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The Importance Of Integrating HIV Prevention With Addiction Treatment

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In recent update to Nora’s Blog, Dr. Nora Volkow, the director of the National Institute on Drug Abuse, highlighted the importance of integrating HIV prevention and addiction treatment.
Although the number of new HIV infections has been reduced, injection drug use has been the number one cause of recent local epidemics of new HIV infections. Despite that, “worldwide coverage of HIV prevention, treatment, and care services for injection drug users is currently too low,” Dr. Volkow said.
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Recently interviewed by The Fix, Dr. Volkow believes that what is needed today are comprehensive, integrated approaches that combine prevention and treatment of HIV and co-infections like hepatitis C with addiction treatment. A major issue is that new injection drug users are ignorant of the high risk for HIV infection and hepatitis C. Although there has been progress in reducing the number of new HIV infections attributable to injection drug use in the United States, localized outbreaks, as happened recently in Indiana, continue to occur.
“Research shows that substance abuse treatment leads to initiating HIV treatment earlier, improves treatment adherence, reduces the risk of discontinuing antiretroviral therapy prematurely, and promotes suppression of the virus,” she said.
The question is how to best integrate and optimize addiction treatment with early HIV testing and diagnosis, resulting in the early initiation of antiretroviral therapy in injection drug users. Dr. Volkow believes a key to such integration is combining HIV antiretroviral therapy with agonist and antagonist medications like buprenorphine in the common Suboxone formulation or naltrexone to manage opioid addiction.
Beyond prevention, NIDA researchers are actively studying innovative approaches to integrate treatment for substance abuse and HIV treatment.
In 2015, three of NIDA’s four HIV-focused Avenir awards will be looking specifically at injection drug users. Avenir Awards are given to young investigators working in HIV and SUD research. By integrating effective addiction treatment into HIV screening and care, both the battles against addiction and the spread of HIV infections can be addressed and maybe even won.