<h3>HIV Transmission Through Intravenous Drugs Use</h3>

Intravenous (IV) drug use is the third highest cause of transmission of the human immunodeficiency virus (HIV) (Karon, Song, Brookmeyer, Kaplan, & Hall, 2008). The number of HIV infections secondary to IV drug use may be under estimated because of the illicit nature of drugs and the stigma attached to their use (Mathers et al., 2008). IV drug users may fear legal action or reprisal from their suppliers, making true data collection difficult (Des Jarlais & Semaan, 2008). The sharing of needles has been shown to introduce HIV infection rapidly into the body (Des Jarlais & Semaan, 2008). The combination of risky behavior, namely unprotected sexual practices, along with IV drug use is a potentially deadly combination for spreading HIV. This is made worse by the fact that over 20% of persons with HIV are unaware they are infected (Marks, Crepaz, & Janssen, 2006) and may continue their behavior oblivious to their status. In addition to HIV, infections such as Hepatitis B and C are spread by sharing of needles (Aitken et al., 2008). Needle exchange programs have been implemented with some success, however they are legal in only 24 states, which may present barriers to efforts to reduce infections spread by needle sharing (Miles, 2014).

It is important that you know your HIV status. Have you been tested for HIV? If so, when was the last time and how many unprotected sexual encounters or times have you used IV drugs since then? You may get tested by contacting your local health department. In the event your test is positive, there are very effective treatments available. HIV is not curable, but people with the HIV infection can live long and productive lives (Burgoyne & Tan, 2008).

If you are using IV drugs, it is important that you not use a needle used by someone else, nor should you share your needle with someone. Do you know for certain that the persons who have used the needle you are using to inject are HIV negative? If you are going to use IV drugs, you should use a sterile needle to protect yourself, your loved ones and those with whom you associate. Contact your county health department to see if there is a needle exchange program. They will also provide you with information about services that you are eligible for to treat your drug use habit.

Copyright 2014 by AIDS.GOV

Unprotected sex, with members of the opposite or your sex, puts you at risk for contracting HIV or transmitting it if you are HIV positive. Whatever your sexual preference, it is important that you protect yourself and your partner by using condoms. Monogamous sex (one partner) is the best way to reduce your risk of contracting or transmitting HIV through sex (Abdool Karim, Sibeko, & Baxter, 2010). Of course it is also important you both know your HIV status.

Efforts to reduce HIV transmission among those who use IV drugs requires a multi-prong effort. This includes reaching out to those who use IV drugs and offering testing and referral to treatment both if they test positive for HIV, and treatment for their drug addiction. A clean needle distribution or exchange program, along with education about how to reduce the risk of contracting or spreading the disease is important. There is no evidence to suggest that clean needle distribution worsens IV drug use (Des Jarlais & Semaan, 2008). Educational initiatives about safe needle use, also offers opportunities to educate the individual about the risk involved with unprotected sex and the potential proliferation of HIV among those who have more than one risk factor for the disease (Des Jarlais & Semaan, 2008).

Written by P. Fenn

Substance Abuse Treatment (CDC.GOV)

Question: 

Individuals who use IV drugs may feel stigmatized because of legal and social reasons and be reticent to seek HIV testing in a traditional format (Des Jarlais & Semaan, 2008).  What are some suggestions for creating a safe environment, so that these individuals will be amenable to HIV testing and treatment?

References

Abdool Karim, Q., Sibeko, S., & Baxter, C. (2010). Preventing HIV infection in women: A global health imperative. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 50 Suppl 3, S122-9. http://dx.doi.org/10.1086/651483

Aitken, C. K., Lewis, J., Tracy, S. L., Spelman, T., Bowden, D. S., Bharadwaj, M., Hellard, M. (2008). High incidence of hepatitis C virus reinfection in a cohort of injecting drug users. Hepatology, 48(6), 1746-1752. http://dx.doi.org/10.1002/hep.22534

Burgoyne, R. W., & Tan, D. H. (2008). Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): A balancing act. The Journal of Antimicrobial Chemotherapy, 61(3), 469-473. http://dx.doi.org/10.1093/jac/dkm499

Des Jarlais, D. C., & Semaan, S. (2008). HIV prevention for injecting drug users: The first 25 years and counting. Psychosomatic Medicine, 70(5), 606-611. http://dx.doi.org/10.1097/PSY.0b013e3181772157

Karon, J. M., Song, R., Brookmeyer, R., Kaplan, E. H., & Hall, H. I. (2008). Estimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results. Statistics in Medicine, 27(23), 4617-4633. http://dx.doi.org/ 10.1002/sim.3144

Marks, G., Crepaz, N., & Janssen, R. S. (2006). Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS (London, England), 20(10), 1447-1450. http://dx.doi.org/10.1097/01.aids.0000233579.79714.8d

Mathers, B. M., Degenhardt, L., Phillips, B., Wiessing, L., Hickman, M., Strathdee, S. A., Toufik, A. (2008). Global epidemiology of injecting drug use and HIV among people who inject drugs: A systematic review. The Lancet, 372(9651), 1733-1745. http://dx.doi.org/ 10.1016/S0140-6736(10)60232-2

Miles, K. (2014). This program would save heroin addicts lives, help curb disease and save money. Retrieved from http://www.huffingtonpost.com/2014/03/17/needle-exchanges-heroin-disease_n_4922237.html