. Popular opinion seems to favor controlling drug use, but expansion of drug use has still occurred and open discussion of drug problems is limited in some quarters. Historically and recently, there seems to be an ambivalence about directions for sustained policy, and this seems evident in recent calls for both draconian measures and more pragmatic responses. Without a stronger consensus and a more integrated multi-sectoral approach, it would appear that drug use will be harder to control as a risk factor for HIV. In this case the apparent fragmentation of cultural norms and the policy that develops in this environment demonstrates some of the challenges of addressing cultural norms in preventing HIV and other health problems.