From Introduction to the First Edition, by Dr. Nick Crofts, Director, The Centre for Harm Reduction

This manual grew out of the combined efforts of many people battling in Asia to stop HIV. It contains the accumulated experience of over a decade of attempts to change policy and implement programs to stop this devastating scourge, collected over several years from many countries in Asia.

From the Introduction to the Second Edition, by Dr. Nick Crofts, Director, The Centre for Harm Reduction

There has been heightened awareness and recognition of the HIV epidemics among IDUs (injection drug users) in most Asian countries. An increasing level of awareness has been partly matched by an increasing level of funding for programs and for program development. It is no longer the case that these epidemics are seen as unimportant; there have been trials of most comprehensive HIV prevention and care programs for injection drug user and strategies in Asia, including outreach, peer education, needle and syringe programs, and substitution therapies.

However, programs are still too few and too small. Few comprehensive HIV prevention and care programs for injection drug user programs in Asia are government-supported or integrated into mainstraim service delivery, be it primary health care or drug treatment. There is little if any evidence that a decade's work has actually had any significant impact on the rate of growth of the multiple HIV epidemics centred around IDU transmission.

There is now the challenge of scaling-up programs which have been demonstrated to be safe and effective to a point at which they will have a significant impact - this is being attempted in Dhaka, Bangladesh; Manipur State, India; and Nepal. It is to be hoped these scaling-up efforts will show the way forward.

In working with people at high risk of HIV infection, FHI conducts its programs in accordance with guidelines established by the United States government.