Substance abuse and HIV: A risky business.

The dangers and risks associated with substance abuse and their link to HIV.

Substance abuse and HIV: A risky business.

HIV and substance abuse have been very closely linked

Since HIV was discovered, HIV transmission and substance abuse have been closely linked. HIV used to be associated with injecting drug users and promiscuous behaviour prevalent amongst substance abusers. In the USA alone, injection drug use is responsible for approximately 10% of new HIV infections every year.

Transmission and risky behaviour

As an HIV-positive individual when you inject drugs and share the drug equipment with HIV-negative people you can infect them with HIV. Your blood might stay on the needles or spread in the drug mixture, meaning that the next user could inject the virus straight into their bloodstream.

In addition, the use of alcohol, including binge drinking  and the  non-medical use of drugs  such as methamphetamine, crack cocaine and “club drugs “such as ecstasy can significantly increase the likelihood that you will engage in risky behaviours. This can increase your risk of transmitting the virus or getting a sexually transmitted infection. This could weaken your immune system and make it harder to be treated.

Poor response to treatment

Substance abuse can in some cases result in speeding up the progression of the virus in your body.  Some substances like methamphetamine (meth) can decrease your CD4 levels. Drugs and alcohol can also inhibit your memory and ability to make good judgement calls and sound decisions, rendering you at risk of compromising your daily treatment routine. If you don’t consistently take your medication, this interruption in routine may result in your body building a resistance to the ARV drugs. Skipping a dose of ARVs is not optional, even occasionally, as this gives HIV the opportunity to multiply in your body.

Hepatitis C and TB

Hepatitis C is a leading cause of liver disease and cancer, and can be caused by some injectable drugs. Due to a weakened immune system this condition, like many others, progresses even faster in HIV-positive people. Tuberculosis (TB) remains the leading cause of death amongst HIV-positive individuals. This is why the Centre for Disease Control (CDC) recommends TB screening for all people living with the virus. This condition can be made worse by substance abuse as it further weakens the immune system and exposes you to risks associated with opportunistic infections.

The importance of treatment for drug and alcohol use

Substance abuse treatment and rehabilitation programs (rehab) are easier to access these days than ever before. If you are living with HIV and are battling substance abuse getting assistance with this can be just as important as your ARV treatment regime. Continued substance abuse may result in non-adherence to your HIV medication or it not working as it should.

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HIV and smoking

We have all seen the cancer warnings on tobacco products. Smoking continues to be one of the leading causes of many cancers and respiratory disorders. Research by the CDC has indicated that the rate of smoking is 2 to 3 times higher among HIV-positive people as opposed to their HIV-negative counterparts. HIV-positive smokers are more likely to suffer from these conditions:

  • Oral thrush (a mouth infection, also called oral candidiasis).
  • Hairy leukoplakia (white mouth sores).
  • Bacterial pneumonia.
  • Pneumocystis pneumonia (a dangerous lung infection).
  • Heart disease and stroke.
  • Lung cancer, head and neck cancer, cervical cancer, and anal cancer.

Research has also shown that smoking daily reduces the effects of antiretroviral therapy by up to 40%. Passive or second-hand smoking is also harmful to your blood vessels and can increase your risk for heart disease.  Even if you don’t smoke, but surround yourself with smokers, this can be harmful to your health.

Benefits of quitting

Quitting smoking has many major health benefits for everyone. Get the right help from the right people to start your no smoking journey. 

Where to find help

If you or a loved one needs help with Drug addiction you may contact:

083 900 6962

For assistance with Alcohol addiction contact:

011 683 9101

For assistance to quit smoking contact:

011-720 3145 / 0800 22 66 22


Helleberg M, May MT, Ingle SM, et al. Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America. AIDS. 2015;29:221-229

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