Institutional members access full text with Ovid®

Share this article on:

Barriers to HIV treatment among people who use injection drugs: implications for ‘treatment as prevention’

Milloy, Michael-Johna; Montaner, Julioa,b; Wood, Evana,b

Current Opinion in HIV and AIDS: July 2012 - Volume 7 - Issue 4 - p 332–338
doi: 10.1097/COH.0b013e328354bcc8
INJECTING DRUG USE AND HIV: Edited by Lisa Maher and Nick Walsh

Purpose of review Recent research has confirmed the efficacy of employing highly active antiretroviral therapy (HAART) to prevent the transmission of HIV. However, barriers to the use of HAART among people who use injection drugs (PWIDs) remain an international concern. We review recent findings regarding factors determining effective HIV treatment among PWIDs and describe their possible impact on efforts to curb HIV incidence using HAART.

Recent findings Internationally, HIV-seropositive PWIDs continue to experience suboptimal HIV treatment outcomes compared with other risk groups. Recent findings have better elucidated the role of ongoing illicit drug use in limiting access and adherence to HAART. However, recent research has also increasingly demonstrated the important role that social, environmental and structural factors, resulting from the criminalization of PWIDs, have in placing barriers to optimal HAART use among this population.

Summary Treatment as prevention strategies for PWIDs will only be maximally effective if structural barriers to effective addiction and HIV treatment, which stem from the ongoing criminalization of this population, are addressed.

aBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital

bDepartment of Medicine, University of British Columbia, Canada

Correspondence to M.-J. Milloy, BC Centre for Excellence in HIV/AIDS, 608–1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. Tel: +1 604 806 9116; fax: +1 604 806 9044; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.