HIV-1 infection in injection drug users

Effective state-of-the-art care for injection drug users with HIV infection requires making the diagnosis of HIV infection, providing access to health care and a means to pay for it, and assistance with medication adherence for those using antiretroviral medications. It is also increasingly important to manage comorbidities other than traditional opportunistic diseases so that the virologic and clinical benefits of modern antiretroviral therapy lead to longer survival and improved quality of life. Efforts to curtail the HIV epidemic in the United States are now also focusing on reducing transmission behaviors of HIV-infected persons, by bringing them into medical care and by encouraging behavior change. To achieve maximal effectiveness in addressing HIV among drug injectors, infectious disease clinicians must equip themselves with technical knowledge about the infections and with knowledge and skills regarding behavior change and mental health.