Many trans people take hormones via intramuscular injection (directly into a muscle, usually the thigh or butt cheek) or subcutaneously (under the skin). Some trans people choose to share needles for a variety of reasons, but sharing needles creates high risk for HIV as well as hepatitis B and C infections.

Needles for intramuscular and intravenous injections are available for free through needles and syringe distribution programs—visit for listings. Please note that the needles used for hormones are usually a different gauge (size) than the needles normally used for drugs. If you’re getting your needles at a pharmacy, doctor’s office, or community health centre, make sure you ask for the right kind.

The best way to reduce the risk of HIV and hepatitis is to avoid sharing needles. If you have to or choose to share needles, you should clean them with bleach. This reduces the risk, but it is not 100 percent effective in eliminating HIV and is not effective for eliminating Hep C.

For more information about Hep C prevention and safer injection, visit