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Fact Sheets

HIV and Specific Populations

HIV and Drug and Alcohol Users

(Last updated 4/29/2016; last reviewed 4/29/2016)

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Key Points

  • Drug and alcohol use can increase the risk of getting or transmitting HIV infection. People using drugs or alcohol may have sex without a condom or share needles when injecting drugs. In the United States, HIV is spread mainly by having unprotected sex or sharing needles (or other drug injection equipment) with someone who is infected with HIV.
  • Drug and alcohol use can harm the health of a person with HIV. Specifically, drug and alcohol use can weaken the immune system and damage the liver.
  • If a person with HIV is using drugs or alcohol, it can be hard to focus on taking HIV medicines every day. Skipping HIV medicines allows HIV to multiply and damage the immune system.
  • Taking HIV medicines and recreational drugs such as marijuana, cocaine, or heroin together can be dangerous. Certain HIV medicines can increase the concentration of some drugs to dangerous levels in the body.

What is the connection between HIV and drug and alcohol use?

Drug and alcohol use is related to HIV in the following ways:

  • Use of alcohol and recreational drugs such as marijuana (weed, pot), cocaine, or heroin can increase the risk of getting or transmitting HIV infection.
  • Drug and alcohol use can harm the health of a person with HIV. Specifically, drug and alcohol use can weaken the immune system and damage the liver.

How does drug and alcohol use increase the risk of HIV infection?

Drugs and alcohol affect the brain, making it hard to think clearly. People using drugs or alcohol may make poor decisions and take risks.

Some risky behaviors can increase the risk of getting or transmitting HIV. For example, a person using drugs or alcohol may have sex without a condom or share needles when injecting drugs.

In the United States, HIV is spread mainly by having unprotected sex or sharing drug injection equipment with someone who is infected with HIV. (Unprotected sex is sex without using a condom.)

How can drug and alcohol use affect a person with HIV?

Drug and alcohol use can harm the health of a person with HIV in several ways.

Drugs and alcohol can weaken the immune system.
HIV damages the immune system, and further damage from drugs or alcohol can make it easier for HIV infection to advance to AIDS.

Drugs and alcohol can damage the liver and cause liver disease.
One of the main functions of the liver is to remove harmful substances (toxins) from the blood. Toxins are produced when the liver breaks down the chemicals we put in our body, including recreational drugs or alcohol.

Drug and alcohol use can damage the liver, making it work harder to remove toxins from the body. The buildup of toxins can weaken the body and lead to liver disease.

Some recreational drugs can interact with HIV medicines.
Taking HIV medicines and recreational drugs together can be dangerous. Certain HIV medicines can block the breakdown of some recreational drugs. In these cases, the recreational drug can increase to a dangerous level in the body.

Drug and alcohol use can make medication adherence harder.
Medication adherence means sticking firmly to an HIV regimen—taking HIV medicines every day and exactly as prescribed. If a person is using drugs or alcohol, it can be hard to focus and stick to an HIV regimen. Skipping HIV medicines allows HIV to multiply and damage the immune system.

If you do use drugs or drink alcohol, take the following steps to protect your health.

If you use drugs or alcohol:

  • Don’t have sex if you’re high.
  • If you do have sex, use a condom the right way every time. Read this fact sheet from the Centers for Disease Control and Prevention (CDC) on how to use condoms correctly.

If you drink alcohol:

  • Drink in moderation. Moderate drinking is up to 1 drink per day for women and up to 2 drinks per day for men. One drink is a bottle of beer, a glass of wine, or a shot of liquor.
  • Visit Rethinking Drinking, a website from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This website can help you evaluate your drinking habits and consider how alcohol may be affecting your health.

If you inject drugs:

  • Use only sterile needles and drug preparation equipment (“works”).
  • Never share needles and works.
  • Visit CDC’s webpage on HIV prevention for more information on how injection drug users can reduce the risk of getting or transmitting HIV.

Learn more about HIV and drug and alcohol use. This fact sheet is based on information from the following sources:

From CDC

From the Department of Veterans Affairs

From the National Institute on Drug Abuse (NIDA)

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