header_n.gif (7845 bytes)

  Fact Sheet
20
HIV and Substance Abuse

This Fact Sheet explores issues surrounding HIV/AIDS and substance use and abuse, including issues specific to women, Aboriginal peoples and prison populations, and some strategies and recommendations for controlling the spread of HIV/AIDS through IDU.

Fact Sheet #20 is one of an on-going series. Visit the catalogue of Briefing Documents and Fact Sheets.

Go to the related Briefing Document.

The Fact Sheets are created by AIDS Calgary Awareness Association

 aclogosm.gif (2652 bytes)


HIV and Substance Abuse

The use of drugs and alcohol is often related to high risk behaviors. For injection drug users (IDU), high risk of HIV transmission is related to the use of unsterilized, shared needles or syringes (McClure and Grubb 1999:22). In addition, the altered mental state resulting from the use of alcohol and drugs can lead to increased risk due to unsafe sexual practices (Green Rush ND:1, http://www.cpha.ca/ii/injection/ drugs_e.htm).

Statistically Speaking

IDU was responsible for the infection of 20% of active patients at the Southern Alberta Clinic in 1999. Alberta HIV Surveillance indicated that 21 out of 52 new (1998/99) cases of HIV in males and 11 out of 23 new cases in females were attributed to IDU (http://www.crha-health.ab.ca/clin/sac/sac.htm).


Women, Drug Use, and HIV

IDU is a more common risk factor for women. The Centre for Disease Control and Prevention (CDC) in Atlanta, Georgia, states that more AIDS cases in women than in men are attributed to injection drug use (AIDS Alert, June 1999:61). Women infected by men who inject drugs are one of the fastest growing HIV populations in the US (ibid:63).

Aboriginal People, HIV, and Substance Use

Health Canada states that Aboriginal people are over-represented in the areas of inner city injection drug use, needle exchange programs, and counseling and referral services (http://www.hc-sc.gc.ca/ main/lcdc/web/bah/epi/epi411_e.html). The Aboriginal Cluster Project (an HIV/AIDS Strategy, or HAS, Coalition project) in Calgary, as well as other Aboriginal groups are combining substance abuse programs with HIV education and incorporating into those programs elements of Native heritage and culture which non-Native programs might not address (Green Rush ND:3, Safeworks 1999:2).

HIV and Injection Drug Use in Prisons

HIV prevalence in Canadian prisons varies from 1% to 4% in men and 1% to 10% in women. In both groups, HIV infection is associated with a history of IDU
(http://www.hc-sc.gc.ca/ main/lcdc/web/bah/epi/epi411_e.html).
Positive results from needle exchange pilot projects have prompted Swiss prison officials to institute permanent programs in their facilities. Correctional Services of Canada has yet to follow suit, despite recommendations from the Expert Committee on AIDS and Prisons that needle exchange be available in penal institutions (Jurgens 1996:1,40).

Strategies and Recommendations

Canadian AIDS Society priorities for dealing with issues of HIV/AIDS and substance use address social, legal, judicial, and organizational climates and aim to confront discrimination, promote decriminalization of drugs, provide training for front line staff, promoting harm-reduction and prevention, improve access to methadone programs and AIDS treatment for IDU, improve knowledge of interactions between AIDS treatments and substances used, and improve knowledge of the link between safer sex and substance use ("Synopsis of CAS Strategic Plan for HIV/AIDS and Substance Use 1999"). In addition, the CDC has also set out recommendations which would aid in the prevention of HIV through IDU communities, such as permitting pharmacy sales of syringes, ensuring adequate education with substance abuse intervention, needle exchange, and the committment of governments to drug treatment programs.

Emerging Issue

Reports from Vancouver, B.C. allege that HIV positive injection drug users have been denied access to anti-retroviral drugs by some inner city doctors. IDUs have complained of conditions placed on their receiving anti-retroviral drugs, such as mandatory drug treatment, taking methadone, altered living situations, or losing weight. The medical rationale is that a failure to adhere to the required drug regimen could lead to the development of drug-resistant strains of HIV. Discussion of this issue within the medical community is ongoing (O’Neill 1999:11-13).

News, Features & FAQ's | Events & Fund Development | Services, Programs & Stuff | Web Links & Articles | Home

aclogosm.gif (2652 bytes)

Copyright � 1998-2002
AIDS Calgary Awareness Association
Suite 200, 1509 Centre St South
Calgary, AB T2G 2E6
Tel: (403) 508-2500, Fax: (403) 263-7358
Web: www.aidscalgary.org
Questions? Send email to [email protected]

Read about this web site. Created & maintained by Humantec Consulting. Comments about the site can be sent to Humantec Consulting.

Thanks to Shane H, our first Web volunteer, for getting us started.