HIV and Substance Use in Latin America: A Scoping Review

Abstract

This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.

Quality of Life in Drug-dependent Adults: a systematic review

“…(7) Por otra parte, en relación a Latino américa se estima entre el 0,4 % y 3,9 % se obtiene conocimiento que estas cifras están en aumento. (8) Dentro de las sustancias de mayor consumo engloba el alcohol, cafeína, cannabis, alucinógenos, inhalantes, opioides, hipnóticos, sedantes, tabacos y estimulantes. (9) Además, representa un conflicto de interés a nivel económico, político, social e igualmente dentro de los factores más predisponentes para que se desencadene esta problemática son los efectos psicosociales, los mismo que engloban, desde enfermedades con alteraciones a nivel molecular y celular, accidentes o situaciones relacionadas a su entorno familiar.…”

Promoting HIV care continuum outcomes among people who use drugs and alcohol: A systematic review of randomized trials published from 2011 to 2021

“…Substance use remains a robust predictor of HIV infection across resource-diverse contexts and settings (Allen, Myers, & Ray, 2015; Huff et al, 2022; Rumbwere Dube, Marshall, Ryan, & Omonijo, 2018; Shuper et al, 2010). Specifically, a recent systematic review found that injecting drugs, smoking crack-cocaine, and binge-drinking (as well as similar behaviors by one’s partner) predicted HIV infection among adults in high-income countries (Rumbwere Dube et al, 2018), while separate reviews similarly reported that injecting drugs and using stimulants (such as methamphetamines) contributed to HIV burden in lower-resource environments (El-Bassel, Shaw, Dasgupta, & Strathdee, 2014).…”

“…Specifically, a recent systematic review found that injecting drugs, smoking crack-cocaine, and binge-drinking (as well as similar behaviors by one’s partner) predicted HIV infection among adults in high-income countries (Rumbwere Dube et al, 2018), while separate reviews similarly reported that injecting drugs and using stimulants (such as methamphetamines) contributed to HIV burden in lower-resource environments (El-Bassel, Shaw, Dasgupta, & Strathdee, 2014). Pathways linking substance use to HIV infection include direct routes, such as needle sharing among people who inject drugs, and indirect routes, through behavioral disinhibition (e.g., through heavy alcohol use or stimulant use) in the form of condomless sex (El-Bassel et al, 2014; Heath, Lanoye, & Maisto, 2012; Huff et al, 2022; Rehm, Probst, Shield, & Shuper, 2017; Sandfort et al, 2017; Vosburgh, Mansergh, Sullivan, & Purcell, 2012).…”

“…Among people living with HIV (PLHIV), substance use has also been shown to impede progress at multiple stages of the HIV care continuum, from late HIV diagnosis to treatment failure (Huff et al, 2022), accelerating HIV disease progression (Carrico, 2011). For example, engaging in heavy alcohol use – harmful or hazardous alcohol use, binge-drinking, or levels of drinking that are consistent with those seen in alcohol use disorders – has been shown to hamper uptake/initiation of antiretroviral therapy (ART), decrease ART adherence and CD4 cell count, increase viral load, and overall accelerate HIV disease symptom onset (Azar, Springer, Meyer, & Altice, 2010; Molina, Simon, Amedee, Welsh, & Ferguson, 2018; Rehm et al, 2017; Shuper et al, 2010).…”

SEROPREVALENCE OF HBsAg, Anti-HBs, Anti-HCV, and Anti-HIV IN PATIENTS WITH ALCOHOL AND SUBSTANCE ABUSE IN AN AMATEM CLINIC IN EASTERN TURKIYE: A SIX-YEAR RETROSPECTIVE EVALUATION

“…It is estimated that 1 in 8 substance users lives with HIV, and that this number is 1.4 million people worldwide. HIV infection is 22 times more common in those with intravenous substance use compared to the general population (4). National Institute on Drug Abuse (NIDA) considers drug addiction and HIV to be intertwined epidemics, and emphasizes the close connection between substance addiction and hepatitis (NIDA, 2013) (1).…”