skip to content

HIV and Specific Populations

  • Table of Contents  Table of Contents

Need Help?

  • Call 1-800-448-0440
  • (1 p.m. to 4 p.m. ET)
  • Send us an email

HIV and Drug and Alcohol Users

Last Reviewed: April 17, 2017

Key Points

  • Drug and alcohol use can lead to risky behaviors that increase the chances of getting or transmitting HIV infection. For example, a person using drugs or alcohol may have unprotected sex (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.
  • People with HIV take a combination of HIV medicines (called an HIV regimen) every day to stay healthy. Drug or alcohol use can make it hard to focus and stick to a daily HIV regimen. Skipping HIV medicines allows HIV to multiply and damage the immune system.
  • Drug interactions between HIV medicines and recreational drugs such as marijuana, cocaine, or heroin can increase the risk of dangerous side effects.

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 can lead to risky behaviors that increase the chances of getting or transmitting HIV infection. Recreational drugs include injection and noninjection drugs such as heroin, cocaine, and marijuana (weed, pot).
  • 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 (unprotected sex) 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.

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, making it harder for the body to fight infections and certain cancers. Drug or alcohol use can further damage the immune system and cause HIV infection to worsen.

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.
Drug interactions between HIV medicines and recreational drugs can increase the risk of dangerous side effects. For example, overdoses due to interactions between HIV medicines and drugs such as ecstasy (MDMA) or GHB have been reported.

Drug and alcohol use can make it hard to take HIV medicines every day.
People with HIV take a combination of HIV medicines (called an HIV regimen) every day to stay healthy. Drug or alcohol use can make it hard to focus and stick to a daily HIV regimen. Skipping HIV medicines allows HIV to multiply and damage the immune system.

If you 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.
  • Use a condom every time you have sex. 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 12-oz bottle of beer, a 5-oz 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 Health and Human Services:

From the Department of Veterans Affairs:

From the National Institute on Drug Abuse (NIDA):

Need Help?

  • Call 1-800-448-0440
  • (1 p.m. to 4 p.m. ET)
  • Send us an email