The Importance Of Integrating HIV Prevention With Addiction Treatment

By John Lavitt 10/27/15

Dr. Nora Volkow recently wrote about the lack of preventative services.

Dr. Nora Volkow
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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.

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.

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.