Can HIV transmission be prevented in active substance abusers?
A comprehensive HIV prevention strategy in a primary care practice includes interventions to provide drug treatment, to take care of mental health problems, and to prevent HIV transmission during drug use and sexual activity. The primary care provider should routinely screen for drug abuse and treat or refer for treatment as quickly as possible. This is particularly important for adolescents who are at high risk for HIV, hepatitis B and C, and other infections. One study has shown that once adolescents start injecting drugs, over 90% will become infected with hepatitis C within 18 months. The provider should also counsel patients who are actively using drugs not to share needles with others and to take advantage of programs that distribute clean needles. Programs use the needle distribution strategy as a first step to engage individuals who can then be encouraged to accept medical and drug abuse treatment services. When is an active substance abuser ready for HIV treatment? The most im
