Substance Use Impact on HIV Treatment Outcomes
Summary
Substance use remains a major impediment to effective HIV treatment globally. People living with HIV who engage in hazardous drinking or illicit drug use frequently experience lower rates of antiretroviral therapy (ART) initiation, poorer adherence, and reduced likelihood of sustaining viral suppression. These effects arise through multiple pathways, including impaired medication management, cognitive and psychological barriers, interactions between substances and antiretroviral drugs, and heightened exposure to social and structural determinants such as stigma, unstable housing and limited access to health services. Behavioural and structural interventions that integrate substance use treatment with HIV care have shown promise in addressing these challenges. Furthermore, new digital approaches seek to enhance engagement and self-management, while tailored programmes aim to reduce disparities experienced by marginalised subgroups. The global significance of this work is underscored by the persistent gap in treatment continuum outcomes for those who use substances, emphasising the need for cohesive strategies that bridge prevention, care and harm-reduction services.
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Substance Use Impact on HIV Treatment Outcomes publication trend
The graph below shows the total number of articles in substance use impact on hiv treatment outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Antiretroviral therapy (ART): Combination pharmacological regimen designed to suppress HIV replication and achieve viral suppression.
Viral suppression: Reduction of HIV RNA in the blood to levels below the threshold of detection, indicating effective control of infection.
Care continuum: Sequential stages of HIV care from diagnosis and linkage to care through treatment initiation, adherence and sustained viral suppression.
mHealth: Use of mobile devices and digital applications to support clinical care and patient self-management.
Substance use disorder: Clinical condition characterised by problematic use of alcohol or drugs leading to significant impairment or distress.
References
- mHealth Engagement for Antiretroviral Medication Adherence Among People With HIV and Substance Use Disorders: Observational Study. Journal of Medical Internet Research (2024).
- Promoting HIV care continuum outcomes among people who use drugs and alcohol: a systematic review of randomized trials evaluating behavioral HIV care interventions published from 2011 to 2023. BMC Public Health (2023).
- Substance use service availability in HIV treatment programs: Data from the global IeDEA consortium, 2014-2015 and 2017. PLOS ONE (2020).
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