How does drug use relate to HIV?

Drug use is a major factor in the spread of HIV infection. Shared equipment for using drugs can carry HIV and hepatitis, and drug use is linked with unsafe sexual activity.

Drug use can also be dangerous for people who are taking anti-HIV medications. Drug users are less likely to take all of their medications, and street drugs may have dangerous interactions with HIV medications.

Injection and Infection

HIV infection spreads easily when people share equipment to use drugs. Sharing equipment also spreads hepatitis B, hepatitis C, and other serious diseases.

Infected blood can be drawn up into a syringe and then get injected along with the drug by the next user of the syringe. This is the easiest way to transmit HIV during drug use because infected blood goes directly into someone's bloodstream.

Even small amounts of blood on cookers, filters, tourniquets, or in rinse water can be enough to infect another user. Blood on your hands - even small amounts - can also be dangerous when you help someone else find a vein, steady their arm, or when you pass equipment.

To reduce the risk of HIV and hepatitis infection, never share any equipment used with drugs, and keep washing your hands. Carefully clean your cookers and the site you will use for injection.

A recent study showed that HIV can survive in a used syringe for at least 4 weeks. If you have to re-use equipment, you can reduce the risk of infection by cleaning it between users. If possible, re-use your own syringe. It still should be cleaned because bacteria can grow in it.

The most effective way to clean a syringe is to use water first, then bleach and a final water rinse. Try to get all blood out of the syringe by shaking vigorously for 30 seconds. Use cold water because hot water can make the blood form clots. To kill most HIV and hepatitis C virus, leave bleach in the syringe for two full minutes. Cleaning does not always kill HIV or hepatitis. Always use a new syringe if possible.

Needle Exchange Programs

Some communities have started needle exchange programs to give free, clean syringes to people so they won't need to share. These programs are controversial because some people think they promote drug use. But research on needle exchange shows that this is not true. Rates of HIV infection go down where there are needle exchange programs, and more drug users sign up for treatment programs.

Needle exchange programs are legal in New Mexico. Call the New Mexico AIDS Hotline at (800) 545-2437 for the location of legal needle exchange programs in New Mexico. The North American Syringe Exchange Network has a web page listing several needle exchange programs at http://www.nasen.org/

Drug Use and Unsafe Sex

For a lot of people, drugs and sex go together. Drug users might trade sex for drugs. Some people think that sexual activity is more enjoyable when they are using drugs.

Drug use, including alcohol, increases the chance that people will not protect themselves during sexual activity. Someone who is trading sex for drugs might find it difficult to set limits on what they are willing to do. Anyone using drugs is less likely to remember about using protection, or to care about it.

Medications and Drugs

It is very important to take every dose of anti-HIV medications. People who are not adherent (miss doses) are more likely to have higher levels of HIV in their blood, and to develop resistance to their medications. Drug use is linked with poor adherence, which can lead to treatment failure.

Some street drugs interact with medications. The liver breaks down some medications used to fight HIV, especially the protease inhibitors and the non-nucleoside analog reverse transcriptase inhibitors. It also breaks down some recreational drugs, including alcohol. When drugs and medications are both "in line" to use the liver, they might both be processed much more slowly. This can lead to a serious overdose of the medication or of the recreational drug.

An overdose of a medication can cause serious side effects. An overdose of a recreational drug can be deadly. At least one death of a person with HIV has been blamed on mixing a protease inhibitor with the recreational drug Ecstasy.

Some antiviral drugs can change the amount of methadone in the bloodstream. It may be necessary to adjust the dosage of methadone in some cases. See the fact sheets for each of the medications you are taking.

The Bottom Line

Drug use is a major cause of new HIV infections. Shared equipment can spread HIV, hepatitis and other diseases. Recreational drug use, including alcohol, contributes to unsafe sexual activities.

To protect yourself from infection, never re-use any equipment for using drugs. Even if you re-use your own syringes, clean them thoroughly between times. Cleaning is only partly effective.

In some communities, needle exchange programs provide free, new syringes. These programs reduce the rate of new HIV infections. Drug use can lead to missed doses of anti-HIV medications. This increases the chances of treatment failure and resistance to medications.

Mixing recreational drugs and anti-HIV medications can be dangerous. Drug interactions can cause serious side effects or dangerous overdoses.