While the response in some areas has been punitive, more typically programs have been developed to reduce the demand for drugs, increase the supply of needles, or teach IVDUs how to sterilize their needles. Street outreach programs to do the latter require cultural sensitivity. However, in many areas, needle sharing practices are changing slowly, and the risk of further spread of the epidemic to sexual partners of IVDUs is going unaddressed. The epidemic heightens the need to re-examine the marginalization of IVDUs. 1 chart, 15 notes, and 20 references. (Author abstract)