The spread of HIV among drug users through the use of contaminated needles and syringes has been responsible for most HIV infections in many Asian countries. It is the major contributor to new cases, and threatens the significant gains made in HIV prevention in others. This particular case study looks at how one therapeutic community has come to terms with HIV and its implications for drug-dependent people working towards a drug-free lifestyle. In doing so, the case study addresses the accusation that there is a dichotomy between abstinence and harm reduction.