Human Immunodeficiency Virus Infection in Young Adults: Treatment of Substance Use Disorders as a Priority Component of HIV Prevention, Care and Treatment in Low and Middle Income Countries

Young adults comprise roughly one-quarter of the global population and are at the developmental stage where personal life goals are formulated and personal independence is obtained. It is also the time of sexual debut and exposure to illicit drug and alcohol use. Thus, young adulthood is a time of high-risk for HIV transmission due to drug and alcohol use in the context of sexual activity. Social-networking, gender norms, economic, educational, familial, personal identity and development factors, among others, play a role in illicit drug and alcohol use and HIV infection in young adults. It is estimated that young adults account for 42% of new HIV infections globally, and that 4 million young adults living with HIV reside in sub-Saharan Africa. In Central Asia, Eastern Europe and the United States key populations are important subpopulations of young adults at high-risk for living with HIV. Subpopulations of young adults, particularly key populations, consume illicit drugs and alcohol with high-risk sexual and injection activity, thereby establishing connections between substance use/injection drug use/substance use disorders and HIV infection. Globally, interventions that comprise evidence-based prevention, care and treatment of substance use disorders targeting young adults and prioritizing treatment of substance use disorders as part of HIV care and treatment are vital to reduce the transmission of HIV infection and promote good clinical outcomes for young adults at-risk for and living with HIV.