A person can acquire Human Immunodeficiency Virus (HIV) through injecting drugs. This occurs when injecting equipment becomes contaminated with blood containing the virus and is then shared with another individual. HIV can be transmitted through direct blood-to-blood contact.
How HIV Spreads Through Injecting Drug Use
HIV transmission through injecting drug use relies on the direct transfer of infected blood. When an individual living with HIV injects drugs, small amounts of their blood can remain in the needle, syringe, or other injection equipment. If this contaminated equipment is then used by another person, the virus can be directly injected into their bloodstream.
The human immunodeficiency virus primarily resides in specific bodily fluids, including blood. HIV can survive in a used syringe for a period, potentially up to 42 days, with the exact duration depending on factors such as temperature. This means that even if equipment is not used immediately after an infected person, the virus may still be viable and capable of transmission.
Individuals in the acute stage of HIV infection, which occurs shortly after exposure, often have a very high viral load, meaning a large amount of the virus is present in their blood. This high viral load makes them particularly contagious. Even in later stages, if an individual with HIV is not on effective treatment, their viral load can remain high, increasing the likelihood of transmission through shared equipment.
Other Shared Equipment Risks
While needles and syringes are the most direct means of transmission, other items used in the drug preparation and injection process can also facilitate HIV spread. These items can become contaminated with blood and pose a risk if shared. This includes equipment like “cookers” or containers used to dissolve and heat drugs, cotton or filters used to strain the drug solution, and rinse water.
Even microscopic amounts of blood can carry enough virus to cause an infection. If any of these shared items come into contact with blood from an HIV-positive individual and are subsequently used by another person, the virus can enter their bloodstream. For instance, sharing rinse water that contains blood residue or using a filter that has been contaminated can lead to transmission.
Reducing Transmission Risk
To minimize the risk of HIV transmission among people who inject drugs, using new, sterile needles and syringes for every injection is important. Sterile equipment ensures that no bloodborne pathogens, including HIV, are transferred between individuals.
Proper disposal of used needles and syringes is important to prevent accidental exposures. These should be placed in designated sharps containers or other puncture-resistant containers, such as empty bleach or laundry detergent bottles, to prevent injury and potential transmission to others. Never sharing any drug injection equipment, including cookers, cotton, or rinse water, is another key prevention measure.
Public health interventions, such as needle and syringe programs (NSPs), help reduce transmission risk. These programs provide access to sterile injecting equipment, facilitate safe disposal of used syringes, and often offer other services like HIV testing and referrals to drug treatment. Studies demonstrate that NSPs are effective in reducing injection risk behaviors and HIV transmission without increasing drug use.
What to Do After Possible Exposure
If there is a concern about recent exposure to HIV through injecting drug use, seek medical attention promptly. Visit a healthcare provider, emergency room, or urgent care clinic for time-sensitive interventions.
One such intervention is Post-Exposure Prophylaxis (PEP), which involves taking a combination of HIV medications for 28 days to prevent the virus from establishing an infection. For PEP to be most effective, it must be started as soon as possible after exposure, ideally within 24 hours, and no later than 72 hours (three days).
PEP is not a guaranteed prevention method but can substantially reduce the risk of infection when taken correctly. Consistent adherence to the medication regimen is necessary for the treatment to work effectively. Follow-up HIV testing will also be necessary to confirm HIV status after completing the PEP regimen.