Checklist for injection drug users after an HIV/Hepatitis C diagnosis

By David Heitz

You just found out you have HIV and Hepatitis C. And, you’re addicted to drugs. Now what? Perhaps no low seems lower – except death – to an injection drug user who finds out they have contracted HIV, Hepatitis C, or even both (not uncommon). But what that injection drug user may not know is that Hepatitis C now is curable, and living with HIV is no different from managing diabetes. Talking about a cure for HIV isn’t even considered heresy anymore. So, don’t turn an HIV/Hepatitis C diagnosis into the end of the world when it isn’t. In fact, it might be the start of a whole new way of life. Now, what should you do next?

Immediately see a doctor and work to obtain the treatment and medications you need. Consider getting sober, it would be a great time to do it.

You might have learned you have HIV and/or Hepatitis C via an outreach worker, at a local testing center, or at a needle exchange. Or, maybe an injection drug use (needle sharing) or sexual partner told you they have the disease(s), and you suspect you do, too. If you live in a rural area and there is no HIV/AIDS service organization near you, call the AIDS service organization in the biggest city closest to you if you’re not sure about where to get treatment. Most people who learn of their HIV status also receive referrals to treatment at that time. It is absolutely critical to get into treatment immediately. Once you get your HIV treated, it drops to levels so low you cannot even transmit it. There are various medication assistance plans sponsored by the pharmaceutical companies. You can learn about those by clicking here: AIDS Healthcare Foundation and HCV Advocate also are great websites for beginning to learn all you can about HIV and Hepatitis C and how to obtain treatment. If left untreated, it is believed the diseases work in entourage to advance disease even faster than one without the other. According to the Centers for Disease Control and Prevention (CDC), “approximately 25% of people with HIV in the United States also have HCV. Among people with HIV who inject drugs, about 50% to 90% also have HCV.” (1) “In people with HIV/HCV coinfection, HIV may cause chronic HCV to advance faster. Whether HCV causes HIV to advance faster is unclear,”(AIDSInfo.gov reports)

Understand that you probably are going to live just as long a life as someone who does not have HIV or Hepatitis C, or both. All the more reason to get sober.

There have been revolutionary breakthroughs in the treatment of HIV and Hepatitis C. Today, there even is a cure for Hepatitis C that is a simple, once a day pill for two months. However, this medication can be very difficult to obtain depending on what kind of insurance you have and where you live. As for HIV, injections that would last 90 days are in the works in terms of treatment. The end of daily pills could be fast upon us. Meanwhile, modern treatments keep the virus at undetectable levels with relatively few side effects. Today, not only is there talk of a vaccine for HIV (we’re not there yet, however) but even a cure. In November, The Scripps Research Institute in San Diego announced their latest HIV research results: Stopping the replication of the virus in mice.

The study was led by TSRI Associate Professor Susana Valente. It was published online Oct. 17 in the journal Cell Reports. Valente used “a natural compound called didehydro-Cortistatin A (dCA), which blocks replication in HIV-infected cells by inhibiting the viral transcriptional activator, called Tat, halting viral production, reactivation and replenishment of the latent viral reservoir,” according to Scripps. (2) “No other anti-retroviral used in the clinic today is able to completely suppress viral production in infected cells in vivo,” Valente said in the news release. “When combining this drug with the standard cocktail of anti-retrovirals used to suppress infection in humanized mouse models of HIV-1 infection, our study found a drastic reduction in virus RNA present—it is really the proof-of-concept for a ‘functional cure.’”

Consider working or volunteering with an organization that helps others know they are not alone

HIV and Hepatitis C via injection drug use has become a national epidemic that must be talked about to be addressed. We can’t just sweep it all under the drug. amfAR has created an online Opioid & Health Indicators database. It shows, by Congressional district, how well prepared our country is in the battle against the opioid epidemic. Some places are better prepared than others. “The amfAR Opioid database provides local and national statistics on new HIV and hepatitis C infections, opioid use, overdose death rates, and the availability of services like drug treatment and syringe services programs,” the organization explains in a news release. “Users will also be able to examine data at the state and county levels to view and compare the differential impact of the opioid epidemic in communities and states across America.” (3)
“This tool was developed with the goal of raising awareness of the opioid epidemic while educating the public on how they can get involved in their communities to minimize overdose rates and maximize recovery rates.”

If you’re reading this, are actively injecting, and not ready to get sober, please make sure to always use clean needles. And don’t judge those who do inject if you don’t.

There is no debate about what is scientifically proven to stop HIV and Hepatitis C among injection drug users: Needle exchanges. As America’s opioid epidemic is thrust into the national spotlight, and so is the public financial burden for treating it, needle exchanges are being looked upon with less judgement. Not only do they save lives that eventually become ready for sobriety, but they also save taxpayers and third-party payers hundreds of millions of dollars by preventing the infection of HIV and Hepatitis C. In an exclusive interview with Plus, Don Des Jarlais of Mount Sinai Beth Israel in New York City explained how needle exchanges have saved injection communities from an HIV/Hepatitis C scourge before. Des Jarlais is known as the “father of the modern needle exchange.” He is Director of Research at the Baron Edmond de Rothschild Chemical Dependency Institute at Mount Sinai Beth Israel in New York City. Des Jarlais has been awarded a $2.5 million grant to help fund research aimed at helping injection drug users break the cycle. They will be taught skills on how to discourage someone who wants to shoot up for the first time. “Almost all injectors are at least ambivalent about injecting. It clearly has created a lot of problems in their lives,” he told Plus. ”Most of them do not want to do that to their friends.” But he added, “They may feel they do want to initiate somebody.”
Des Jarlais also said it’s important to be non-judgmental so as not to further stigmatize the situation. (4)
Bibliography
1. U.S. Department of Health and Human Services. HIV and Hepatitis C. (2017, July 25). AIDSInfo. Retrieved Nov. 7, 2017, from https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/26/88/hiv-and-hepatitis-c
2. The Scripps Research Institute. (2017, Oct. 17). New research opens the door to ‘functional cure’ for HIV. Retrieved Nov. 7, 2017, from http://www.scripps.edu/news/press/2017/20171017valente.html
3. Opioid & Health Indicators Database. amfAR. More information at http://opioid.amfar.org
4. Heitz, D. (2015, May 11). Grant may help needle exchange trailblazer clear new paths. Healthline via Plus. Retrieved Nov. 7, 2017, from https://www.hivplusmag.com/stigma/2015/05/11/grant-may-help-needle-exchange-trailblazer-clear-new-paths