Therapeutic Intervention of Substance Use and HIV/AIDS

Therapeutic Intervention of Substance Use and HIV/AIDS

 

Introduction

It is the remarkable connection between substance use and HIV infection, which leads to AIDS. Substance use is now the major risk factor identified in new cases of AIDS and other infectious diseases. There are many national and international researches that provide the both short and long term consequences associated with substance use and HIV infection. The major problem that both substance use and HIV infection occurrence is the behavior of substance using and sexual activity which both can defy in two categories: injection drug users and self-medication. However, all issues are linked under the pattern of individual users and behaviors.

 

Understanding Addiction

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000) divides substance use disorders into two main categories: substance dependence and substance abuse. Maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

Tolerance: need for use of increasing amounts of the substance in order to achieve intoxication Withdrawal symptoms typical for the substance Substance taken in larger amounts or over a longer period of time than intended Desire to cut down or control use Great deal of time spent on using, obtaining, or recovering from the substance Reduced social, occupational or recreational activities because of substance use Continued use despite adverse physical or psychological consequences

Maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home Recurrent substance use in situations in which it is physically hazardous Recurrent substance-related legal problems Continued substance use despite having persistent or recurrent

 

Epidemiology of HIV/AIDS

Epidemiology of substance use and HIV/AIDS will help to identify high risk group and promote the targeting of effective HIV prevention and treatment efforts. The issue also improves medical management of HIV/AIDS:

Understanding substance use-HIV/AIDS relationship through population-based studies which describe the substance use patterns of groups at risk for HIV infection Identify and model the impact of patterns of alcohol consumption on the spread of HIV infection and opportunistic infections Describe substance use and disorders in high-risk groups with HIV/AIDS and co-occurring medical and psychiatric complications

Risk Groups of Substance Use Related HIV/AIDS

The activities that transmit AIDS infected individual use of HIV contaminated injection drug and may interact directly and indirectly with drug use. However, it affects HIV risk behaviors at an individual level is not precisely understood; for example, heavy alcohol consumers predict increased rates of HIV risk behaviors and infection by no controlling their sexual activities (unsafe sex).

The overlap between individuals at risk for substance abuse and HIV infection is very high. Dual risk groups including, gays, lesbians, transvestites, runaways and homeless, injecting drug users, and sexual coercing victims (rape) are very high risk to easily transmit HIV infection to each other with unsafe sex.

The high risk is created by substance users and infected people in term of phenomenal settings or parties, particular activities and cerebrations. All triggers generate and share substances and ending with sexual activities with un-planning.

 

Identifying Prevention of Substance User Related to HIV/AIDS

People, clients, or participants have to prove by intake and orientation process that they are substance users no matter what they use and have potential and risky behaviors in HIV infection in different practices. Participants identified several HIV prevention principles that would be effective for guiding practitioners and policymakers. Implement process recommends multiple intervention strategies to active substance users, recruitment and referral to treatment, and risk behavior reduction including teaching hot to use of sterile technique or universal precaution to apply in every experiment especially, injecting drug users and HIV culprits.

Clients also suggested that any efforts should create opportunities for increased exposure to interventions through sessions to reinforce skills and knowledge learned in the initial intervention to increase the effectiveness of interventions. Simultaneously, appropriate programs have to identify that populations at risk for HIV are in different stages of willingness to participate in an intervention and need to be occupied appropriately to maintain them in the interventions, for instance, using motivational interviewing techniques, contingency and case management, cognitive strategies, and peer or group-driven interventions.

 

Prevention of Substance Use Related HIV/AIDS

Substance use prevention and treatment interventions are effective in reducing HIV risk behaviors and preventing HIV infection. Interventions need to provide in long term and different levels, intra and interpersonal, for instance, individual, group, community, organization, and social network, in term of decreasing or limiting the risky substance use and sexual activities, educating the danger of both relating issues, and developing community or organization-based interventions of prevention, protection and treatment.

Substance use and HIV infected may happen individually with single partner or a couple. They need to acknowledge information and relation of treatment of both issues in term of negative bio-psycho-social disturbance. Providing knowledge of medical care, medication, infectious control, recovery program, rehabilitation, relapse prevention, and continuing care are very important and have to be maintaining.

Behavioral and cognitive therapies not only help the substance use side, but also control HIV infection that maintaining for long, not apply to AIDS rapidly. The model of theory will develop interrelation both major factors which mean the relationship drug uses, HIV infection, sexual anticipation, and individual and social concerns, and decision making on HIV risk behavior for different vulnerable groups. Moreover, it include the relationship substance use and HIV therapeutic regimen, which are delivery, duration, and cost of different services and affect to the social and environmental dynamics and regulations, which further influence to assessing and analyzing the problems and intervention in particular issues.

 

Intervention Strategies to Reduce Substance Use and HIV/AIDS

Many researches have found  that some percentage of client who refuse treatment and the can change their behavior and life style to eliminate substance use and drug related high HIV risk behaviors, especially using and sharing needle for IUCs and malpractice of unsafe sex because they feel fear about HIV/AIDS. But they still keep going relapse and being to run the cycle of step of change. On the other hand, substance use treatment is highly effective in preventing the spread of HIV and other infectious diseases. The NIDA is still conducting extensive research to develop community or organization based outreach interventions to reduce the expansive of HIV and other infectious diseases among substance users.

The research from NIDA about substance use and HIV suggest that a range of HIV intervention strategies should be introduced early to control the extension of the HIV epidemic. Interventions have to be introduced in a variety of settings to reach at-risk and drug-using populations and to provide them with the means for changing their drug use, needle practices, and sexual behaviors simultaneously. The experiential data reported from the NIDA-funded research studies consistently demonstrate that among those participating in interventions, decreases in the prevalence of risk behaviors and increases in protective behaviors are linked to declines in incident HIV infections.

 

HIV and Risk of Relapse

Unhealthy situation and poor health as a result of HIV is a remarkable risk factor for relapse into substance use. Physical and psychological stresses associated with HIV including pain, fatigue, weakness, poor functional ability of body, and complications of disease make them give up and turn to isolation and separation from peer groups, social and community, which is increasing individual’s risk of substance use to reduce their tensions.

HIV infectious people milestones are significant for the clients, their significant others and his support network. Therapist or counselor and medical teams have to expect crisis or a readiness for change when client reach their HIV/AIDS milestones. Providing practice from counselor by letting them know and understand their goal and milestones, which has the opportunity to prepare clients through the development of coping skills and strategies. And it is a time for change and new life with practice. The milestones will create the impulsion for a new way and learning new behaviors by their own in positive ways and self-constructive perspectives.

 

 

Dealing with Client Relapse

The most successful relapse counseling is nonjudgmental. However, clients should understand that preventing relapse is their responsibility. If they relapse into a risk behavior for substance use and HIV infection, the counselor's role is to help them to understand their conditions that caused the behavior to occur and to identify alternative behaviors. And these behaviors could have been replaced to prevent the relapse. Relapse should be inspected as a learning experience and a part of the recovery process. Clients should not be dismissed from substance use treatment and HIV/AIDS support groups because of a relapse. Moreover, peer pressure will be constructively used to help them acknowledge the reasons for and the consequences of their actions

On the other side, medical teams have to help them in term of medical knowledge or education about their disease, medication administration, nutrition, exercise, pattern of life style, and other things, which relate to the disease.

 

Sample Substance Use Affect to Physical Problem and AIDS

Cocaine is a very popular substance use and the inhalation of cocaine has caused severe respiratory illnesses that needed long- term treatment with high doses of powerful anti-inflammatory drugs. FDA approved the use of glucocorticoids by inhalation to treat the inflammation of the respiratory system and asthma that are caused by inhaling crack cocaine. The chronic use of medications containing glucocorticoids at high doses by inhalation caused severe impairment of the immune defenses of the lungs and the upper respiratory tract. This led to the infection of the lungs and other organs with opportunistic microorganisms and the development of cancer

The prescriptions containing glucocorticoids have increased tremendously to treat more than forty medical conditions induced by narcotics. The side effects of these medications include thrombocytopenia, peripheral neuropathy, and chronic opportunistic infections. Glucocorticoids have also been given to hemophiliacs to prevent the development of antibodies against foreign transfused clotting factors. They are also given to pregnant women who are expected to have premature infants as the result of the use of illicit drugs, and to their infants to enhance the maturation of the lungs. The use of other immuno-suppressant agents, cytotoxic drugs, antibiotics, antiviral, and antifungal has also increased tremendously since the1970s. Most of these agents cause bone marrow depression and other tissue damages, which have also contributed to the pathogenesis of AIDS.

 

Conclusion

It is very clear that effective alcohol and substance use has a huge connection with HIV infection and leading to AIDS. And all has negative outcome in term of bio-psycho-social perspectives widely. Prevention and intervention of both are very significant inter of education and support, as well as advocacy and engagement with the key coalitions. Intervention is practical acting to take the clients in enhancing initiative that address both addiction and HIV/AIDS, which they are misunderstood and malpractice in daily life. The point of limit and stop spreading HIV/AIDS in substance users is concerned and need to continue in practice and community.

References

 

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Issue Brief: The Importance of Addiction Prevention, Intervention, and Treatment in Addressing the Nation’s HIV/AIDS Epidemic. From the World Wide Web: http://naadac.org/documents/display.php?DocumentID=109

 

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Kris Trairatana