In a Comment which forms part of the Series in Lancet, 12 myths about HIV/AIDS are debunked.
The Comment is by Dr Steffanie Strathdee, University of California San Diego, CA, USA, and Professor Chris Beyrer, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (both paper authors in the Series) and colleagues.
- Drug users are non-compliant
- Drug users do not respond as well to antiretrovirals as do non-drug-using patients
- Drug users are difficult to study and have poor retention rates in cohorts, making prospective research studies with drug users difficult or impossible
- Drug users are more concerned about getting high than using injecting equipment safely
- Drug users don't have much sex; their HIV risks are largely or entirely from needle sharing
- If drug users keep using, it is almost inevitable that they will acquire HIV infection
- Unlike gay men or sex workers, drug users don't have strong communities, so community interventions are unlikely to work
- Rates of drug use are higher among minorities in the USA and other industrialised countries
- Needle exchanges encourage drug use
- Methadone (or buprenorphine) treatment just exchanges one drug for another
- People who use stimulants are all heavy, out-of-control users who won't change their risky behaviours
- Fear is an effective deterrent for drug use
The authors conclude: "The myths about HIV acquisition and people who use drugs are straightforwardly countered by scientific evidence, but like so many forms of prejudice, they persist despite the evidence. It is past time for these prejudices to change. Providers, decision makers, and all engaged in the global fight against HIV infection have an obligation to examine biases against people who use drugs, learn the facts beyond the myths, and let evidence drive responses."