Researchers do not yet fully understand all of the interactions that occur between HIV medications and other drugs, and recommendations tend to change over time as new evidence becomes available. However, it is known that the interaction between some HIV medications and recreational drugs can cause serious complications.
Interaction of one drug with another drug can increase its level in the bloodstream and even lead to overdose.
This kind of risk is greatest when the recreational drug and the HIV medication is processed in the same way by the body, especially in the liver.
The risk of drug interaction is greater in the first few weeks or months of taking HIV medication, when the body is adjusting to processing the drugs. Taking a recreational drug at this time could be associated with additional risks.
Both steroids and the protease inhibitors used as an HIV treatment can raise the level of low-density lipoprotein (LDL) or bad cholesterol in the blood and individuals who are taking both of these require close monitoring, particularly if they are at risk of heart disease.
Corticosteroids, which are prescribed for a wide range of conditions, can also interact with protease inhibitors.
The protease inhibitor may increase the amount of corticosteroid in the body, which can raise the likelihood of experiencing adverse side effects.
A recent study published in BMJ Open by Public Health England (PHE) showed that men who take anabolic steroids are at an increased risk of HIV transmission.
PHE researchers surveyed almost 400 men who used anabolic steroids and found that 1 in 65 of them had HIV.
Overall, one in ten of the men had been infected with atleast one of the blood-borne viruses - hepatitis B, hepatitis C, and HIV, suggesting a high transmission rate among this group.
PHE expert, Vivian Hope who specializes in infections among injectable drug users says the study suggests that there has been an increase in the HIV infection and hepatitis since the 1990s among men who use these body- and performance-enhancing drugs.
Also from the PHE agency, expert on injected drug use, Dr Fortune Ncube says: “These findings suggest we must maintain and strengthen public health interventions focused on reducing injection-related risk behaviours to prevent HIV and hepatitis infections in this group.
This includes ensuring those providing voluntary confidential testing services and care related to HIV and hepatitis are alert to the risks associated with image and performance enhancing drug use.”
In addition, co-author Jim McVeigh of the Public Health at Liverpool John Moores University says that “injectors of anabolic steroids and associated drugs are now the biggest client group at many needle and syringe programmes in the UK.
This research shows that anyone who injects drugs is at risk of HIV and other blood borne viruses, regardless of their substance of choice.”
He recommends that all health services as well as the people who use drug are informed of this risk and states that the development of appropriate prevention strategies is essential.