Drug abuse and HIV
Drug abuse is directly and non-directly related to HIV transmission. Injection drug use is one of the transmission ways of HIV, whereas drug abuse in general affects behavior and may increase the risk getting infected.
The human immunodeficiency virus is a retrovirus (Retroviridae family) that contains RNA and affects the immune system by attacking CD4+ T-lymphocytes, macrophages and dendritic cells.
There are two types of HIV distinguished – HIV-1 and HIV-2. HIV-1 is more common, whereas HIV-2 is mainly found in West Africa.
- Sexual transmission (male-to-male sexual contact, heterosexual contact –unprotected vaginal or oral sex);
- Transmission by blood and blood products (injection drug use, blood transfusions, blood products or organ transplantation, direct contact between wounds, broken skin or mucous membranes and infected blood, blood-contaminated body fluids or other infected body fluids, reused or not properly sterilized needles or other equipment used for piercing or tattoo);
- Occupational transmission (injuries with needles of sharp medical instruments);
- Maternal-fetal/infant transmission during pregnancy, vaginal delivery, or breastfeeding);
Injection drug use (IDU)
According to the WHO, around 13 million people worldwide inject drugs, approximately 1.7 million of them are HIV-positive. Sharing needles, syringes, the water in which drugs are mixed, or the cotton through which drugs are filtered with an infected person puts you at risk of contracting HIV. If several persons share the same needles and equipment the risk of HIV is even higher.
Some individuals believe that they may acquire HIV only by injecting the drug directly into the blood and if they avoid intravenous injection they are protected against HIV. However, intramuscular or subcutaneous drug injection may also put you at risk of catching HIV.
According to the CDC, about 7% of HIV positive persons were infected by injection drug use in the USA and about 10% – worldwide. HIV prevalence rates are higher (up to 15%) among injection drug users than in the general population.
Individuals who use injection drugs are also more likely to be affected by hepatitis C. It was estimated that the global prevalence of hepatitis C in those who inject drugs is 67%. There are about 2.2 million HIV–hepatitis C virus co-infections, more than half of these cases are detected in those who inject drugs.
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Certain drugs and HIV risk
- Opioids are associated with HIV risk behaviors as addicted persons share needles and are having risky/unsafe sex.
- Methamphetamine is linked to risky sexual behavior which is associated with a risk of HIV transmission. Methamphetamine may also be injected, which increases the risk of getting infected if people share needles and other equipment for injections.
- Crack cocaine users tend to spend all their money on the drugs and as a result, they may be involved in the sex industry to earn money, which increases risk of HIV.
- Inhalants (such as amyl nitrite) are associated with risky sexual behavior, drug abuse, and sexually transmitted diseases (HIV) among gay and bisexual men.
Prevention of HIV
- Avoid sharing needles, syringes and other injection equipment with others;
- Use new sterile needles and syringes. In some countries, there are established syringe services programs/ syringe exchange programs or needle exchange programs where you can get sterile syringes for free;
- Use alcohol swab to clean your skin before injections;
- Use sterile water to mix drugs;
- Use barrier methods of contraception – male condom provides the best protection against sexually transmitted diseases;
- Get tested for HIV regularly, at least once per year;