Substance use risk factors for HIV infection

Although needle sharing by intravenous drug users is a well-recognized risk factor for HIV infection, other HIV risk factors also are associated with drug use and may contribute significantly to the spread of HIV infection. Nonintravenous drug use (e.g., 'crack') and other risk factors (e.g., unprotected sex) associated with drug dependence also may play a role in the spread of HIV infection among intravenous drug users and between intravenous drug users and their sexual partners. Because of its dependence potential 'crack' cocaine may come to play a major role in HIV transmission, primarily because of its link to unprotected sexual behavior.