Can HCV be prevented among injection drug users?

The hepatitis-C virus (HCV) spreads rapidly among injection drug users (IDUs) because each act of sharing injection equipment carries a high risk of transmission. IDUs are hard to reach, especially in the early stages of their drug-using careers. IDUs are also poorly organized for self-help. For these three reasons, prevention campaigns that worked against the spread of HIV among gay men will be far less effective against the spread of HCV among IDUs. The best hope for such HCV prevention lies in (1) education of middle and high school youth on parenteral risks, and (2) normalization of needle exchange.