 Violence and extortion of IDUs and sex workers directly and indirectly elevate the levels of risk behavior and poor health outcomes among members of these groups.Marginalization of these vulnerable groups by way of physical and sexual violence and extortion by police threatens the cross-over of infection from high-prevalence groups to the general population.In particular, decreased access to public health services, such as syringe exchange programs, and confiscation of syringes, even in view of syringe access and possession being legal, can precipitate a cascade of health harms.