Substance Use and HIV Risk
How Can Using Drugs Put Me at Risk for Getting or Transmitting HIV?
Using drugs affects your brain, alters your judgment, and lowers your inhibitions. When you’re high, you may be more likely to make poor decisions that put you at risk for getting or transmitting HIV, such as having sex without a condom, have a hard time using a condom the right way every time you have sex, have more sexual partners, or use other drugs. These behaviors can increase your risk of exposure to HIV and other sexually transmitted diseases. Or, if you have HIV, they can increase your risk of spreading HIV to others.
And if you inject drugs, you are at risk for getting or transmitting HIV and hepatitis B and C if you share needles or equipment (or "works") used to prepare drugs, like cotton, cookers, and water. This is because the needles or works may have blood in them, and blood can carry HIV. You should not share needles or works for injecting silicone, hormones, or steroids for the same reason.
Here are some commonly used substances and their link to HIV risk:
- Alcohol. Excessive alcohol consumption, notably binge drinking, can be an important risk factor for HIV because it is linked to risky sexual behaviors and, among people living with HIV, can hurt treatment outcomes.
- Opioids. Opioids, a class of drugs that reduce pain, include both prescription drugs and heroin. They are associated with HIV risk behaviors such as needle sharing when infected and risky sexual behaviors, and have been linked to outbreaks of HIV and viral hepatitis. People who are addicted to opioids are also at risk of turning to other ways to get the drug, including trading sex for drugs or money, which increases HIV risk.
- Methamphetamine. “Meth” is linked to risky sexual behaviors, such as having more sexual partners or sex without a condom, that place people at greater risk for HIV and other sexually transmitted diseases. Meth acn be injected, which also increases HIV risk if people share needles and other injection equipment.
- Crack cocaine. Crack cocaine is a stimulant that can create a cycle in which people quickly exhaust their resources and may engage in behaviors to obtain the drug that increase their HV risk.
- Inhalants. Use of amyl nitrite (“poppers”) has long been linked to risky sexual behaviors, illegal drug use, and sexually transmitted diseases among gay and bisexual men.
Therapy, medicines, and other methods are available to help you stop or cut down on drinking or using drugs. Talk with a counselor, doctor, or other health care provider about options that might be right for you. To find a substance abuse treatment center near you, visit SAMHSA’s treatment locator or call 1-800-662-HELP (4357).
How Can You Prevent Getting or Transmitting HIV from Injection Drug Use?
Your risk is high for getting or transmitting HIV and hepatitis B and C if you share needles or equipment (or "works") used to prepare drugs, like cotton, cookers, and water. This is because the needles or works may have blood in them, and blood can carry HIV.
If you inject drugs, you are also at risk of getting HIV (and other sexually transmitted diseases) because you may be more likely to take risks with sex when you are high.
The best way to lower your chances of getting HIV is to stop injecting drugs. You may need help to stop or cut down using drugs, but there are many resources available to help you. To find a substance abuse treatment center near you, visit SAMHSA’s treatment locator or call 1-800-662-HELP (4357).
If you keep injecting drugs, here are some ways to lower your risk for getting HIV and other infections:
- Use only new, sterile needles and works each time you inject. Many communities have needle exchange programs where you can get new needles and works, and some pharmacies may sell needles without a prescription.
- Never share needles or works.
- Clean used needles with bleach only when you can’t get new ones. Bleaching a needle may reduce the risk of HIV but doesn’t eliminate it.
- Use sterile water to fix drugs.
- Clean your skin with a new alcohol swab before you inject.
- Be careful not to get someone else’s blood on your hands or your needle or works.
- Dispose of needles safely after one use. Use a sharps container, or keep used needles away from other people.
- Get tested for HIV at least once a year
- Ask your doctor about taking daily medicine to prevent HIV called pre-exposure prophylaxis (PrEP).
- If you think you’ve been exposed to HIV within the last 3 days, ask a health care provider about post-exposure prophylaxis (PEP) right away. PEP can prevent HIV, but it must be started within 72 hours.
- Don’t have sex if you’re high. If you do have sex, make sure to protect yourself and your partner by using a condom the right way every time or by using other effective methods.
What Are Syringe Services Programs?
Many communities have syringe services programs, also called syringe exchange programs or needle exchange programs. SSPs are places where injection drug users can get new needles and works, along with other services such as help with stopping substance abuse; testing and, if needed, linkage to treatment for HIV, hepatitis B, and hepatitis C; and education on what to do for an overdose. SSPs have been demonstrated to be an effective component of a comprehensive approach to prevent HIV and viral hepatitis among people who inject drugs, while not increasing illegal drug use.Find one near you.Exit Disclaimer
If you are living with HIV, substance use can be harmful to your brain and body and affect your ability to stick to your HIV treatment regimen. Learn about the health effects of alcohol and other substance use and how to access substance abuse treatment programs if you need them.