The Relationship Between HIV and Drug Abuse


Christopher Iliades, MD

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pills and needles

Living with HIV is challenging enough for a woman. If you also struggle with drug abuse, it can interfere with your treatment, make your HIV worse, and increase the chances of passing HIV to others.

How do you know if you have a drug abuse problem? You're abusing a drug if you use it excessively and often, to the point that you put yourself in danger. If you have legal problems, relationship problems, or health problems because of drug use, you may have a drug abuse problem.

Alcohol abuse is considered a form of drug abuse. In fact, alcohol is the most frequently abused drug in the United States.

How Drug Abuse Increases Your Risk for HIV

You can put yourself at risk in two ways. If you inject drugs, you can get HIV by sharing needles. Also, drug use can cause you to make bad decisions like not using a condom or having sex with someone you don’t know. All of these actions can put you at risk for an HIV infection.

Consider these facts about HIV risk and drug abuse:

  • 84% of women get HIV from risky sex with an HIV-infected man.

  • 15% of women get HIV from injecting drugs.

  • If you abuse drugs, you are more likely to trade sex for drugs, which is an HIV risk.

How Drug Abuse Makes HIV Worse

If you have HIV and are injecting drugs or having risky sex because of drug abuse, you can pass on HIV to others. Drug abuse also makes HIV worse for you. Here’s why:

  • Drug abuse makes HIV symptoms worse.

  • People who abuse alcohol, are nine times less likely to follow through on HIV treatment than someone who does not abuse alcohol.

  • People who inject drugs are at higher risk of getting the liver infection hepatitis C. Hepatitis C makes it harder to treat HIV.

  • Alcohol abuse and other drugs can cause HIV to multiply more quickly in your body, increasing your viral load. Alcohol also can worsen the side effects that HIV medications already have on your liver.

How to Protect Yourself

The first and most important step is to get help for drug or alcohol abuse. Talk to your medical team and ask for a referral to a treatment program.

Here are some other things you can do:

  • Remember that drug abuse affects your judgment and increases risky sexual behavior.

  • If you do inject drugs, never share needles.

  • Protect yourself from other infections. Know how to use a condom safely. Insist on condom use any time you're in doubt about your risk for other sexually transmitted diseases.

Key Takeaways

  • Drug abuse increases your risk for complications from HIV.

  • If you have HIV and use drugs, you are less likely to get well.

  • Treatment for drug abuse improves your HIV treatment outcome.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Jan 8, 2016

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View Sources

Medical References

  1. Women and HIV/AIDS in the United States. Kaiser Family Foundation
  2. Alcohol and HIV/AIDS: Intertwining Stories. National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism.
  3. How Are Drug Use and HIV Related?
  4. HIV Among Women. Centers for Disease Control and Prevention.
  5. DrugFacts: HIV/AIDS and Drug Abuse: Intertwined Epidemics. National Institutes of Health. National Institute on Drug Abuse.
  6. Addiction in women. Harvard Health Publications.
  7. Alcohol and substance abuse and HIV risk.

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