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Substance Abuse

Injection Drug Use

In 2007, people infected with HIV through injection drug use (IDU) accounted for 9% of all HIV diagnoses (5,694 persons). Sharing needles and other equipment for drug injection is a well-known way to transmit HIV. People who have sex with an injection drug user are also at risk for infection through the sexual transmission of HIV.

Why does injecting drugs put you at risk for HIV?

Sharing drug equipment (or "works") is a major risk factor for spreading HIV. Infected blood can be introduced into drug solutions by:

• Using blood-contaminated syringes to prepare drugs
• Reusing bottle caps, spoons, or other containers ("spoons" and "cookers") used to dissolve drugs in water and to heat drug solutions
• Reusing small pieces of cotton or cigarette filters ("cottons") used to filter out particles that could block the needle
• Reusing water used to dissolve drugs or clean syringes

For more information, see CDC’s Why is injecting drugs a risk for HIV?

How can injection drug users reduce their risk for HIV infection?

The best way to reduce your risk of HIV is to stop injecting drugs—but here are some other things that will reduce your risk of getting HIV or transmitting it to others:

• Never reuse or "share" syringes, water, or drug preparation equipment.
• Only use syringes obtained from a reliable source (such as pharmacies or needle-exchange programs).
• Use a new, sterile syringe each time to prepare and inject drugs.
• If possible, use sterile water to prepare drugs—otherwise, use 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.
• Clean the injection site with a new alcohol swab before you inject.
• Safely dispose of syringes after one use.

For more information, see CDC’s How can injection drug users reduce their risk for HIV infection?

In recent years, new cases of IDU-related HIV infection have decreased, thanks to prevention programs aimed at substance users. Prevention measures work!

Other Drug-Related Risks for HIV

Methamphetamine ("meth") is a highly addictive stimulant drug that can increase sexual arousal while reducing inhibitions. It can also be injected. These factors put meth users at an increased risk of getting or transmitting HIV infection, both through sexual transmission and injection drug use.

Although meth use is an HIV risk factor for anyone who uses it, research suggests that there is a particularly 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
• Inject meth instead of smoking or snorting it

Alcohol and Other Drugs

The risk for HIV associated with substance abuse involves more than simply the sharing of drug injecting equipment. Use of drugs and alcohol can interfere with judgment about sexual and other behavior. As a result, substance users may be more likely to have unplanned and unprotected sex.