How Are Drug Use and HIV Related?
Drug use plays a big role in the spread of HIV.
- Injection drug use is a leading cause of HIV in the United States. If you inject drugs, you can get HIV from sharing used needles or other equipment (“works”) with an infected person. You can also then pass HIV to your sex and drug-using partners.
- Drinking alcohol or taking other drugs can also increase your risk for HIV. Being drunk or high affects your ability to make safe choices and lowers your inhibitions, leading you to take risks you are less likely to take when sober, such as having sex without a condom.
- Any kind of drug use can lead to HIV transmission when sex is traded for drugs or other high-risk behaviors take place while under the influence of drugs.
What Are the HIV Risks of Using Different Types of Drugs?
It’s important to know how different types of drugs can increase your risk of getting HIV or passing it to others.
Injection Drug Use
Drug Use and HIV Infection
According to the most recent CDC data (2008):
- Injection drug users represent 12% of annual new HIV infections in the United States.
- Injection drug users represent 19% of those living with HIV in the United States.
- Among males, 9% of diagnosed HIV infections were attributed to injection drug use and another 4% were attributed to male-to-male sexual contact and injection drug use.
- Among females, 15% of diagnosed HIV infections were attributed to injection drug use.
For more details, including analysis by race/ethnicity, gender and region of the country, see CDC’s HIV Surveillance in Injection Drug Users (through 2008).
In 2008 alone an estimated 4,444 Americans were infected with HIV by injecting drugs.
Sharing drug equipment (or "works") can expose you to HIV-infected blood. If you share works with someone who is HIV-positive, that person’s blood can stay on needles or spread to the drug solution. In that case, you can inject HIV directly into your body.
You can get HIV-infected blood into drug solutions by preparing drugs with:
- A used syringe
- Used bottle caps, spoons, or other containers ("cookers")
- Used pieces of filtering cotton or cigarette filters ("cottons")
- Water that was already used to dissolve drugs or clean syringes
If you are an injection drug user (IDU), you can also pass HIV to your sex partners.
For more information, see CDC’s Why Is Injecting Drugs a Risk for HIV?
Injecting Drug Users Are Also At-Risk of Hepatitis Infection
HIV infection isn’t the only risk: Injecting drugs is also the main way of becoming infected with the Hepatitis C virus (HCV). In fact, 50%-90% of HIV-infected injection drug users are also infected with Hepatitis C, a liver disease caused by HCV.
HCV infection sometimes results in an acute illness, but most often becomes a chronic condition that can lead to cirrhosis of the liver and liver cancer. HCV infection is more serious in HIV-infected persons. It leads to liver damage more quickly. Co-infection with HCV may also affect the treatment of HIV infection. Therefore, it’s important for people who inject drugs to know whether they are also infected with HCV and, if they aren’t, to take steps to prevent infection. To find out if you are infected, your doctor or other health care provider will have to test your blood to check for the virus. Hepatitis C can be treated successfully, even in HIV-infected persons.
Methamphetamine ("meth") is a very addictive stimulant that can be snorted, smoked, or injected. It has many street names including: crystal, tina, black beauties and more. View a list of more street names.
Meth can reduce your inhibitions and interfere with sound judgment regarding your behavior, which may make you less likely to protect yourself or others. This increases your risk of getting or transmitting HIV infection, both through sex and injection drug use.
Even though using meth is an HIV risk factor for anyone who does it, there is a strong link between meth use and HIV transmission for men who have sex with men (MSM). Studies show that MSM who use meth may increase their sexual AND drug-use risk factors. They may:
- Use condoms less often
- Have more sex partners
- Engage in unprotected anal sex—especially as the receptive partner (“instant bottom”)
- Inject meth instead of smoking or snorting it
Meth use can make the effects of HIV worse for people who already have HIV disease. Studies on animals suggest that meth makes HIV reproduce faster. Other studies show that when HIV-positive people used meth, they suffered more damage to their brain cells. Their ability to think was also more damaged than meth users who were HIV-negative.
Alcohol and Other Drugs
Using alcohol and “club drugs” like Ecstasy can alter your judgment and impair your decisions about sex or other drug use. You may be more likely to have unplanned and unprotected sex or use other drugs, including injection drugs or meth. Those behaviors can increase your risk of exposure to HIV. If you have HIV, this can also increase your risk of transmitting HIV to others.
If I Use Drugs, How Can I Reduce My Risk of HIV Infection?
If you are using drugs—injecting drugs, meth, alcohol or other drugs—the best way to reduce your risk of HIV is to stop using drugs. To find a drug treatment program near you, enter your ZIP code in the “Find HIV/AIDS Prevention & Service Providers” widget. You’ll then see a list of nearby substance abuse treatment providers who can assist and support you in your decision to take control. (If you have a web site to which you’d like to add this widget, visit this page for instructions on how to add the widget to your site.)
If you are injecting drugs and believe you cannot stop using yet, here are some other things that will reduce your risk of getting HIV or transmitting it to others:
- Never use or "share” syringes (needles), water, or drug preparation equipment that has already been used by someone else.
- Use a new, sterile syringe each time you prepare and inject drugs. You can get clean needles from pharmacies or syringe services programs (often also called needle-exchange programs).
- Only use syringes that come from a reliable source (e.g., pharmacies or syringe services programs).
- Use sterile water to prepare drugs, such as water that has been boiled for 5 minutes or clean water from a reliable source (such as fresh tap water).
- Use a new or disinfected container ("cooker") and a new filter ("cotton") each time you prepare drugs.
- Before you inject, clean the injection site with a new alcohol swab.
- Safely dispose of syringes after one use.
Also, if you engage in sexual activity, reduce your sexual risk factors for HIV infection.
Finally, the CDC also recommends that people who inject drugs get screened for HIV at least once every year.
In recent years, new cases of HIV infection resulting from injection drug use have decreased thanks to prevention programs for substance users.
For more information, see CDC’s How Can Injection Drug Users Reduce Their Risk for HIV Infection?
What If I Already Have HIV?
If you have HIV disease, you need to take care of yourself so that you do not develop AIDS. See AIDS.gov’s Staying Healthy With HIV/AIDS: Substance Abuse Issues for more information.
Fact Sheets & Print Materials
- SAMHSA -- Drugs Alcohol and HIV/AIDS—A Consumer’s Guide (also available in Chinese, Korean, Spanish and Vietnamese)
- CDC – Methamphetamine Use and Risk for HIV/AIDS
- CDC – Coinfection with HIV and Hepatitis C Virus
- NIDA – NIH -- NIDA InfoFacts: Drug Abuse and the link to HIV/AIDS and Other Infectious Diseases
- Center for AIDS Prevention Studies – What Are Injection Drug Users’ (IDU) HIV Prevention Needs? (PDF)
- Center for AIDS Prevention Studies – How does methamphetamine use affect HIV prevention?
Related Topics on AIDS.gov
Frequently Asked Questions
Can I get HIV from sharing needles or drug equipment?
Yes. Used needles and equipment (or “works”) can have HIV-infected blood on or inside them. If they do, you put that blood—and possibly HIV—directly into your body when you use them to inject or prepare your drugs. Only sterile equipment carries no risk of HIV contamination. If you inject drugs (including steroids, insulin, etc.), don’t share used needles or equipment with anyone.
Where can I go to find treatment or rehab?
If you’re ready to quit or need help, you can use the HIV/AIDS Prevention and Services Locator, which provides information on places you can find help to quit using drugs (as well as information on HIV testing and other services). For other resources, use SAMHSA’s Substance Abuse and Mental Health Treatment Resources page.
If I’m not ready to quit, how can I protect myself from HIV?
Quitting or getting into rehab is the best way to reduce your drug-related risk of getting HIV. But if you’re not ready to quit, you can at least protect yourself and others from HIV and other diseases by using clean equipment. Syringe services programs let you turn in your dirty needles and equipment for clean ones. They can also give you information on where you can get help to quit drugs.
To find a needle exchange or syringe services program near you, use the Harm Reduction Coalition’s Interactive Harm Reduction Resources Locator. Even though some service organizations provide syringe services, it may not be legal in a particular jurisdiction so be sure to check before participating in the program.
Do syringe services programs increase drug use?
No. National and international studies show that syringe services programs do not increase drug use. The research also shows that syringe services programs are very effective in decreasing blood-borne illnesses (like HIV and hepatitis) among IDUs when they are included as part of medical and substance abuse treatment and prevention services. Syringe services programs protect IDU’s sexual partners or children, who could otherwise be at risk for HIV infection. These programs also serve as important doorways to health information, treatment, and rehab. Because of the overwhelming evidence that they do not increase drug use and because of their clear effectiveness in decreasing HIV and other diseases, Congress voted to lift the ban on Federal funding for syringe services programs in December 2009.
- NIH – NIDA – drugs + HIV > learn the link
- CDC – HIV Surveillance in Injection Drug Users (through 2008)
- CDC NPIN – HIV and IDU Resource Collection
- NIH – NIDA -- Linked Epidemics: Drug Abuse and HIV/AIDS
- NIH – NIDA -- Research Report Series - HIV/AIDS
- CDC – Department Of Health And Human Services Implementation Guidance For Syringe Services Programs, June 2010 (PDF)
- SAMHSA -- Substance Abuse Treatment for Persons with HIV/AIDS
- New York State Department of Health AIDS Institute – HIV And Substance Use Guidelines
- World Health Organization – Policy Guidelines For Collaborative TB And HIV Services For Injecting Or Other Drug Users, Technical Paper (PDF)
- World Health Organization – Policy Guidelines For Collaborative TB And HIV Services For Injecting Or Other Drug Users, Policy Brief (PDF)
Last revised: 06/20/2011