There IS a rhetorical distinction (that is actually key here, in the psychology behind this), but not an actual distinction. It is the rhetorical distinction that allows them to feel okay (for those that MIGHT feel something) for doing it.

People dying because of this are just incidental outcomes arising from unfortunate circumstances. If these people were "decent people" they wouldn't have or wouldn't expose themselves to HIV/AIDs--and wouldn't need the drugs, so it's THEIR fault... and not our responsibility.

That is the thought process (though not usually explicit only implicit) in this.

Blaming the victim is just another psychological defense mechanism/justification for shitty behavior.