This issue goes to press as the world media turns its eyes on the World Aids Conference being held in Durban, South Africa. No doubt “the gap” in HIV care provision between developed and developing nations which the last congress in Geneva sought to bridge will seem wider than ever. Reports from the conference will follow in future issues, but in this one we focus on problems commonly faced by clinicians primarily caring for intravenous drug users. Mark Wright and Janice Main give an overview of the management of co-infection with HIV and Hepatitis C viruses, and Ray Brettle discusses the difficulties of antiretroviral selection in the context of methadone and other recreational drug use.