Question

My brother recently diagnosed with HIV. No one in the family has HIV so this was a shocking news. He is very much worried about the situation. The doctor said he needs to take proper medications but before that, he should stop using drugs. Since he is very much addicted to it, we are planning to take him to an addiction treatment centre in Toronto ( https://helixhealthcaregroup.com/spectrum/treatments/addiction-counseling/ ). Will there be any effect if he takes both treatments (HIV and addiction) together?

Answer

Thanks for writing. I'm sorry to hear about your brother but glad that he is engaged both in HIV care and will be addressing his substance abuse. Co-occurring HIV and substance abuse is not uncommon, and represents a risk for both becoming HIV+ in the first place and being inconsistent taking HIV medication, known as adherence, which is vital to keep the virus suppressed.

Some HIV doctors worry about starting someone on antiretroviral therapy if they have an active substance abuse problem because of inconsistent adherence, which can lead to resistance to HIV drugs. I feel that both should be addressed concurrently. Substance abuse treatment is effective but it requires commitment, patience, and a willingness to change behaviors. Treatment needs to be supplemented by outside support groups such as aa.org, NA, or SMART Recovery. More and more research is documenting the connection of social connection to recovery from substances.

I would also suggest that his care for both these conditions be coordinated with all providers. For example, sometimes these "specialties" offer treatments that are counterproductive. For example, I see many HIV clients who are prescribed benzodiazepines (antianxiety medications) which are highly addictive.

Best wishes to all your family, David