Preventing Opportunistic Infections in HIV-Infected Injection Drug Users

Abstract

To the Editor. —The newly revised guidelines issued by the US Public Health Service and the Infectious Diseases Society of America (USPHS/IDSA) provide excellent, evidence-based recommendations for strategies to reduce the risk of opportunistic infections in persons infected with the human immunodeficiency virus (HIV). 1 The new guidelines now contain suggestions for behavioral interventions to reduce exposure to relevant infectious pathogens, including those acquired through sexual behaviors and through environmental, occupational, food, water, travel, and pet-related exposures. 1,2 However, there is no mention of behavioral interventions or strategies to reduce the risks of infectious disease transmission associated with illicit injection drug use. Injection drug use now accounts for approximately half of new HIV infections in the United States. 3 While the use of antiretroviral therapies and opportunistic infection prophylactic regimens has contributed to declines in acquired immunodeficiency syndrome (AIDS)—related opportunistic infection incidence and deaths, the reductions have been less marked