HIV and Substance Use
- Published on June 18, 2008
It has long been understood that a there is a significant risk of acquiring HIV through needle sharing when injecting drugs. The HIV transmission risk caused by sharing needles is further intensified when substances are used. Under the influence of substances, individuals may be more likely to engage in sexual behaviors that increase the risk of HIV transmission, not ask about the HIV status from their partners or neglect to use a condom. Even when condoms are used, mistakes in overall use, including proper fitting, are common when an individual is drunk or high.
HIV and substance use as a co-occurring condition is a medical concern. Substance use can cause medications not to function properly in the body; therefore, many physicians will not prescribe if patients are using or thought to be using drugs. Adherence to HIV medications is critical for people living with HIV and this is significantly more difficult when drug cravings compete with medication schedules. HIV medications are harsh on the liver especially when combined with the damaging effects of substance use on the liver. Subsequently, co-infection with Hepatitis is a common concern.
Prevention that minimizes HIV transmission by substance users to others can include safe sex, life skills training, assistance with basic needs, peer support, case management services, avoiding sharing needles and education with assessment of risk perception.
Substance use treatment for the HIV positive population involves balancing pain management with substance use; medical care and symptom control; accessing treatment and insurance and addressing co-occurring factors such as mental health concerns.