DRUG Use and HIVAIDS:

1
DRUG Use and HIV/AIDS Breaking the Cycle of
Infection
Nora D. Volkow, M.D. Director National Institute
on Drug Abuse
2
Proportions of AIDS Cases in Adults and
Adolescents by Exposure in the USA
70 60 50 40 30 20 10 0
Men who have sex with men (MSM)
of Cases
Injection drug use
Heterosexual contact
MSM who inject drugs
1985 1987 1989 1991 1993 1995
1997 1999 2001 2003
Year of Diagnosis
Source Centers for Disease Control and
Prevention (CDC)
3
Drug Use Has Played a Prominent Role in the
HIV/AIDS Epidemic In Several Ways
Disease Transmission IV Drug Use Drug
User Disinhibition Leading to High Risk
Sexual Behaviors Progression of Disease
4
Drug and Alcohol Intoxication MARKEDLY Disrupt
Brain Function Effects of alcohol
intoxication on brain metabolism
sober
intoxicated (0.1 mg)
5
In Adults, Emotional Self Regulation Is
Normally Implemented By A Neural Circuit
Comprising Various Prefrontal Regions
Subcortical

Limbic Structures
6
Effects of Alcohol Intoxication on Brain Glucose
Metabolism (Marker of Brain Function)
Alcohol decreases activity of areas involved with
control and increases activity of areas involved
with emotional reactivity
7
Drug Use Has Played a Prominent Role in the
HIV/AIDS Epidemic In Several Ways
Disease Transmission IV Drug Use Drug
User Disinhibition Leading to High Risk
Sexual Behaviors Progression of Disease
8
In Addition to Increasing the Risk of HIV
Transmission Some Psychoactive Drugs May Also
Accelerate HIV Progression
9
Acceleration of HIV Degeneration of Dopamine
Cells With Cocaine
10
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11
HIV/AIDS Disproportionately Affects Minority
Populations
NIDA Priorities in HIV/AIDS Research Minority
Populations
100
1
4
6
12
15
23
80
11
16
60
50
40
70
65
20
26
0
Population
White
Black
Hispanic
Other
Sources 2002 NSDUH, DHHS, SAMHSA, 2003.
CDC HIV/AIDS Surveillance
Report 2002.
12
AIDS Cases in Females is Increasing Particularly
in African American Females
13
Relative Risk Ratio of Black Participants
Belonging to a Behavior Cluster Compared with
Whites
Multiple partners Sex for Drugs or Money High MJ
Use and Sex
Females
Source Tucker Halpern, C et al., Perspectives on
Sexual and Reproductive Health, 36(6), December
2004.
14
HIV Seroconversion at 18 MonthsBy Receipt of
Treatment
The Most Effective HIV/AIDS Prevention Strategy
is Drug Abuse Treatment
25
No treatment
20
Partial treatment
15
Rate of Seroconversion ()
Continuous treatment
10
5
0
Treatment Status
Source Metzger, D. S., Woody, G. E., McLellan,
A. T., OBrien, C. P., Druley, P., Navaline, H.,
De Philipps, D., Stolley, P., Abrutyn, E.
(1993). Human immunodeficiency virus
seroconversion among intravenous drug users in-
and out-of-treatment An 18-month prospective
follow-up. Journal of Acquired Immune Deficiency
Syndromes, 6, 1049-1056.
15
Smoking Prevention Programs Have Proven to Be An
Effective Strategy in Combating Cancer
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PREVENTION is Also Key to Breaking the Cycle of
DRUG USE--------HIV/AIDS
NIDAs Goal Is to Use the SCIENCE to PREVENT
Drug Abuse and HIV/AIDS