Addiction And HIV/AIDS

How Does Substance Use Increase The Risk Of HIV Transmission?

Human immunodeficiency virus (HIV) is contracted through infected bodily fluids such as blood, semen, vaginal fluid, and breast milk. In the US, HIV is primarily spread by sharing needles with someone who has HIV or having unprotected sexual intercourse with someone who has HIV.

Substance misuse directly increases the risk of HIV transmission by increasing the risk of dangerous behaviors like needle sharing and impaired decision-making while under the influence.

• Sharing needles and other equipment to inject drugs increases the risk of contracting HIV. Sharing needles is particularly common among people who use meth and heroin.
• Drinking and using drugs can impair clear thinking and decision-making, resulting in uninhibited behaviors such as unprotected sex with partners who could be carrying HIV.
• Being under the influence of drugs or alcohol increases the risk of needle sharing when using intravenous drugs, which increases the risk of contracting HIV.
• People who use drugs are more likely to trade sex, especially unprotected sex, for drugs or money to buy drugs, increasing their risk of contracting HIV.
• Substance abuse can cause financial strain and homelessness, often affecting minority populations. Living in impoverished areas makes it more difficult or impossible to access medical services or harm reduction services, such as needle exchange services, increasing the vulnerability to HIV.

How Does Addiction Affect Someone With HIV?

Weakened Immune System

HIV enters the blood and directly weakens the immune system by destroying white blood cells (CD4 T helper cells) that fight off infections, making people more at risk for opportunistic infections that can lead to serious illness and death.

Substance abuse also weakens the immune system by damaging immune cells, such as killing white blood cells and damaging tissues (i.e., alcohol damages liver tissue, snorting cocaine damages nasal tissue, smoking destroys lung tissue). When tissue is damaged by drug use, the immune system has to work to repair it. But when immune-fighting white blood cells are destroyed by HIV and other drugs, the immune system struggles to repair these tissues, putting people at risk of infections and illnesses.

People struggling with addiction often have poor nutritional habits, unhealthy sleep patterns, and chronic stress, which can also weaken their immune system.

Organ Damage

When an individual has HIV and is using drugs and alcohol, their immune system is taking on more damage caused by the substances and is working overtime to try to repair every organ system in the body, particularly the liver.

The liver’s job is to process and break down drugs and other toxins that enter the body. HIV medications also rely on the liver for metabolism. Therefore, when someone takes them together, the resulting overload on the liver can directly damage liver tissue. When the liver is damaged, it cannot metabolize HIV medications properly.

As a result, these medications may become less effective or start to build up in the body, worsening liver damage and reducing the drugs’ effectiveness. In these situations, healthcare providers may need to adjust the dose or switch medications.

Disrupted Medication Adherence

When a person who has HIV is under the influence of drugs or alcohol or is struggling with an addiction, they are at an increased risk of not taking their HIV medication as prescribed, or they may miss a dosage because of their impaired judgment and decision-making skills.

They may miss follow-up doctor’s appointments, may not pick up their medication refills, or may abandon their health and HIV diagnosis altogether, worsening their immune system and increasing the likelihood of opportunistic infections.

How To Reduce The Risk Of HIV

Reducing the risk of HIV means understanding the risk factors associated with the disease.

Since unprotected sex and intravenous drug use are the primary ways HIV is spread, it is important to practice safe sex and avoid any intravenous drug use. Additionally, a person should:

• Always wear a condom during sexual intercourse
• Be aware of a partner’s HIV status
• Educate themselves on HIV transmission
• Get tested regularly
• Avoid intravenous drug use altogether
• Never share needles, and always use a clean, sterile needle
• Research needle exchange programs, harm reduction programs that allow users to dispose of their used needles and receive new, sterile needles

Additionally, there are medications to help reduce the risk of HIV transmission, including:

Pre-exposure prophylaxis (PrEP): PrEP is a daily pill taken by people who are HIV-negative but at risk of contracting the virus, such as those with an HIV-positive partner, individuals who have unprotected sex, sex workers, or intravenous drug users, as it can drastically reduce the risk of HIV transmission.

Post-Exposure Prophylaxis (PEP): PEP is an emergency medication that is taken for 28 days and within 72 hours after a potential exposure to HIV to prevent infection.

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How Does HIV/AIDS Develop?

HIV enters the bloodstream, specifically targets, and infects CD4 cells — specifically CD4 T cells — which are white blood cells that protect the immune system by fighting off infections.

Once inside a CD4 cell, HIV uses its components to replicate, kill the CD4 cell, and enter the bloodstream to infect another CD4 cell. The virus continues to replicate, producing thousands of variants while destroying CD4 cells and further weakening the immune system. As the HIV viral load increases, the CD4 population decreases, and acquired immunodeficiency syndrome (AIDS) develops once the CD4 cells drop below 200 per microliter of blood.

AIDS is the final stage of HIV infection, although not everyone with HIV develops AIDS. Some opportunistic infections are considered AIDS-defining conditions, which are specific illnesses and infections that signal a person’s HIV has advanced to AIDS. These conditions take advantage of the body’s weakened immune system.

Some of these opportunistic infections include:

• Tuberculosis
• Toxoplasmosis
• Pneumocystis pneumonia (PCP)
• Fungal infections, like thrush
• ​​Herpes simplex virus 1 (HSV-1) infection

While singularly experiencing these conditions does not mean a person has AIDS, if someone with HIV develops one of these conditions, they are diagnosed with AIDS regardless of the CD4 count.

What Are The Symptoms Of HIV?

Symptoms of HIV vary depending on the individual and the stage of the disease. The only way to accurately determine an HIV diagnosis is through testing.

Not all individuals will experience the same symptoms. Some people will develop a flu-like illness within 2-4 weeks after infection. Others, however, will show no symptoms at all.

Symptoms of HIV may include:

• Fever
• Chills
• Night sweats
• Muscle aches
• Sore throat
• Fatigue
• Swollen lymph nodes
• Mouth ulcers

These symptoms can last anywhere from a few days to several weeks. During the early stage of HIV infection, the virus may not show up on a test; individuals are still highly contagious during this time, however.

If an individual is concerned that they may have been exposed to HIV, the best action to take is to get tested. Most HIV tests detect antibodies, proteins the body makes in response to HIV infection. It may take a few weeks for the body to produce the antibodies that HIV tests detect. Most often, people are encouraged to test three months after possible infection to be certain of the results.

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Addiction Treatment For People With HIV Or AIDS

Despite an increase in awareness of and treatment options for HIV, many people still feel there is a stigma around the disease. Fortunately, many addiction counselors have experience and training in helping people cope and heal after receiving a positive test result. It’s important to find a knowledgeable and compassionate therapist who understands the nuances of the experience and who can help provide peace and recovery.

If you have HIV, it’s important to understand the role drug abuse or addiction plays in the progression of the disease. Addiction treatment programs can help get you on the path to sobriety so that you can live a healthy lifestyle. By utilizing treatment medication, therapy, and relapse prevention techniques, you can have the highest chance of decreasing HIV’s progression and living a full, healthy life.

To find an addiction treatment center near you and explore your rehab options, visit our rehab directory or contact a treatment provider today.