Identifying the Links Between Hiv, Hepatitis and Substance Misuse.

The risk of HIV or hepatitis infection is linked to drug injecting, as opposed to the abuse of a specific drug. The route of administration is relevant not only to acute toxicity but also to ???secondary??? harms. The spread of blood borne viruses such as hepatitis and HIV, have huge health implications for the individual and society.
The role that non injection drug abuse plays in the spread of HIV is less recognized. This is partly due to the addictive and intoxicating effects of many drugs, which can alter judgement and inhibition and lead people to engage in impulsive and unsafe behaviours.
The illegal nature of injection drug use can also create barriers to accessing adequate treatment and prevention services making them more vulnerable to HIV and its effects.
Infected blood can be drawn up into a syringe and then get injected along with the drug by the next user of the syringe. This is the easiest way to transmit HIV during drug use because infected blood goes directly into someone??™s bloodstream.
Biological effects of drugs. Drug abuse and addiction can affect a persons overall health, thereby altering susceptibility to HIV and progression of AIDS. Drugs of abuse and HIV both affect the brain. Research has shown that HIV causes greater injury to cells in the brain and cognitive impairment among methamphetamine abusers than among HIV patients who do not abuse drugs. In animal studies, methamphetamine has been shown to increase the amount of HIV in brain cells
Generally there is a greater prevalence of certain illnesses amongst the drug-misusing population, including viral hepatitis, bacterial endocarditis, HIV, tuberculosis, septicemia, pneumonia, deep vein thrombosis, pulmonary embolism, abscesses and dental disease. Injecting drug misuse carries the greatest risk of infection, particularly when equipment is shared or inadequately cleaned. Dirty and unhygienic injecting habits can result in local or systemic infections and poor injecting technique can cause venous or arterial thrombosis. Some drug users inject subcutaneously (???skin-popping??™) and some intramuscularly, but the most favoured route is intravenous, with the associated increased risk of overdose.
Hepatitis B is transmitted parentally and sexually. Transmission most commonly occurs following vaginal or anal intercourse or as the result of blood to blood contact, including sharing blood contaminated needles and other injecting equipment by IV drug use, or by parental transmission from mother to child.
The hepatitis C virus was first identified in 1989. Now that infections resulting from the transfusion of blood and blood products have largely been eliminated, the commonest route of transmission of hepatitis C in the UK is by sharing blood-contaminated needles or injecting equipment during IV drug use.

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