How to lower your risk of HIV from injectable drugs

injection drug-positive peers

By: Ann Avery, MD, Infectious Disease Physician at MetroHealth Medical Center

Heroin (or any other drug you might inject) addiction is tough to kick. If you’re injecting, it pays to adopt basic safety practices. Safer injecting means reducing the risk of germs and viruses passing between you and others. It also means protecting your veins and avoiding accidental overdoses.

Following these tips can help you reduce the risks of injection drug use:

injection drug-positive peers

1. Find a needle-exchange program

It’s crucial to start with a clean, sterile needle. In Cleveland, Circle Health Services (formerly the Free Clinic) offers a needle exchange program where you can trade a used needle for a clean one.

Remember, you can get one new needle for every used one you turn in. The best practice is to use a new needle every single time you inject, but we know sometimes that’s unrealistic in the real world. Just remember, the more times you exchange and the fewer times you reuse a needle, the less damage you’ll do to your veins and your overall health.

People will not judge you for doing a needle exchange. They want you to, because it’s better for your health and the health of others. The van workers are trained to treat small abscesses and can even refer you to detox or treatment if you ever feel ready.

injection drug-positive peers

2. Don’t share your needle or works

Of course, you want to avoid HIV, hepatitis, and other diseases that pass through the bloodstream, but there are other reasons to avoid sharing (or to do it as little as possible).

Even if your shooting partners have managed to dodge HIV or the other more serious diseases, their skin, blood, and bodily fluids can contain bacteria and viruses that can infect you where you inject, making it harder to inject there in the future.


injection drug-positive peers

3. Don’t go solo & carry Narcan

Injecting alone is incredibly risky. If you overdose, there won’t be anybody around to help. It’s a good idea to have the overdose antidote, Narcan, on hand & someone who’s trained on how to use it. Narcan is free & easily available through MetroHealth’s Project DAWN program. Learn more here: A drug overdose does not have to be fatal, but it can be if you don’t have Narcan and/or you don’t get to a doctor within a reasonable time.



Come join our private, stigma-free, supportive community.

Health management tools with medication & appointment reminders.
Social networking in a community conversation & private chats.


4. Use safe injection locations

First off, avoid hitting arteries. Any place where you can feel a pulse is an artery — if you shoot there, it may be hard to stop the bleeding, which could be fatal.

Avoid the groin, for example. It has major arteries passing through it, and it is full of germs that can lead to infections.

This is why the arms are the most common injection sites. They have plenty of veins that are near the skin level and easy to access. Just avoid the wrist area where you can feel a pulse. Generally it’s better to start lower on your arms and work your way up.

injection drug-positive peers

5. Protect your veins

Do your best to keep your veins from getting infected. Clean the site with alcohol and a cotton swab, then let it dry quickly before you inject. Give each injection site a chance to heal before you use it again.

Always point the needle in the direction of your heart, inject slowly and use a tourniquet that flexes or stretches. Tighten it enough to make veins appear, but don’t leave it on while injecting. Also, don’t remove the needle too quickly: that can cause the vein to collapse.

injection drug-positive peers

6. Keep everything clean

Spoons and needles trap a lot of germs. You may not be able to get them completely sterile again after using, but if you can’t get new ones you should still try to sanitize them as much as possible.

Using bleach on a spoon and boiled water will get rid of a lot of germs, though not all of them (viruses are especially difficult to get rid of this way). Cleaning your needle tip will prevent blood particles from sticking in there and attracting germs.

injection drug-positive peers

7. Ask for help at your local clinic

Your local clinic may have pamphlets providing more details on injection drug safety. If you have a question, go ahead and ask.

Developing a few safety habits can be the first steps in your commitment to get clean. Every time you make up your mind to inject safely, you’re getting closer to the point where you can make up your mind to give up injected drugs for good.

Related Blogs:






Positive Peers is made possible through a U.S. Department of Health and Human Services Health Resources and Services Administration, HIV/AIDS Bureau Special Projects of National Significance (SPNS) Grant to The MetroHealth System. Click here for more information about the SPNS grant initiative.
Positive Peers is a private app for young people living with HIV. Learn how you can earn rewards for your participation.