Are people who abuse methamphetamine at risk for contracting HIV/AIDS and hepatitis B and C?
Methamphetamine abuse raises the risk of contracting or transmitting HIV and hepatitis B and C—not only for individuals who inject the drug but also for noninjecting methamphetamine abusers. Among injecting drug users, HIV and other infectious diseases are spread primarily through the re-use or sharing of contaminated syringes, needles, or related paraphernalia. But regardless of how methamphetamine is taken, its intoxicating effects can alter judgment and inhibition and lead people to engage in unsafe behaviors like unprotected sex.
Methamphetamine abuse is associated with a culture of risky sexual behavior, both among men who have sex with men and in heterosexual populations, a link that may be attributed to the fact that methamphetamine and related stimulants can increase libido. (Although paradoxically, long-term methamphetamine abuse may be associated with decreased sexual functioning, at least in men.) The combination of injection practices and sexual risk-taking may result in HIV becoming a greater problem among methamphetamine abusers than among other drug abusers, and some epidemiologic reports are already showing this trend. For example, while the link between HIV infection and methamphetamine abuse has not yet been established for heterosexuals, data show an association between methamphetamine abuse and the spread of HIV among men who have sex with men.
Methamphetamine abuse may also worsen the progression of HIV disease and its consequences. In animal studies, methamphetamine has been shown to increase viral replication. Clinical studies in humans suggest that current methamphetamine users taking highly active antiretroviral therapy (HAART) to treat HIV may be at greater risk of developing AIDS than non-users, possibly as a result of poor medication adherence. Methamphetamine abusers with HIV also have shown greater neuronal injury and cognitive impairment due to HIV, compared with those who do not abuse the drug.
NIDA-funded research has found that, through drug abuse treatment, prevention, and community-based outreach programs, drug abusers can change their HIV risk behaviors. Drug abuse and drug-related risk behaviors, such as needle sharing and unsafe sexual practices, can be reduced significantly, thus decreasing the risk of exposure to HIV and other infectious diseases. Therefore, drug abuse treatment is HIV prevention.
Dopamine PathwaysIn the brain, dopamine plays an important role in the regulation of reward and movement. As a major chemical messenger in the reward pathway, dopamine is manufactured in nerve cell bodies located within a group of neurons called the ventral tegmental area and is released in the nucleus accumbens, sometimes called the “pleasure center” because of its role in producing rewarding feelings, as well as in the prefrontal cortex, which is responsible for higher cognitive functions like decision-making and selfcontrol. Dopamine’s regulation of motor functions is linked to a separate pathway: Cell bodies in the substantia nigra manufacture and release dopamine into the striatum, which is involved in executing and inhibiting movements and reward-seeking behavior.
This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.