Substance abuse and use are a primary public health concern for many reasons. In addition to increasing the risk of HIV transmission, it can also affect a person’s overall health, making them susceptible to HIV infection. For those already infected with HIV substance use can cause the virus to progress more rapidly and also have negative effects on adherence to the treatment. 

Substance abuse can lower the user’s inhibitions leading to riskier sexual behavior. 

Vulnerable Populations

  • Those who live in lower income communities and neighborhoods are more likely to have higher rates of alcohol and illegal drugs use
  • Those with mental illness 
  • Those with history of abuse 
  • Gay and bisexual men 

These groups of people have more risk for substance and alcohol use which can lead to risky lifestyle behaviors.  Which lead to higher risk of HIV.

Frequently abused substances

Alcohol – over indulgence of alcohol like binge drinking is associated with several harmful health and social consequences and sometimes is linked with other drug use. Alcohol is linked to not always using condoms and having multiple sex partners making it a risk factor for HIV infection.

Crack Cocaine – The short term high and addictiveness of this drug leads to an overwhelming cycle of the user quickly burning through their resources and turning to other means of getting the crack they need, including trading sex for drugs or money to get their drugs which in turn leads to a greater risk of becoming HIV infected.

Meth (Methamphetamine)- has become a public health threat in recent years because like other substances it too is linked to high risk behaviors like multiple sex partners or not using condoms. In addition it is highly addictive making it a high risk factor for HIV infection

Inhalants- Nitrate inhalants have long been associated with a high risk of HIV infection. In recent years it has become extremely popular with teenagers as it is found in many household items making it easy to get. 

Prevention Strategies

Sexual Risk Factors – substance use leads to higher risks of spreading HIV including not using condoms since it lowers inhibitions.

Stigma and discrimination – Often substance use and abuse has a stigma because it is viewed as a criminal activity, this means many users fail to get tested for HIV, getting treatment or care. 

Differences between people who use drugs and alcohol – when implementing prevention programs a number of things should be taken into consideration. Things like:

  • Location – urban or rural
  • Ability to get treatment for drug and alcohol abuse
  • Race, ethnicity, and gender
  • HIV testing and counseling
  • Socioeconomic and cultural issues

Health and social needs – those who use drugs often have other complex health and social needs, like the need for substance abuse and mental issues. 

Effects on HIV treatment – Many drug users aren’t willing to start antiviral treatment because of side effects or interrupting their drug use

What the CDC is doing

The CDC supports the circulation of information by health departments and community-based organizations around the country. These include:

  • Community promise
  • Safety counts
  • Shield