problematic relationship to drug harm prevention measures, needle exchanges remain controversial.