Since 1985 several European Institutes of Forensic Medicine have cooperated in a multicenter study providing a constant monitoring of HIV-1 prevalence among drug-related deaths. From 1985 to 1991 the HIV status of 5372 drug-related fatalities (4328 males, 1044 females) has been tested. A total of 764 (14%) drug deaths were HIV-positive (13% of the males, 21% of the females). In contrast to the steadily increasing number of drug-related fatalities the HIV-1 prevalence is decreasing, especially in the German cities. Regional differences are obvious. The development of the HIV prevalence of drug deaths is comparable with that of the still living intravenous drug addicts.