Most drug injectors know about most HIV related risks. Further significant risk reduction will be achieved not through education but through subcultural change. This involves mobilising and organising members of a drug scene to make changes for themselves and to influence each other. Involving as much of the scene as possible through democratic structures and effective advocacy are pre-requisites. Such work presupposes a high degree of respect for the capacities of drug injectors to implement change and to care about their own health and that of others.