Meeting Reviews Roles of Drug Abuse and Risky Behavior in HIV
More than 400 researchers and clinicians gathered in Bethesda,
Maryland, May 8-9 to discuss the impact of drug abuse on the spread
of HIV. NIDA sponsored the meeting in collaboration with other
National Institutes of Health agencies and the Centers for Disease
Control and Prevention.
Drug and alcohol abuse can prompt poor judgment and actions
that people might not engage in otherwise, for example, risky sexual
behaviors with infected partners. Drug abuse also may increase HIV
transmission when abusers trade sex for drugs or money. The
increased risk of HIV related to drug abuse extends beyond the sharing
of drug injection equipment to include such risky behaviors.
Dr. Igor Grant of the University of California, San Diego,
addressed methamphetamine abuse and HIV. The drug and the
infection each cause degenerative brain disease. They may damage
neural tissue through a common biological pathway—for example,
enhanced inflammatory responses—but also seem to generate
distinct pathologies that may combine to exacerbate each other.
The resulting cognitive impairments may explain why methamphetamine
abuse reduces adherence to HIV medications, that, in
turn, may facilitate HIV transmission.
Dr. Jonathan M. Ellen of the Johns Hopkins University School
of Medicine linked marijuana abuse with risky sexual behavior
among African-American youth in San Francisco. Another study
indicated that HIV-infected young women who abuse marijuana are
less likely to keep medical appointments.
Dr. Richard A. Rawson of the University of California, Los
Angeles, reported preliminary results suggesting that addiction
treatment reduced risky sexual behaviors among methamphetamine
abusers—adding to similar findings among
methamphetamine-abusing men who have sex with men (see
"Treatment Curbs Methamphetamine Abuse Among Gay and
Bisexual Men"). Similarly, Dr. Kenzie L.
Preston of NIDA's Intramural Research Program reported that
adding behavioral therapy to methadone maintenance treatment
can reduce risky behaviors among outpatients addicted to heroin
and cocaine.
NIDA-funded research on the link between drug abuse and HIV
infection extends to the international community. Dr. Steffanie A.
Strathdee, an infectious disease epidemiologist at the University of
California, San Diego, reported that HIV infection among injection
drug users has risen sharply in many countries—including the
Ukraine, the Russian Federation, Vietnam, Iran, and China—with
emerging epidemics in other nations. Interventions that reduce
risky behaviors among populations that interact with both high- and
low-risk individuals (for example, prisoners, non-injecting drug
users, and sex workers who inject drugs) are important
opportunities for HIV prevention.
Participants also discussed the disproportionate burden of
HIV/AIDS among people in prisons and jails and the importance
of interventions in such settings. Improved technology now allows
for faster HIV testing, and expanded testing and counseling are key
components of prevention strategies for drug abusers and other
groups.
Adolescent Inhalant Use Is Stable Overall, but Rising Among Girls
Almost 5 percent of girls between the ages of 12 and 17 used an
inhalant to get high in 2005, an increase from 4.1 percent in 2002,
according to a new report. Overall, inhalant use by boys and girls in
this age group remained stable over the 4-year period, at an average
annual rate of 4.5 percent, or an estimated 1.1 million adolescents.
The report, "Patterns and Trends in Inhalant Use by Adolescent
Males and Females: 2002-2005," is based on an analysis of the 2002-2005 National Household Survey on Drug Use and Health, an
annual survey sponsored by the Substance Abuse and Mental
Health Services Administration (SAMHSA). SAMHSA, NIDA, and
other federal agencies released the report at a March 15 press conference
to kick off the 15th National Inhalants and Poisons Awareness
Week, March 18-25.
"Young people who turn to inhalants may be completely
unaware of the serious health risks," said NIDA Deputy Director Dr.
Timothy P. Condon. "We know that inhalant abuse can start early,
with research suggesting that even preadolescent children seek
them out because they are easy to obtain. NIDA research also
indicates that those who begin using inhalants at an early age are
more likely to become dependent on them—and long-term inhalant
abusers are among the most difficult drug abuse patients to treat."
The report is available at http://www.drugabusestatistics.samhsa.gov/2k7/inhalants/inhalants.pdf.
Volume 21, Number 4 (October 2007)
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