Chapter 41. HIV/AIDS and Hepatitis C

Steven L. Batki, M.D.; Kalpana I. Nathan, M.D.
DOI: 10.1176/appi.books.9781585623440.356483



Human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and hepatitis C virus (HCV) infections are defining features of the landscape of medical comorbidity seen in substance use disorders. The connection between HIV and substance use is significant primarily because injection drug use is a major conduit for HIV transmission to heterosexual adults, women, minorities, and children. Injection drug use is also the major risk factor for new HCV infections (Sulkowski and Thomas 2005). Noninjection substance use is also known to be associated with increased risk for contracting HIV and, to a lesser degree, HCV.

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Table Reference Number

With better treatment options now available, the number of persons living with AIDS in the United States has been growing, with a 30% increase from 2000 through 2004. It is also estimated that the AIDS epidemic may be larger than known, with many individuals living with the infection, unaware and not yet diagnosed. Mental health and addiction providers must actively encourage HIV and hepatitis C (HCV) testing, early detection, and prevention efforts.

Although outreach efforts still need to focus on injection drug users who are at great risk for HIV and HCV infections, there must be a greater awareness of other at-risk groups such as methamphetamine users who might benefit from sexual risk reduction interventions.

HIV, HCV, and substance use disorders create complex behavioral, medical, and pharmacological interactions with one another, requiring careful diagnostic and treatment approaches.

The clinical complexity of HIV, HCV, and substance use disorder comorbidity is best addressed through integrated treatment approaches.

Patients with substance use disorders and other psychiatric disorders have been shown to succeed in HCV and HIV treatment and may require advocacy by mental health and substance use disorder treatment providers to be considered for medical treatment.

Treatment of substance use disorders and psychiatric disorders enhances engagement in, adherence to, and outcome in HIV and HCV treatment.


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Which of the following groups has the highest population rate of HIV/AIDS cases, at 73 per 100,000 persons?
Which of the followings statements regarding hepatitis C (HCV) epidemiology is true?
Which of the following was not included in the Semaan et al. (2006) study of sexual risk reduction strategies?
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