Abstract The epidemics of HIV infection among injecting drug users (IDUs) which have ravaged many parts of south and south-east Asia show no signs of diminishing. While they have been documented to an extent, they have received far less attention than sexually transmitted HIV in the region. The reasons for this include discrimination against drug users and a lack of awareness of the role that HIV epidemics among IDUs play in fostering wider spread in the community. There are few effective and pragmatic responses to these epidemics in Asia, and there is certainly a pressing need both for more programs but strategically for evaluations of these programs to provide convincing evidence that they work. Above all this, however, is the need to change attitudes and policy in Asian countries, as in the rest of the world, towards drug users, so that discrimination and unconcern no longer pose barriers to access to health care and to HIV prevention, and to redress constant abrogation of human rights. This is harm reduction's new frontier.