Lecture Notes Session 9

Question 1

Significance of HIV and Hepatitis C in Substance use Disorders

Answer 1

Connection between HIV and SUD is significant b/c injection drug use is a major route for HIV transmission to heterosexual adults, women, minorities, and children as well as for new HCV infections

Question 2

Triple Diagnosis (2)

Answer 2

1. HIV or HCV infection + SUDs + Comorbid MH disorders: requires integrated treatment including assessment and management. HIV and HCV complicate addiction treatment and SUDs make the medical management of HIV and HCV more difficult 2. behavioral disturbances that accompany DD interfere with adherence to medical treatment.

Question 3

HIV transmission (3)

Answer 3

1. Injection use - potential route of infection 2. male-to-male sexual contact 3. high-risk heterosexual contact

Question 4

Drug of Choice Factors

Answer 4

1. injection drug use is major HIV risk in opioid dependent individuals 2. sexual risk behaviors are significantly causative among stimulant users 3. need for counseling which aims to reduce risky sexual behaviors as well as unsafe injection practices 4. meth use is prevalent among persons who are already infected with HIV, especially MSM

Question 5

Hepatitis C Epidemiology

Answer 5

1. mot common chronic blood-borne infection in US 2. high rates are reflected in incarcerated populations 3. occupational, perinatal and sexual exposures can also result in HCV transmission 4. HCV and HIV commonly co-occur

Question 6

Prevention of HIV and HCV Transmission in Drug Users (4)

Answer 6

1. Prevention efforts: reduce risk behaviors, such as injection and risky sexual behavior. 2. Comprehensive HIV prevention strategies: community-based outreach, substance abuse treatment and syringe programs 3. behavioral interventions designed to change HIV-specific transmission risk behaviors (both drug use and sexual practices) 4. community-based intervention: HIV testing and counseling, public funding, expansion of community-based syringe exchange programs

Question 7

Psychiatric and SUDs in HIV and HCV

Answer 7

1. drug abuse contributes to psychiatric disorders in seropositive drug users, and drug use appears to be a more important cause of psychopathology than HIV itself 2. antiretroviral agents used to treat HIV/AIDS can produce psychiatric and neurological adverse effects (anxeity, depression, suicidal ideation, confusion, hallucinations) 3. drug users face greater delays in accessing HIV or HCV medical services than non-drug users