People who inject substances (PWIS), those who have done so in the past, or are perceived to inject, and are living with HIV experience severe stigmatisation and discrimination (28).  Despite Australia’s proactive stance in developing and implementing harm reduction policies (41), evidence suggests that people who inject drugs still experience reduced access to health care, and discrimination and poor treatment within healthcare services (41). PWIS are at greater risk of late HIV diagnosis than men who have sex with men or heterosexuals (42).  

Without a firm commitment to the provision of harm minimisation and peer-based responses, HIV epidemics can develop and spread rapidly (41).  The World Health Organization called for the decriminalisation of drug use in 2014 (43) in order to reduce the harms associated with criminalisation. WHO has reaffirmed this position in the WHO 2022 Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations (44).