Injecting drug use emerging as major HIV risk in Sri Lanka

Injecting drug use is emerging as a major public health concern in Sri Lanka and is contributing to new HIV infections, Consultant Venereologist Dr Nimali Jayasuriya has warned, as the country continues to record increases in HIV and other sexually transmitted infections.

Speaking at a media briefing on Wednesday on developments in sexual health and HIV medicine, Jayasuriya said infections were now being detected among people who inject drugs and described the trend as a serious risk.

She said HIV control efforts had progressed well until around 2021, but the situation began to deteriorate following the Covid-19 pandemic. Since 2023, Sri Lanka has recorded a renewed increase in HIV cases, with the upward trend continuing into 2026.

Jayasuriya said several factors had contributed to the increase, including greater access to the internet following the pandemic, the economic crisis, wider drug use and a rise in the number of people injecting drugs.

She said another concern was the growing tendency for people to engage in unprotected sex in exchange for money, which had also contributed to the spread of HIV and other sexually transmitted infections.

Despite prevention and control programmes, she said existing measures were proving insufficient to contain the increase.

HIV cases were being reported across all age groups, occupations and regions of the country, although Colombo continued to record the largest number, she said.

Jayasuriya said unsafe sexual activity between men was currently one of the main factors driving HIV transmission in Sri Lanka.

She said approximately seven men were being diagnosed for every woman diagnosed with HIV and that the highest prevalence was among men who have sex with men.

The increasing number of infections among people who inject drugs was an additional warning sign, she said.

Jayasuriya said Sri Lanka now had simpler treatment options for HIV, with fewer side effects and fewer medicines required. Treatment is provided free of charge, while programmes are also being implemented to improve public knowledge and prevent infection.

She said syphilis had also increased sharply. Before 2021, around 80 to 100 cases were reported annually, but the figure had now risen to about 1,500 cases a year.

Hepatitis B cases reported this year were about twice the level recorded last year, while hepatitis C infections in 2025 were around four times higher, she said.

Jayasuriya identified HIV, syphilis, hepatitis B and hepatitis C as major current public health concerns.

She said Sri Lanka had made substantial progress in controlling sexually transmitted infections since the country's first AIDS case was reported in 1986, through the work of the National STD/AIDS Control Programme and the Sri Lanka College of Sexual Health and HIV Medicine.

The briefing was held ahead of the 31st annual academic sessions of the Sri Lanka College of Sexual Health and HIV Medicine, which will take place from 29 to 31 October at the ITC Ratnadipa in Colombo.

The conference, organised jointly with the British HIV Association, will be held under the theme “Bridging to Tomorrow – Advancing Sexual Health and HIV Medicine through Collaboration and Innovation.”

The opening session will be held on 29 October under the patronage of Health and Mass Media Minister Dr Nalinda Jayatissa.

Consultant Venereologists Dr Prageeth Premadasa and Dr Lilani Rajapaksa also addressed the media briefing.