This article first appeared in HIV Update, a publication of aidsmap.com, here.
A new study from the United States suggests that many people living with HIV intentionally miss doses of their HIV treatment when they use recreational drugs or drink alcohol. Many of those in the study were concerned about potential interactions between their HIV treatment, drugs and alcohol.
While in some cases this is a legitimate concern, with a number of drugs there is no evidence of dangerous interactions. A frank discussion with your HIV doctor or your HIV pharmacist is the best way to check.
Taking two or more different drugs together can alter the effect of one or more of the drugs. There are potential interactions between some recreational drugs (including ketamine, ecstasy and crystal meth) and some non-nucleoside reverse-transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs).
But alcohol does not interact with anti-HIV drugs. Some recreational drugs, such as cannabis, only interact with a few anti-HIV drugs. In many cases, you can do more harm by missing doses of HIV treatment than by taking HIV treatment together with alcohol or drugs.
The study recruited over 500 people living with HIV who all used recreational drugs – mostly cannabis and cocaine. A third agreed with the statement “I stop taking my HIV medications when I will be using drugs to get high”. Half of these people also said that they stop taking their HIV treatment when drinking alcohol.
People agreeing with the statement missed more doses than other drug users. They were less likely to have an undetectable viral load.
The researchers say that as well as deliberately missing doses, some people also probably forget to take their HIV treatment because they are drunk, high or otherwise intoxicated.
They say that doctors should talk with their patients about drug use and HIV treatment, in order to address concerns about potential interactions.
There’s more information about drug interactions in NAM’s booklet Taking your HIV treatment.