HIV-prevention measures specific to injection drug users (IDUs), such as opioid substitution treatment and needle-and-syringe programs, are not provided in many countries where injection drug use is endemic. We describe the incidence of diagnosed HIV infection in IDUs and the availability and coverage of opioid substitution and needle-and-syringe programs in the European Union and 5 middle- and high-income countries. Countries with greater provision of both prevention measures in 2000 to 2004 had lower incidence of diagnosed HIV infection in 2005 and 2006.