Questions and answers

7 Drug users and HIV

---

Answers PDF 52 Kb

Questions | Section 7: Drug users and HIV

Answers

1. Why are drug users sometimes excluded from ARV treatment?

Drug users are excluded form ARV treatment because of the wrong but widespread belief that they are less likely to be adherent to treatment and less likely to have a good response to treatment.

2. Is exclusion of drug users from ARV treatment based on scientific evidence?

No. Several studies showed that drug users can achieve high levels of adherence and benefit from treatment just like any other group of people with HIV.

3. What treatment and services would you include in a system of comprehensive care for injecting drug users? List at least 5.

• Access to ARVs
• Access to substitution therapy: methadone or buprenorphine
• Opportunistic infection prophylaxis and treatment.
• Accessible, non-judgemental healthcare team.
• Needle exchange.
• Adherence support and counselling.
• Strong links with community based programmes.
• Food programmes and public transport.
• Outreach.

4. Is there an interaction between ritonavir and ecstasy? If so, describe the interaction

Yes. 2 to 3 fold increase in ecstasy levels because of an interaction with ritonavir.

5. Is there an interaction between ritonavir and heroin? If so, describe the interaction

Yes. About 50% decrease in blood levels of heroin because of an interaction with ritonavir.

6. Is there an interaction between efavirenz and methadone? If so, what is recommended to manage this?

Yes. People using methadone and efavirenz will have a reduced dose of methadone of up to 60% and may need to increase the dose of their methadone.

7. Is there an interaction between AZT and methadone? If so, what is recommended to manage this?

Yes. Methadone approximately doubles AZT concentrations. Half the normal dose of AZT is recommended when used with methadone.

8. What is an opiate?

A drug originating from the opium poppy, including heroin, codeine and morphine. Methadone is a man-made (synthetic) opiate substitute.

9. How would you distinguish between symptoms of ARV side effects and symptoms of methadone withdrawal?

Symptoms that develop within 2-3 days are more likely to be a result of ARV side effects. Symptoms that develop after 6 days are more likely to be associated with methadone withdrawal.

Questions | Section 7: Drug users and HIV

Learning resources.

Questions.

Contents.

---