Understanding the Intersection of HIV and Substance Use Disorder

NIDA Director Dr. Nora Volkow and Johns Hopkins School of Public Health’s Dr. Chris Beyer discuss how understanding the intersection between HIV and drug use is essential to ending the HIV epidemic.

Video length: 3:01

Transcript

[Music]

Dr. Nora Volkow speaking:

HIV and drug use have been interlinked since the inception of the epidemic. And currently, 10% of all cases of HIV are driven by injection drug practices, which actually increase the risk of HIV through the contamination of injection and sharing of material used in order to inject. There’s also behavioral changes that happen when people take drugs that lead them to have much riskier behaviors that can result in infection. 

Dr. Chris Beyer speaking: 

When you look, the most recent UNAIDS report, for example, the 2020 report showed really for the first time that the majority of new infections worldwide are in the people we call key populations, people who inject drugs, men who have sex with men, transgender women who have sex with men, sex workers of all genders. These are prisoners and detainees. These are now the communities, the individuals for whom the HIV response has been insufficient.

Dr. Nora Volkow speaking:

So, therefore the importance of addressing drug use, including injection drug practices, as part of the strategies to prevent and take care of HIV globally.

Dr. Chris Beyer speaking: 

And of course, we have seen in our own country the terrible ravages of the opioid epidemic which has led in many places to a transition to injection drug use and again, to outbreaks of hepatitis C and outbreaks of HIV in places where we saw, for example, in Indiana, in Scott County famously, needle and syringe exchange was illegal, still illegal. Just extraordinary. A basic provision of a simple tool to help people reduce their risk of disease acquisition and transmission. 

Dr. Nora Volkow speaking:

One of the major problems that we face in the field of substance use disorder, including of course people who inject drugs, is that addiction is highly, highly stigmatized. People that take drugs are highly, highly stigmatized. And this stigmatization actually has two sides to it. The stigma leads to actually reluctance to provide the treatment and help to these individuals by a society that move towards criminalizing and putting them in prison or jail or just neglecting them.

Dr. Chris Beyer speaking:  

We have a very, very long way to go to improve our response for substance users, and we won't get control of the HIV pandemic if we can't.