Infections and Substance Use

Substance-use contexts can affect exposure to infections, the body's response and access to prevention and care. The links vary by infection, exposure and circumstances. Substance use alone does not establish that someone has an infection.

Infection risk is often discussed as though it concerns only injecting. Sharing contaminated injection equipment is an important route for some infections, but it is only part of the picture. Sexual exposure, broken skin, living conditions, existing illness and difficulty reaching care can also matter. These circumstances differ between people and do not reveal someone's infection status.

Prevention works best when it matches the actual route. Vaccination, condoms, sterile injection equipment when relevant, and timely testing each address different problems. An infection can be present without obvious symptoms. Getting tested is a way to gain information and care, not a judgement about a person's character.

Some infections can be cured; others can be controlled with treatment. Continuing substance use does not make HIV or hepatitis C treatment pointless.

A possible recent HIV exposure needs immediate medical advice because preventive treatment is time-sensitive. Sudden confusion, severe breathing difficulty, collapse or rapidly worsening serious illness needs immediate medical help. Do not assume these changes are intoxication or withdrawal, or wait for an infection test before getting help.

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