HIV/AIDS and Drug Use

The National Institute on Drug Abuse (NIDA) has launched a new public awareness campaign highlighting the link between the spread of HIV/AIDS and drug use. Today, there are about one million people in the United States living with AIDS; about one-third of those cases are attributed to drug use.

Transmission by the contaminated needles of intravenous drug users has long been understood as a method of HIV transmission. But the new ad campaign focuses on the more insidious link between drug use and new AIDS infections: the behavioral effects of drug use that leadto risky sexual activity.

According to NIDA director Nora D. Volkov, drug use leads to intoxication and the breakdown of the brain’s executive function systems; this causes impaired judgment which can lead to behaviors that increase the risk of AIDS — as well as to more risky drug use. A study by San Francisco Department of Public Health researcher Grant Colfax found that men were 2.4 times as likely to engage in risky sexual behavior after six drinks and 1.5 times as likely after taking methamphetamine. This research highlights the fact that even drugs like alcohol, generally considered safer than illegal drugs and widely used by young people, can still lead to AIDS transmission.

Besides contributing to new cases of AIDS, drug use can also affect the course of the disease and its treatment. Researchers David Vlahov of the New York Academy of Medicine and Elinore F. McCance- Katz of Virginia Commonwealth University have both found that drug users have more trouble adhering to treatment schedules and are more likely to relapse into risky behaviors. According to Vlahov, 80 percent of people with AIDS in America are receiving antiretroviral therapy whereas only 40 percent of intravenous drug users with AIDS are receiving that treatment. Higher adherence can be reached with treatment and/or methadone maintenance to control drug use and stabilize an addict’s lifestyle. Seemingly simple measures like daily reminders to take medication can also be effective.

Beyond affecting treatment, drug use may influence the course of the disease. Neurological impairments caused by the virus may be worse in HIV-positive drug users than in non-using HIV-positive individuals. In studies conducted by Eileen Martin of the University of Illinois, Chicago, HIV-positive drug users showed more risky decision making than their non-drug-using counterparts did, even when not under the influence of a drug.

For more information about this new public health campaign and the research behind it, visit http://hiv.drugabuse.gov.

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