The author first examines the mechanism by which blood-borne disease is transmitted through the sharing of injection equipment. He then presents a public health strategy for reducing multi-person use of contaminated injection equipment. This strategy includes repealing or modifying current laws and regulations that make possession and distribution of sterile injection equipment a criminal offense. It also involves the implementation of syringe exchange programs to expand access to new syringes for users of injection drugs. Further, there should be counseling, education, and treatment targeted to intravenous drug users (IDUs), including those in the prison and health care systems. The objective of a public health approach is not to encourage or enable IDUs to obtain and use drugs. Rather, public health strategies actively seek to reduce drug use due to its adverse effects on physical and mental health. The public health approach aims to improve health outcomes for IDUs who cannot or will not stop using drugs. 169 footnotes