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Talking With Your Doctor About HIV and Substance Use

By Larry Siegel, M.D., with Kevin Shipman, M.H.S.


If you're HIV+ and a substance user, it can be tough to talk to your doctor about your substance use. The concerns and solutions below are designed to help you and your doctor overcome any misconceptions so that an effective HIV treatment plan can be put in place.

Many active substance users have strong feelings of fear, shame and guilt for using drugs and having HIV. This coupled with a lack of trust and fear of being judged make it difficult for them to speak openly and honestly about drug use with their providers. In addition, substance abusers often deny that they are using, but it is important to be honest with your doctor. Remember that everything you say is confidential.

Your doctor needs to have all the facts in order to provide you with the best possible care. Working openly with your doctor is the key to building a trusting relationship and protecting your health. Try bringing this article to your doctor and using it as a tool to begin discussions about your situation.

Larry Siegel, M.D. serves as the Senior Deputy Director for Substance Abuse Services at the District of Columbia Department of Health. Kevin Shipman, M.H.S., L.P.C., is the Assistant Deputy Administrator for Special Populations, APRA.

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