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This week we had Lisa Hinson, LCDC, NCAC, CAI, present on HIV and Intravenous Drug Use.
There is a higher risk of COVID 19 exposure in people who use IV drugs due to multiple factors.
• Unsanitary environments/poor hygiene
• Stigmatization
• Decreased access to services
• Challenges with social distancing and quarantine
• Incarceration
• Co-morbidities/HIV/Hepatitis/TB/Liver disease/infectious endocarditis
Some of the most common IV drugs used are heroin, methamphetamine, cocaine, and ketamine. In southern and western regions, there is a higher use of stimulants. In the Midwest and Northeast, they use heroin and other opioids primarily. The most commonly injected drugs in Texas are heroin, speedballs (heroin/cocaine), and cocaine.
IV drug use increases exposure to illness in a variety of ways. Needles & Syringes - Sharing or reusing needles and syringes can spread the Hepatitis C virus. Syringes with detachable needles increase this risk even more because they can retain more blood after being used than syringes with fixed needles. Preparation Equipment - Equipment, such as cookers, cottons, water, ties, and alcohol swabs, can quickly become contaminated during the drug preparation process. Fingers - Contact with infected blood can spread Hepatitis. Blood on fingers and hands can contaminate the injection site, cottons, cookers, ties, and swabs. And the last is Surfaces - Spreads when blood from an infected person contaminates a surface, and then that surface is reused by another person to prepare injection equipment.
With HIV and IV Drug Use, 1/10 new cases are attributed to injection drug use or M2M unprotected sex and injection drug use. Many don’t realize that HIV can survive in a used syringe for up to 42 days, depending on temperature and other factors. There is a 1/160 chance of transmitting HIV every time a person injects drugs.
When sharing needles, you risk contracting or transmitting HIV. According to the Centers for Disease Control and Prevention, injection drug use is the second leading cause of HIV infection for African American women and the third leading cause for African American men. Approximately 1 in 10 or 10% of HIV diagnoses among Hispanics/Latinos were attributed to injection drug use, including 3% of cases among MSM and IDU. White female IV drug users have the highest rate of HIV at 50%.
There are a few viral infections associated with IV drug use.
• HIV
• Hep A-D
• Co-Occurring Infections –
• HIV/Hepatitis
• Hepatitis/TB
• HIV/TB
• HIV/STI’s
• STI’s/Hep/TB
With HIV, many times, there are co-infections like syphilis, gonorrhea, and herpes. There are ways to protect yourself if you have an HIV-positive partner. Infection is less likely if the person with HIV is on a treatment called antiretroviral therapy (ART). ART can produce an undetectable viral load with virtually no risk to HIV-negative partner. They also encourage them to choose less risky sex activities and use a new condom for every act. Risk is also reduced with HIV-negative partners taking PreP consistently; this only works to prevent infection of HIV.
How to treat someone with HIV and Substance Use Disorder.
• Treat both concurrently
• Assessment /referral for SUD/MH treatment – most appropriate level of care to support HIV diagnosis
• Harm reduction/MAT/SSP’s (syringe services programs)
• 6 in Texas –Dallas, Houston, Waco, Austin, Ft. Worth, Abilene
• PEP – Post-exposure prophylaxis
• Medication after exposure within 72 hours. Must take for 28 days. Not ongoing, emergency use only.
• PrEP – Pre-exposure prophylaxis
• Not positive, but high risk. Blocks the HIV virus from entering the cell. One pill daily for 30 days. Strict adherence for the best outcome. Not guaranteed
For more information on Kemah Palms Recovery's program please call 866-604-1873 or visit https://www.kemahpalms.com/heroin-add...
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