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Sexually Transmitted Diseases Transmission Involving Drug Use
Sexually transmitted diseases (STDs) have become a significant issue in the twenty-first century. Studies show that most of the infections can be traced to drug addicts and sex workers (Abad et al. 1705-1706). The high prevalence of STDs is often a result of sharing syringes to insert drugs and an increased number of sexual partners (Arasteh et al. 3320). While there are effective methods of controlling the spread amongst non-addicts, the treatment of the addicted proves to be difficult. This paper claims that preventive techniques need to specifically target drug addicts and sex workers to combat the STD epidemic and offer interventions to reduce risky sexual behaviors and drug use.
Human immunodeficiency virus (HIV) has caused a pandemic that has stimulated an increased focus on developing new antiretroviral (ARV) drugs to treat the disease. The period between 1994 and 1998 marked the rise of another new class of non-nucleoside reverse transcriptase inhibitors (NNRTIs) to address and slow the spread of HIV (Crepaz et al. 334). Since they were easier and cheaper to produce than protease inhibitors, they aided in scaling up the ARV therapy in resource-limited settings (Crepaz et al. 335). Identifying novel drug targets has been significant in the discovery as well as the development of other ARV drug classes. For instance, since the 80s, researchers have believed that a molecule named CD4 is the primary receptor for HIV in immune cells (Crepaz et al. 335). Later, they reported the finding of a co-receptor called CXCR4, which was needed to enter particular HIV strains into immune cells (Crepaz et al. 335). The discovery motivated scientists and researchers to search for other co-receptors.
Numerous groups, such as NIAID scientists, believed that another receptor named CCR5 is the actual primary co-receptor utilized by the disease to infect immune cells (Crepaz et al. 336). This discovery established the basis for developing the CCR5-blocking drug maraviroc, which was approved by the FDA in 2007 (Parra et al. 529). Another significant ARV drug class that arose in 2007 was called integrase inhibitor raltegravir. It became a valued part of combination antiretroviral treatment (Crepaz et al. 336). However, HIV can seek numerous pathways to develop resistance to the medicine. Its variants that are resistant to raltegravir may as well be resilient to elvitegravir, which is another integrase inhibitor of the first generation.
Dolutegravir, which was approved by the FDA in 2013, is a second-generation integrase inhibitor that had a high barrier to the development of drug resistance (Wainberg and Han). In clinical experiments, raltegravir proved effective for individuals infected with HIV who had not previously undergone therapy (Wagner et al. 988). The drug proved to be effective even when the first-generation drugs were ineffective. Other benefits of the raltegravir include convenience in terms of once-a-day dosing, relatively low production cost, and a good safety profile (Crepaz et al. 337). It is now included in two of the initial line regimens that the United States Department of Health and Human Services medical practice guidelines suggest for infected adults. Recently, it was added to the WHO policies as an optional first-line agent for grown people (Wainberg and Han).
Medical trials suggest that treatment with ARV therapy slows the progression of AIDS, improves the patients quality of life, and increases survival rates (Crepaz et al. 338). However, the viral suppression therapy effect was lower among drug addicts compared with other groups because repetitive transmission prior to the therapy has had a positive impact (Crepaz et al. 338). Drug addicts and sex workers have low access to viral suppression therapy since most lack insurance, food, and accommodation due to poverty (Abad et al.,1710). Identifying and sustaining treatment has to be a prerogative in handling the STD situation (Crepaz et al. 338). The utilization of one or several medications for drug addicts is related to a high rate of disease progression and the emergence of virus resistance. Nowadays, three or more ARV drugs are used at the same time for the purpose of treating HIV infection. Trials to induce virus suppression with multiple ARV drugs and then maintain the accomplished impact with only two drugs resulted in an unacceptably high frequency of disease return (Crepaz et al. 338).
There are various risks of STD development among sex workers and drug-addict groups associated with their lifestyle. These factors can be divided into individual risks, such as the relationship between the addicted and non-addicts and environmental risks (Abad et al. 1710). The combination of factors from these two groups determines the high level of infections in a particular population. The first group consists of the structure of drug-dealing networks where all new members are actively encouraged to abuse drugs. This is usually done on the level of personal relationships, such as attachment or love. Creating relationships with personal network members can lead to dangerous patterns of behavior, such as sharing syringes or having unprotected sex may. Childhood abuse and violent relations often lead to trauma that pushes people into prostitution or drugs and thus greatly increases individual-level risk factors (Crepaz et al. 338).
Environmental factors consist of the availability of needles, poverty, and inefficient law enforcement practices. Syringes are practically available at all drugstores and can be acquired without the need for a prescription. Food shortage and lack of accommodation contribute to feeling hopeless, which may result in people abusing drugs or prostitution (Wagner et al. 989). It is important to note that when it comes to drug abusers, even substances such as alcohol, methamphetamine, crack cocaine, and inhalants are associated with high rates of infections (Kamyar et al. 3319).
Excessive consumption of alcohol can be an essential risk factor for HIV since it is connected to dangerous sexual behaviors and, among those already infected, can negatively impact the treatment outcomes (Abad et al. 1711). Abuse of opioids, which is a drug class that aims to minimize pain, has also been linked with the growth of the number of infections. Research shows that the majority of sex workers prefer using this group of substances since they are readily available on the streets (Abad et al. 1712). Due to the restrictions and regulations guiding prescription in hospitals, individuals have opted for cheaper, more dangerous forms.
Meth, which is also called methamphetamine, is associated with unhealthy sexual behaviors that put individuals in greater danger of contracting HIV. Meth can be either injected or smoked (Lansky et al. 1). If a person decides to inject methamphetamine, the syringes or needles utilized in such occurrences can transmit diseases from one infected person to a non-infected. Crack cocaine and inhalants are the other drugs that rank high in the list of substances that can lead to unsafe decisions (Arasteh et al. 3318). The former refers to a stimulant that has the ability to create a cycle whereby people quickly exhaust their resources and turn to other ways to obtain the drug. This includes having sex to get the money they can use to buy what they need (Lansky et al. 2). Lastly, for a long time, amyl nitrite, which is an inhalant, has been connected to careless behaviors when it comes to sex (Lansky et al. 2).
The two primary ways of spreading STDs include repetitive utilization of syringes by several individuals and s unprotected sex with numerous partners. To prevent such practices, measures need to be taken to monitor distributive syringe sharing and syringe services programs among addicted individuals (Adams et al. 3306). Furthermore, more governmental measures must be adopted to avoid issues such as prostitution, for instance, minimizing factors that lead to it, for example, poverty, childhood abuse, violence in families, and criminal activities.
Distributive syringe sharing (DSS) and syringe services programs (SSP) are aimed at controlling the use of syringes by drug addicts (Adams et al. 3307). These initiatives proved to be effective in curbing the spread of HIV and hepatitis C since they allow the exchange of used needles for clean ones (Adams et al. 3307). The programs are financed by states and non-profit organizations and provide guidelines for drug addicts on how to avoid STD infections.
The problem of poverty in the United States can be addressed with the help of state governments and non-profit organizations. The assistance from these actors is not always monetary, as, at times, states provide free access to laundry services, movies, and educational programs (Abad et al. 1709). Employment services play a significant role in providing citizens with an opportunity to find a job or some employment (Abad et al. 1709). Some programs may include providing the poor with medical insurance to improve their access to healthcare.
Sex education plays a significant role in the prevention of STDs. Sex education programs targeting children and adolescents can promote an understanding of the essence of the relationship between the sexes and norms of behavior in sexual life. Addressing the spread of STDs requires a versatile social approach to the problem, the promotion of moral values, and comprehensive education of the younger generation (Sieving 208). Teenagers must be aware of the diseases that can be transferred through unprotected sex and assume responsibility for their own health and the health of their partners.
The United States government promoted sexual education with the help of various agencies to help adolescents receive comprehensive sexual education. Without systematic education, younger peoples knowledge about sex and STDs is fragmented, which may lead to significant risks of unhealthy sexual behavior. Providing children with adequate knowledge concerning sex and STDs can help reduce risky behavior among adolescents and young adults, which will reduce the risks of STDs.
The paper has drawn claimed that prevention interventions need to target drug addicts and sex workers to combat the STD epidemic. HIV is the cause of a pandemic, which spurred the search for antiretroviral drugs for the treatment of the disease. In the mid-90s, there emerged a new class of NNRTIs that were cheaper to produce than protease inhibitors. This boosted the effectiveness and access to ARV therapy. The paper demonstrates that recognizing novel drug targets has been critical development of new ARV drug classes. For instance, the discovery that the central receptor of the HIV virus was not a molecule named CD4 but the CXCR4 cells spurred the development of a new type of ARV medication. ARV treatment slows the emergence of AIDS while improving patients quality of life and survival rates. Nevertheless, in the drug-addict populace, the viral suppression therapy effect was greatly lower than in other groups as a result of repetitive transmission prior to the therapy having had a positive impact.
Drug addicts and sex workers have low access to viral suppression therapy since most lack insurance, food, and accommodation due to poverty. Identifying and sustaining treatment must be a prerogative in handling an STD situation. The utilization of a single or more medication for drug addicts is related to a high rate of disease progression as well as the emergence of virus resistance. Nowadays, three or more ART drugs are used at the same time for the purpose of treating HIV infection. The two primary ways of spreading STDs include repeated use of syringes by several people as well as unprotected sex with numerous partners. To prevent such practices, measures need to be taken to monitor distributive syringe sharing and syringe services programs among addicted individuals. Furthermore, more governmental interventions are required to reduce prostitution by addressing the factors that lead to it, such as poverty, childhood abuse, violence in families, and criminal activities.
Works Cited
Abad, Neetu et al. A Systematic Review of HIV and STI Behavior Change Interventions for Female Sex Workers in the United States. AIDS and Behavior, vol. 5, 2015, pp. 17011719.
Adams, Monica, et al. Distributive Syringe Sharing and Use of Syringe Services Programs (SSPs) Among Persons Who Inject Drugs. AIDS and Behavior, vol. 23, 2019, pp. 33063314.
Arasteh, Kamyar, et al. Injection and Heterosexual Risk Behaviors for HIV Infection among Non-Gay Identifying Men Who Have Sex with Men and Women. AIDS and Behavior, vol. 23, 2019, 33153323.
Crepaz, Nicole, et al. Brief Report: Racial and Ethnic Disparities in Sustained Viral Suppression and Transmission Risk Potential Among Persons Aged 1329 Years Living with Diagnosed HIV Infection, United States, 2016. AIDS Journal of Acquired Immune Deficiency Syndromes, vol. 83, no. 4, 2020, pp. 334-339.
Lansky, Amy, et al. Estimating the Number of Persons Who Inject Drugs in the United States by Meta-Analysis to Calculate National Rates of HIV and Hepatitis C Virus Infections. PLOS ONE, vol. 9, no. 5, 2014, e97596.
Parra, Jorge, et al. Clinical utility of maraviroc. Clinical drug investigation, vol. 31, no. 8, 2011, pp. 527-542.
Sieving, Renee E., et al. Sexually transmitted diseases among us adolescents and young adults: Patterns, clinical considerations, and prevention, Nursing Clinics, vol. 54, no. 2, 2019, pp. 207-225.
Wagner, Karla. Place of Residence Moderates the Relationship Between Emotional Closeness and Syringe Sharing Among Injection Drug Using Clients of Sex Workers in the US-Mexico Border Region. AIDS and Behavior, vol. 9, 2015, pp. 987995.
Wainberg, Mark A., and Ying-Shan Han. Will drug resistance against dolutegravir in initial therapy ever occur? Frontiers in Pharmacology, vol. 6, no 90, 2015.
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