HIV, Hepatitis C, and Abstinence from Alcohol Among Injection and Non-injection Drug Users

Abstract

Individuals using illicit drugs are at risk for heavy drinking and infection with human immunodeficiency virus (HIV) and/or hepatitis C virus (HCV). Despite medical consequences of drinking with HIV and/or HCV, whether drug users with these infections are less likely to drink is unclear. Using samples of drug users in treatment with lifetime injection use (n = 1309) and non-injection use (n = 1996) participating in a large, serial, cross-sectional study, we investigated the associations between HIV and HCV with abstinence from alcohol. About half of injection drug users (52.8 %) and 26.6 % of non-injection drug users abstained from alcohol. Among non-injection drug users, those with HIV were less likely to abstain [odds ratio (OR) 0.55; adjusted odds ratio (AOR) 0.58] while those with HCV were more likely to abstain (OR 1.46; AOR 1.34). In contrast, among injection drug users, neither HIV nor HCV was associated with drinking. However, exploratory analyses suggested that younger injection drug users with HIV or HCV were more likely to drink, whereas older injection drug users with HIV or HCV were more likely to abstain. In summary, individuals using drugs, especially non-injection users and those with HIV, are likely to drink. Age may modify the risk of drinking among injection drug users with HIV and HCV, a finding requiring replication. Alcohol intervention for HIV and HCV infected drug users is needed to prevent further harm.

The societal cost of heroin use disorder in the United States

“…[ 8 , 9 ] Additionally, heroin use, specifically via injection, is associated with several chronic infectious diseases—Hepatitis C (HCV), Hepatitis B (HBV), HIV-AIDS, and Tuberculosis (TB). [ 10 – 12 ] The treatment costs for these chronic conditions are substantial; for instance, HIV treatment is estimated to cost more than $300,000 over a lifetime. [ 13 ]…”

Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China

“…Finally, promoting needle and syringe programs among drug users should be considered to reduce transmission of blood-borne diseases, as this approach has proven to be an effective intervention in other countries 55 . This study indicates that intravenous drug injection is still the primary route of HCV transmission 56 , 57 for both poly-drug users and heroin-only users. Also, our research shows that drug users with lower income are more likely to be HCV-positive.…”

Substance use disorder treatment providers’ knowledge and opinions toward testing and treatment of chronic hepatitis C in rural North Carolina.

“…In fact, a greater number of clients are in need of effective treatment for alcohol, methamphetamine, and cocaine. Clients injecting other substances such as methamphetamine and using noninjection drugs (e.g., cocaine) are also at increased risk for HCV due to drug use paraphernalia (Elliott et al, 2016; Teles et al, 2018; Zule et al, 2016). Clients with alcohol use disorders require effective treatment to reduce the risk of alcoholic cirrhosis, liver-related deaths, and liver transplantations (National Institute on Alcohol Abuse and Alcoholism, 2020).…”