Many cities throughout the globe are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, HIV has become endemic among IDUs in many settings. In an effort to reduce this and related public health concerns, medically supervised safer injecting facilities (SIFs), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff, have been established in several countries. The following review assesses the role that SIFs can play in reducing the harms associated with HIV infection among IDUs and points to ways in which SIFs can be further developed to better respond to the challenges associated with HIV/AIDS among this population.