Substance Use and HIV

24 Oct, 2022
Substance Use and HIV

Receiving a diagnosis of Human Immunodeficiency Virus (HIV) can feel terrifying, but there are effective medications to help patients manage the virus and live longer lives. Nearly half of people diagnosed with HIV in America are over 50 years old. Many of these people have lived with HIV for years. Early diagnosis and taking antiretroviral treatment impact the successful management of the illness. Substance use can negatively impact anyone, its adverse effects are heightened for people living with HIV.

What is HIV?

HIV is transmitted through contact with blood and bodily fluids. HIV attacks and weakens the immune system by damaging CD4 T-cells. Illnesses that would be mild in a person with a healthy immune system can prove life-threatening in someone with HIV. HIV can lead to Acquired Immunodeficiency Syndrome (AIDS) if not treated.

Substance Use and Increased Risk of Transmitting or Contracting HIV

Using substances can lead to risky behaviors such as unprotected sex and sex with multiple partners. Partners exchanging bodily fluids can pass HIV from one person to another. Additionally, people who inject drugs and share supplies face a significant risk of spreading or contracting HIV. This is because there can be blood containing the virus in the needle. The items used to prepare drugs, such as cotton and water, can also contain blood.

Meth and Its Effects on HIV Viral Load

The effect of meth on HIV viral load is complex and still poorly understood. In the Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune, a systematic review looks at the previous studies on the subject. Research indicates that methamphetamine (meth) use may increase HIV viral load.

Meth is one of the most widely used substances among people with HIV. Data implicates meth in altering the immune system and HIV replication and spread. There is also a correlation between meth use and rapid progression to AIDS. It appears that meth use has a greater impact than other illicit substances. Regardless, illicit drugs, including meth, can make it easier for HIV to enter the brain and trigger an immune response leading to neuroinflammation.

Does Substance Use Lead to Decreased Adherence to ART?

The HIV/AIDS pandemic has taken the lives of approximately 35 million people worldwide, and a diagnosis was an automatic death sentence 30 years ago. Although there is still no cure, this illness can be effectively managed with medications. What about people who are HIV positive and use substances? Does using substances increase non-adherence to treatment for HIV?

Across studies, it has been shown that substance use is a consistent barrier to ART adherence. People who use substances are more likely to be non-adherent to ART even though these medications can lengthen lifespan significantly. The underlying factors for this relation need more study and research. What was noted was that the type of drug used, stimulant vs. non-stimulant, had differing effects on treatment adherent rates.

Improving Outcomes for People with HIV Who Use Substances

Since substance use can have an enormous negative impact on people living with HIV, it is essential to take action to improve outcomes for this population. Some measures that could help include:

  • Decrease stigma surrounding substance use and HIV: Many people may be hesitant to seek treatment for substance use or testing for HIV due to the stigma.
  • Improve treatment access: Although treatment exists for substance use and HIV, accessing these resources may be difficult for the homeless, people with lower incomes, and people lacking transportation. Improving access can be a complicated issue. It requires creativity and cooperation from everyone, from policymakers to people working in grassroots movements.
  • Ongoing substance use assessments for people in treatment for substance use: Some people continue to use substances even while in treatment. With continuous assessment, this can be discovered and addressed with the patient.
  • Utilizing peer support services, case management, and community health workers: These dedicated workers meet people where they are. They offer additional support and can connect people to needed resources such as treatment, transportation, and food.
  • Contingency management strategies: This approach is helpful with people with substance use disorders and could be adapted to HIV treatment.

Why Care About Treatment Adherence?

Some people may think that these conditions are not their problem if they are not touched by substance use or HIV. However, as humans, we are all connected. Non-adherence to HIV treatment affects everyone since non-adherence can promote the development of drug-resistant strains of the virus.

Even people who do not have a substance use disorder are affected. This can be in the form of decreased resources (ambulances, paramedics to respond to 911 calls, ER beds, etc.), lost productivity of employees or coworkers, etc. The biggest tragedy of all is always the loss of life.

That is why we must keep striving and pushing to find new treatments and promote access and adherence to those treatments. We must remember that the best minds are continually working on these problems. There is always hope for better care and improved outcomes for people who live with HIV and substance use.

With improved medications and treatment, people with HIV are living much longer and more active lives. People with HIV who use substances are more likely to have negative outcomes including poorer quality of life and shortened life spans.

At Sober Life, we welcome people who are HIV positive and want to begin treatment to stop using substances or continue their treatment after detox or residential services. Our expert, compassionate staff will work with you to develop a treatment plan that addresses your needs. You will be supported and challenged to meet those treatment plan goals, and you will be supported the entire time you are in treatment with us. Whether you are looking for partial hospitalization, intensive outpatient, or outpatient treatment, we have a program to suit your needs. We understand busy lives so we also offer virtual treatment options. Call Sober Life today at (619) 542-9542 to learn more.

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