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Criminalization, stigmatization and the psychological, physical, behavioural and economic consequences of substance use make people who inject drugs (PWID) extremely vulnerable to many infectious diseases. While relationships between drug use and blood\u2010borne and sexually transmitted infections are well studied, less attention has been paid to other infectious disease outbreaks among PWID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>COVID\u201019 is likely to disproportionally affect PWID due to a high prevalence of comorbidities that make the disease more severe, unsanitary and overcrowded living conditions, stigmatization, common incarceration, homelessness and difficulties in adhering to quarantine, social distancing or self\u2010isolation mandates. The COVID\u201019 pandemic also jeopardizes essential for PWID services, such as needle exchange or substitution therapy programmes, which can be affected both in a short\u2010 and a long\u2010term perspective. Importantly, there is substantial evidence of other infectious disease outbreaks in PWID that were associated with factors that enable COVID\u201019 transmission, such as poor hygiene, overcrowded living conditions and communal ways of using drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The COVID\u201019 crisis might increase risks of homelessnes, overdoses and unsafe injecting and sexual practices for PWID. In order to address existing inequalities, consultations with PWID advocacy groups are vital when designing inclusive health response to the COVID\u201019 pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25583","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T02:59:26Z","timestamp":1595213966000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":142,"title":["Challenges posed by COVID\u201019 to people who inject drugs and lessons from other outbreaks"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-7022","authenticated-orcid":false,"given":"Tetyana I","family":"Vasylyeva","sequence":"first","affiliation":[{"name":"Department of Zoology University of Oxford Oxford United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavlo","family":"Smyrnov","sequence":"additional","affiliation":[{"name":"Alliance for Public Health Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffanie","family":"Strathdee","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego San Diego CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel R","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Population Health New York University New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30375-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105779"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.027540-0"},{"key":"e_1_2_7_5_1","unstructured":"INPUD.COVID\u201019 crisis: harm reduction resources for people who use drugs.2020. 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