INJECTION DRUG USERS HIV

HIV in injection drug users
The use of intravenous drugs plays a major role in the acquisition and transmission of HIV.8 In the United States, the proportion of HIV cases directly attributable to intravenous drug use is estimated at 50 percent, and HIV seroprevalence rates in injection drug users range from 10 to 65 percent.

The proportion of HIV cases caused by intravenous drug use increased from 17 to 27 percent from the 1980s to the early 1990s, thought to be largely a result of increasing use of intravenous cocaine. In addition to widespread needle sharing, cocaine's highly addictive properties and short duration of effect encourage frequent injections.

The prevalence of HIV in injection drug users has expanded the spectrum of diseases associated with intravenous drug use to include those typically associated with HIV infection. While AIDS-defining illnesses in intravenous drug users are similar in spectrum to those in nonintravenous drug users, the distribution of such diseases appears to be different.

injection drug users have proportionately more cryptococcal disease, Pneumocystis carinii pneumonia, tuberculosis, and wasting syndrome, and significantly less cytomegalovirus (CMV) infection, non-Hodgkin lymphoma, and Kaposi sarcoma.

Overall, injection drug users generally have a less complicated course than do homosexual HIV patients. However, this advantage is lost by unnecessary complications caused by their psychiatric disorders, noncompliance, and concealment of signs of disease, all of which lead to worse outcomes from infections.