Background People who inject drugs (IDU) face unique systemic, social and individual barriers to conventional HIV voluntary counselling and testing (VCT) programmes. Peer-delivered approaches represent a possible alternative to improve rates of testing among this population.

Methods Cross-sectional data from a prospective cohort of IDU in Vancouver, Canada, were collected between December 2011 and May 2012. Bivariate statistics and multivariate logistic regression were used to identify the prevalence of and factors associated with willingness to receive peer-delivered VCT.

Results Of 600 individuals, 51.5% indicated willingness to receive peer-delivered pretest counselling, 40.7% to receive peer-delivered rapid HIV testing and 42.8% to receive peer-delivered post-test counselling. Multivariate analyses found significant positive associations between willingness for pretest counselling and having used Vancouver's supervised injection facility, Insite, or being a member of VANDU (a local drug user organisation) (all p<0.05). Daily crack smoking and having used Insite were positively associated with willingness to receive peer-delivered HIV testing (p<0.05). Willingness to receive peer-delivered post-test counselling was positively associated with male gender, daily crack smoking, having used Insite and being a member of VANDU (p<0.05).

Conclusions While not universally acceptable, peer-delivered VCT approaches may improve access to HIV testing among IDU.