It describes studies by the American Foundation for AIDS Research (AmFAR) and the Harlem Hospital Center that demonstrate the failure of AIDS education for substance abusers. Preliminary results of the AIDS Outreach Intervention Project and data from the Centers for Disease Control (CDC) are then presented to illustrate the extent of the epidemic among intravenous drug users (IVDU) and their sexual partners. Lastly, a policy response is proposed which advocates confidential reporting to public health officials, aggressive sexual partner notification, elimination of barriers to testing, routine offering of voluntary HIV testing, and criminal penalties for infecting others with HIV.